Rising drug use drives Indiana communities to adopt needle exchanges

At least 20 of Indiana’s 92 counties have either started needle-exchange programs since the April legislation that cleared the way or are moving to do so.

Driving their decisions are rising numbers of IV drug users -- including teenagers -- and fears that they’re facing a looming public health crisis like the one that hit the small town of Austin earlier this year, when it became the epicenter of the largest HIV outbreak in Indiana history.

Since January, more than 170 people have been diagnosed with HIV, linked to the use of contaminated needles among IV drug users in and around Austin, a town of 4,200 in southeast Indiana.

“All of our counties have an Austin, Indiana, in them,” said Kellie Kelley, public information officer for the Madison County Health Department, approved for a needle-exchange program in June. “So for us to look away from that is really concerning."

Kelley testified Monday at a legislative study committee charged with reviewing Indiana’s new needle-exchange law, passed by the Legislature after initial opposition from Republican Gov. Mike Pence.

The committee heard little about how the program is working from state public health officials, charged with overseeing the program. Noticeably absent from the hearing was State Public Health Commissioner Dr. Jerome Adams, who’d privately supported the needle-exchange measure while the governor publicly opposed it.

Joey Fox, the state health department’s legislative liaison, was the only department official to speak at the hearing. He indicated only three counties have received official approval from the state to start their own programs to get clean needles in the hands of drug users.

All three counties – Scott, Madison and Fayette – have high IV drug use and high levels of Hepatitis C, a blood-borne disease that is transmitted through contaminated needles and often accompanies HIV, the virus that causes AIDS.

In his brief testimony, Fox said the state health department had yet to collect enough data to weigh in on how the law is working.

Much more information came from others who testified, including Beth Meyerson, co-director of the Rural Center for AIDS/STD Prevention at Indiana University. Meyerson is part of a team of public health experts advising officials in what she said was 20 counties who’ve started to clear the law’s hurdles to set up their own needle-exchange programs.

Meyerson said elected officials in those communities have been working in concert with local health departments, police and prosecutors to develop community support for the programs and have seen little backlash.

Among the biggest challenges they face, she said, was the state’s “bare-bones public health budget” which provides little money for HIV testing and few treatment resources for drug addicts. Meyerson said Indiana was near the bottom of states in public-health funding.

Also testifying at the hearing was David Powell, head of the Indiana Prosecuting Attorneys Council. Powell has called on lawmakers to restore some of the tough drug-dealing penalties that the Legislature rolled back two years ago in an effort to reduce the state’s prison population.

Powell sharply criticized the Legislature’s past decisions to minimally fund drug-addiction treatment programs, especially in rural communities that he said are seeing “explosive rates” of heroin and opiate addictions, along with what he called “crisis” levels of Hepatitis C, a blood-borne disease spread by IV drug users through contaminated needles.

“In rural Indiana, it’s a terrible situation,” Powell said.

Study committee members have until November to come up with proposals to recommend to the General Assembly for action in the next session.

Some on the committee seemed reluctant to recommend raising the drug-crime penalties, but Powell’s concerns about the lack of treatment options for addicts caught the attention of at least one member, state Sen. Vaneta Becker, R-Evansville.

“It’s been this way for years,” Becker said. “And we’ve ignored it.”