JEFFERSONVILLE — Earlier this month, the Clark County needle exchange expanded operations — an action health officials say they hope will help improve services to members.
Since opening in January 2017, the Interchange on Akers Avenue in Jeffersonville has been open from 9 a.m. to 3 p.m. every Thursday. There, members could get clean syringes in exchange for used ones, heath and addiction treatment if desired, and hepatitis C and HIV testing.
But officials at the Clark County Health Department say that providing opportunities more often, and during the times clients need them, will make the exchange a better resource for the community.
On March 1, the Interchange's hours were expanded to 1 to 3 p.m. Monday, Wednesday, Thursday and Friday — the hours when Interchange staff would see a bulk of the members coming through when it was previously open only on Thursdays.
The additional two hours a week is not a burden on the health department, administrator Laura Lindley said, because it has the staff and volunteers to cover that.
“We're just hoping that this helps the people that need it,” she said. “We're offering them the resources to get clean, to get treatment. It's up to them to take us up on it.”
Lindley said that since it opened, the Interchange has served more than 230 individuals, with around 89 considered 'regulars' — those who return within three months.
Right now, Lindley said they get back about a third to a half of the needles given out. That's because all kinds of unforeseen circumstances — theft, arrest and confiscation among them — can prevent people from being able to return them all.
Between October 2017 and March 1 of this year, 13,028 needles were given out, with 9,487 returned. This one-third to one-half return rate has been pretty consistent since the Jeffersonville exchange opened.
“It's not great,” Lindley said. “It's not where we want it. But I think that runs fairly true [with other programs]."
The program tries to balance maintaining its public health goals, which are to help stop the spread of HIV and Hepatitis C by curbing needle sharing, while trying to get as many of the used needles returned as possible.
That's another reason the extended hours can be a benefit, Lindley said. She expects that they'll start to see the return rate grow.
“They may choose to only get enough for a few days, if they knew they can come back sooner,” she said. When the exchange operated one day a week, the program's policy was to give out as many needles as a person estimated they used in a week, sometimes in the hundreds.
A Centers for Disease Control and Prevention report published last week studied the effects of the needle exchange in Scott County, the first in the state and the site of an unprecedented HIV outbreak by needle-sharing that warranted its opening.
In early 2016, a year after the program began, researchers from the CDC, Indiana State Department of Health and Indiana University interviewed 200 people — many HIV positive — to determine how the needle exchange may have changed behaviors.
Of the 124 people who reported injecting drugs both before and after the needle exchange opened, those who said they shared needles fell from 74 percent to 22 percent. The number using sharps containers for used syringes rose from 18 percent to 82 percent.
In conclusion, "the response to this outbreak, including the establishing of the [needle exchange], decreased injection behaviors associated with the transmission of HIV among people who inject drugs,” according to the CDC.
In Clark County, Lindley said the program has shown success, and she hopes it will grow as long as it's needed in the community. At least 15 people are known to have gone into treatment, but that number could be higher, she said, because some people may have stopped going to the Interchange without reporting why.
Several times, people have returned all of their unused supplies because they had quit using heroin. Overdoses are down as well, she said, and that may be due to the naloxone that's administered in emergency situations and given out at the exchange.
“That's huge,” she said. “That's success.”
Between 2015 and 2016, heroin overdoses in Clark County jumped from 51 to 182, before dropping to 171 in 2017. By the end of February 2017, there had been 45 overdoses. During the first two months of 2018, there were only 25.
"Hopefully, it's the naloxone or Narcan helping,” she said. “And hopefully people are getting into treatment.”