Letter: Correcting misinformation about needle program

Dear Editor:

On July 9, Buckhannon City Councilman Robbie Skinner chose to be interviewed on the radio by the mayor of Charleston, W.Va., Danny Jones, who has a regular talk show on a local radio station. The topic was the needle exchange program in Upshur County. (Feel free to Google and hear the complete interview.) The comments from Councilman Skinner were not only incorrect but also did not provide complete information.

That very same week the Buckhannon-Upshur County Board of Health held a public meeting and identified concerns from our citizens about the needle exchange program. Those concerns are currently being discussed with the provider of the program, Mylan Puskar Health Right out of Morgantown. Those concerns will hopefully be resolved in the near future. The incorrect and incomplete information from the radio interview is what needs to be corrected at this time.

The Buckhannon-Upshur County Health Department Board is comprised of a local physician, a physical therapist, a physician assistant, a respiratory therapist and two nonmedical persons. In 2017 that board began gathering information about starting a needle exchange program to guard against the spread of HIV and hepatitis, but also to help IV drug abusers to get the help they need to regain their lives without addiction. This is where the first incorrect statement occurs in the radio interview. We did look at the Charleston Health Department program, but definitely not as a model. The conclusion the board got from this observation was that we felt that no health department in the state of West Virginia should be doing a needle exchange program. With all the state budget cuts the health departments do not have the resources, nor the expertise, to adequately run these programs to be successful.

Yes, these programs are designed to prevent the spread of HIV and hepatitis commonly associated with IV drug use, but the end purpose is a rehab program. Many times when the IV drug users have decided they need help and are willing to commit to a rehab program the availability of these programs can be limited. For example, one program in Morgantown has openings for 500 patients. Currently all openings are filled and the waiting list is 600. The needle exchange programs are designed to keep the public and the addict safe from disease until the rehab needs can be met.

After nearly a year of looking at options for a needle exchange program, the board enlisted the services of the Mylan Puskar Health Right group from Morgantown. This group began as a free clinic to provide medical care for anyone that did not have insurance. The seed money for the clinic was provided by Mylan Pharmaceutical and the Puskar family, and that is where the association ended. This clinic has flourished and expanded over the years but does not create any financial gains for Mylan or the Puskar family.

Prior to implementing the needle exchange program in our county, an informational program was scheduled with 100 invitations sent to city, county, educational and medical offices. Unfortunately the invitations were sent via e-mail and by the postal system but not all were received. A very poor turnout prompted a second informational session to be scheduled, but by this time the program had already started accepting clients.

The next concern from the radio interview is the misinformation that, and I quote, “they are giving out needles out of a van.” What the councilman failed to tell you is that the staff in that mobile unit consists of a registered nurse and a licensed social worker. These professionals bring the medical capability and knowledge to meet the needs of their clients. Wound care, HIV and hepatitis testing, education and protection from sexual transmission — also a means for transferring HIV and hepatitis — are just a few services provide by these professionals. They educate on the importance of using clean needles and disposing of them properly, and give them the supplies to keep them and the community safer. Most importantly, they establish a rapport and a level of trust. With each visit every client is asked, “Are you ready to discuss a rehab program today?”

This now leads us to the next wrong statement in the interview: “No identification required.” Each and every person using these services has an identification that only the staff in the mobile unit will see and understand. This is to protect the privacy of those clients. And another wrong statement is that any underage person can get these services. Someone was not listening at the information session. We have not had any underage people try to get service. But if we did have an underage person try to obtain services, the social worker has to report that to the proper authority or they can lose their license.

Councilman Skinner insisted that local medical personnel, doctors, EMS and police were not involved in creating this program. This may be true, yet all of those people have attended the information programs and they support the need for the needle exchange. He also agreed with mayor Jones that drug dealers will observe the people that visit the mobile unit so they can sell to them. If I were a drug dealer, I most likely would be already selling to those van visitors. If I want new people to sell to, I think I would rather be observing the local pain clinic and doctors’ offices.

Another topic on the show was about retractable needles. They are a wonderful device to help prevent accidental needle sticks. Hospitals and physician’s offices have used retractable needles for years. Unfortunately, the drug user can do the same things with a retractable needle that can be done with a regular syringe needle. Retractable needles are all manual. In other words, that needle is not safely confined until the user activates the system. The system can be a spring system, or a cover that slides over the needle, but whatever the system, the user must activate it. Once confined, the needle cannot be reused, and this is a good thing.

Mayor Jones used an example that the IV drug user will inject the heroin, then draw blood back into the syringe to mix with any remaining heroin to make sure they get all of the drug, then inject the blood mix contents. You can accomplish the same thing with a retractable needle if you don’t fully expel the syringe at the beginning, which would activate the safety system, then draw a portion of blood, mix with the heroin then fully inject thus activating the needle guard. There is never a system that is completely foolproof.

In summary, the needle exchange programs are a needed service to not only protect the public, but to keep IV drug users from contracting HIV or hepatitis through contact with a dirty needle. The end goal for the program is to get that user into a rehab program. These needle exchange programs have been around for many years. We in a rural area are just now facing the same problems that larger cities have been fighting for a long time.

Can we improve these programs? “Lord I hope so.” There are always ways to improve. There is a fine and difficult line between public opinion and medical application, and it can create many questions and opinions. Our hope is that common ground can be obtained and the effectiveness of these programs will protect our community and also provide the help that the IV drug user desperately needs to regain their life, free from addiction.

Larry R. Carpenter

Buckhannon-Upshur Co. Health Department Board Member


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