Community, officials chime in on needle exchange


County commission asks health dept. to hold public hearing

BUCKHANNON — Pointed questions and concerns surrounding the start of a hypodermic needle exchange program in Upshur County have prompted the Upshur Commission to request that the county health department delay the program’s implementation, at least until a public hearing can be scheduled.

Sue McKisic, Upshur-Buckhannon Health Department nurse director, recently announced the department is partnering with Milan Puskar Health Right in Morgantown beginning in May to start a harm reduction program — one component of which is a hypodermic needle exchange.

Needle exchange programs are intended to curb the spread of blood-borne diseases, such as HIV and Hepatitis C and B, by providing clean needles to opioid users in a one-to-one exchange. The idea is to minimize harm to drug users and the community by stopping the spread of disease that’s resulted from the opioid epidemic in West Virginia.

But harm reduction clinics offer much more than clean needles, McKisic has said. Counseling services, connections to treatment and recovery resources, wound care and links to primary care doctors are among the other components of harm reduction programs.

Here in Upshur County, harm reduction clinics will take place once a month in Upshur County on the second Thursday in the health department parking lot and at the intersection of Route 4 and Route 119 beginning Thursday, May 10.

At Thursday’s meeting, commission received a request from local resident Susan Foster asking them to urge the health department to delay the implementation of the hypodermic needle exchange component of the new harm reduction program until residents have had a chance to weigh in on the issue at a public hearing.

Commissioner Terry Cutright said he didn’t “see a thing wrong” with waiting until a public hearing to gather residents’ input has been held.

“I’m not so sure I’m on board with furnishing needles,” Cutright remarked, “especially if they can just come in and ask for a needle or they just give them a one needle for one needle exchange.”

At Thursday’s meeting, commission president Sam Nolte agreed, saying he thought a public hearing was appropriate.

“I think giving the public the ability to ask questions and maybe even … have [Laura Jones, executive director of Milan Puskar Health Right in Morgantown] do a presentation for the public, and that way the public would have time to ask questions and maybe get a better understanding of it … I think people are a little taken aback that our health department will be giving out needles.

“I understand it’s a needle exchange program, and from the health department’s perspective, they are in charge of public health, and they are trying to keep the spread of disease from happening, you know Hepatitis C and HIV, but at the same time, the question that has been posed to be is, ‘When we’re giving out all these needles, are [the recipients] going to be responsible enough to bring them back?’” Nolte added.

Cutright said he wasn’t sure he was fully on board with the program.

“The whole idea is, we arrest them, so we hope that’s a deterrent for some of the kids and the adults because they may get arrested,” he said. “If we give them needles and condone it, why don’t we just say, ‘We’re not going to arrest you?’ and condone that? You can’t take away the reasons for not using drugs.”

Commissioner Troy “Buddy” Brady said although he understood arguments on both sides of the issue, he’s not sure he supports the distribution of hypodermic needles.

“If you’re a drug user, you usually keep your needle because you can’t get another needle, but if you start exchanging needles, I’m like Mr. Cutright, I’m not really sure that I really have an opinion, but I really don’t think we should be giving needles to people because it’s like, ‘Go ahead, we know you’ve got a problem, so let’s furnish your needles,’ so I can see that side,” Brady said.

Nolte said when he’d recently spoken with Foster on the telephone, she had brought up several “really, really good points and concerns.” Foster also recently addressed Buckhannon City Council with those points and concerns at its regular meeting April 19. Among other things, Foster wanted to know if users who are given needles would be required to undergo counseling; whether retractable needles would be distributed; and whether the health department had thought about the possibility of the needle exchange attracting more heroin addicts to the area.

She also said she was concerned about non-users coming into contact with contaminated needles that might be improperly disposed of in the community. Foster cited instances throughout the city of Charleston that led to the suspension of the needle exchange part of the Kanawha-Charleston Health Department’s harm reduction program. (The program was supposed to be amended and reinstituted in mid-April, according to the Charleston Gazette-Mail.)

For answers to these questions and more, The Record Delta sought answers from city police chief Matt Gregory and McKisic.

How the program works

According to McKisic, nurse director at the health department, here’s how the needle exchange portion of the harm reduction program will work: users will initially be given however many needles they would typically use in one month, since the harm reduction clinic will only be offered once a month in Upshur County.

“We give them whatever they need to get through a month’s time,” McKisic said. “At the Kanawha-Charleston Health Department, there are people shooting up upwards of 10 times a day. But we don’t just give them a bunch of needles. We keep a chart on them, keep a record of [how many needles they receive] and then make sure if they’ve been given 50, they return 50. If they are given 50, and they only return 25, they only get 25 back. It’s a one-to-one exchange.”

The program teaches users how to dispose of needles properly if they opt not to return them, and so far, McKisic said that despite the spread of the opioid crisis, the health department hasn’t received any complaints about needles being found in public places.

Retractable needles won’t be used for several reasons, McKisic said: first, users may damage their veins if they don’t use them correctly. Additionally, retractable needles can’t be cleaned and re-used.

“Sometimes, [using retractable needles], when they draw up, they accidentally take more than they normally would, which leads to overdose,” McKisic said.

Who approved the implementation of the program in Upshur County?

Neither the county commission nor the city council approved the needle exchange/harm reduction program. However, the board of health voted to approve its start in January, McKisic said. What McKisic did do, she said, is invite Laura Jones, executive director of Milan Puskar Health Right, to Upshur County for an educational presentation on needle exchange and the theory behind harm reduction.

McKisic said she invited about 100 local officials, school system personnel and first responders to the harm reduction presentation, which was held at the Public Safety Complex Friday, April 13, but only about 20 people attended. She had planned to present the idea to those individuals first before walking the needle exchange program out to the wider community.

“I invited every elected official in Upshur County, and I invited Joe Manchin and Shelley Moore Capito because I wanted them to know that this isn’t just something that’s going on in Huntington or Morgantown. Maybe I went about it wrong. Maybe I should have held a community presentation first.”

The health department is planning to schedule a community educational forum on the needle exchange program — not a public hearing — in June. However, Foster and Jones plan to attend the health board’s meeting Thursday at 6 p.m.

Mixed messages?

One of Foster’s main concerns is that the program sends mixed messages; at city council, she said the health department is basically saying, “Don’t do drugs, but if you do, here are clean needles so you can continue to shoot up. You might die from a drug overdose, but at least you won’t die from Hepatitis B or C.’”

McKisic said the health department isn’t sending a message that it’s “OK” to do drugs.

“We know it’s illegal, but if a person is going to do them, we want to protect people in our community, including the addicts, because what happens if an addict changes and becomes a productive citizen?” she asked. “And we’ve got a few in Buckhannon that have.”

She said when she received a call from Foster, she asked her if she believed in giving people second chances.

“She called me and I said, ‘This is someone’s child,’” McKisic recounted. “I asked her, ‘Don’t you believe in giving people second chances?’”

Another reason why McKisic thinks the needle exchange part of the harm reduction program is essential is the amount of public money and time that would be spent, should an outbreak of HIV, Hepatitis C or Hepatitis B be discovered in Upshur County.

“When we get a report that there’s one of those positives in testing in our county, we have to do an intensive investigation on it,” McKisic said. “That’s one reason we want to prevent it. If people would weigh the cost of taxpayers’ money [that would be spent on the harm reduction program] versus how much we would have to spend if someone would acquire HIV and have it turn into AIDS, say for instance, maybe at the age of 25. You’ve got a lifespan of 85 years, and that medication has to be taken daily. What is that going to cost us, millions of dollars, maybe into the billions?

“We may be spending a few dollars, but wouldn’t we rather spend a small amount and possibly prevent something that’s going to cost a whole lot later in the long-term?”

Pros and cons from a police perspective: addiction as a multi-faceted problem

Buckhannon police chief Matt Gregory said he empathizes with perspectives both for and against starting a needle exchange program.

“I can definitely see both sides of it,” Gregory said Friday. “I definitely heard concerns of folks out there, from the point of view that it’s just feeding into the addiction, and I know there’s been concerns here as well as in other towns like Charleston.”

For one, Gregory said police sometimes worry that needle exchange programs might draw drug users from other areas into their territory.

“When you’re the only needle exchange in the area, there’s a possibility of bringing more people into the community [who are using],” Gregory said. “Charleston has had an influx of problems and I’ve definitely heard about that.”

The police chief said he’s trying to keep an open mind as he learns about the program.

“The positive side is, the goal of it is ultimately within the name,” Gregory said. “So I get that in terms of harm reduction, the thinking is that when an individual is addicted to a controlled substance, they are going to find a way to further that addiction, and harm reduction can at least reduce the incidence of sharing needles and cut down on the spread of blood-borne illnesses by proper disposal of needles.”

The public benefits from these programs, Gregory said, because if clean needles are available, users are less likely to throw out used needles on streets and sidewalks, knowing they can obtain clean ones from the health department if they bring the used ones back.

“It cuts down on the likelihood people will have encounters will paraphernalia,” he said.

Counseling is available but not required for a person to receive needles, and Gregory and McKisic both think no one can force an addict into recovery before he or she is ready.

“I see both sides of it from the perspective of all you’re doing is fueling addiction,” Gregory said. “But also, those that seek the services of harm reduction, individuals involved with harm reduction also have available treatment and recovery options.

“You can’t force people into recovery,” he added. “You won’t be successful. For it to be truly successful, the person has to be willing, and this is just another opportunity or effort to get them steered away from addiction.”

McKisic said, “Until a person is ready [to enter recovery], they’re going to turn you down. Sometimes, we just have to keep them healthy until that time in their life when they’re ready to quit.

“We don’t know what these people have been through. It could have been mental, physical, sexual abuse or all three of those.”

Gregory said one thing’s for sure — addiction is a complex issue that needs to be approached from many sides.

“There’s no one easy solution to addiction,” the police chief said. “It’s going to require a multi-faceted approach and outside-the-box thinking. Enforcement is not the total solution, but it’s part of it. But right, wrong or indifferent, [the needle exchange program] is worthy of discussion.”

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