Boone County law enforcement heads weigh in on syringe exchange

Boone County’s top law enforcement officers find it controversial too. They face the problem of intravenous drug use every day, and their departments see all too often the destruction heroin and methamphetamine create.

They are uniquely qualified to weigh in on a subject that Lebanon Police Department Chief Tyson Warmoth said statistics could be used to slant the topic one way or another.

“Call it what it is … it’s a needle giveaway program,” Warmoth said. “You don’t fight addiction by enabling addiction. This is just giving the user a tool to get it into their bloodstream. It blows my mind we would enable this.”

Boone County Sheriff Mike Nielsen has a different slant on the issue and cited Boone County Health Department Administrator Cindy Murphy, RN, in his reasoning.

“Cindy is an expert in her field on disease prevention, that is not in my duties,” Nielsen said. “I believe and trust in her that a needle exchange program will, in fact, reduce the spread of Hepatitis C and HIV.”

Nielsen said his thoughts on syringe exchange programs, or SEPs, are: they work “if done properly.”

In Nielsen’s eyes, that means a one-for-one needle exchange. Nielsen made it clear he wouldn’t support what some call a “party kit” or an SEP kit that includes clean syringes, a tie-off tube and a clean spoon.

While those two views differ, what can’t be argued is the rise of Hepatitis C cases in Boone County from 2014 to 2016. The number of cases has risen 87 percent in those two years. Those numbers indicate a correlation between the disease and intravenous drug use in the community, according to the BCHD.

Whitestown Police Department Chief Dennis Anderson’s position on an exchange program isn't as black and white.

“I wrestle with the idea and it being the right thing to do,” Anderson said. “Clearly, from a statistical base, we know what we’re currently doing is not working. That leads me to believe we need to try something else.”

In a presentation at the Boone County Healthy Coalition meeting on Wednesday, BCHD Public Health Nurse Brandy Franklin said harm reduction is the main objective. The goal was described as to “decrease the likelihood of disease transmission by providing clean syringes and supplies while educating on how disease transmission occurs and how to prevent its spread, as well as connecting individuals to care.”

Zionsville Police Department Chief Rob Knox said he was on the fence about SEPs, but agreed there needs to be more done to assist addicts so they do not return to the cycle of addiction.

“I don’t want to enable addicts, but I also don’t want people to be sick or dying,” Knox said.

There are nine SEP programs in Indiana.

Since 2015 in Scott County, the site of Indiana’s first SEP, they’ve totaled 594 SEP clients with 125 active, according to the BCHD. During that period they’ve given out 396,500 syringes with 377,671 syringes returned, for a 94 percent return rate.

“If we’re seeing the increase Cindy Murphy is saying (in Hep C cases) we could very easily turn into Scott County,” Nielsen said.

Those numbers did not sway Warmoth’s view.

“There will be more overdoses and more needles discarded in the street,” Warmoth said. “We’re not fighting the scourge of heroin, we are enabling it now. Counties with needle exchanges, their overdose rates are increased.”

The Centers for Disease Control and Prevention said an ideal community-based SEP would provide free sterile needles and syringes; safe disposal of needles and syringes; referral to mental health services; referral to substance use disorder treatment; include medication-assisted treatment; HIV and hepatitis testing and linkage to treatment; overdose treatment and education; Hepatitis A and B vaccination; and other tools to prevent HIV and hepatitis including counseling, condoms and PrEP (medicine to prevent HIV).

Nielsen agreed those tactics fit into his idea of being “done the right way.”

Franklin’s presentation included statistics on the cost of a single syringe ($.08). Franklin compared that to the cost of one HIV patient ($385,000 to $618,000) and 12 weeks of Hepatitis C treatment $84,000. Those numbers stretch into the billions for health care costs, Franklin said.

Sheriff Nielsen said a high percentage of inmates in the Boone County Jail face drug addiction. Many turn to other forms of crime to support that addiction.

Nielsen said when he spoke with incarcerated inmates at the BCJ, he found that many who are intravenous users would utilize an SEP, if available.

“Most tell me they’ve shared a needle with other people,” Nielsen said. “That’s a problem. I know a young lady that said she’s shared a needle with someone else at least 30 times.”