SOUTHERN INDIANA — A piece of legislation making its way through the Indiana statehouse could extend to the next decade the sundown date on syringe service programs, which some Southern Indiana officials credit with saving lives through harm reduction methods.
Indiana House Bill 1203, authored by Rep. Wendy McNamara, R-Evansville, and co-authored by Southern Indiana Reps. Ed Clere, R-New Albany, and Rita Fleming, D-Jeffersonville, includes a provision that would extend the state authorization for the programs to 2030, although each must also be approved locally. The current expiration, which has previously been extended, is set for July 2020.
The bill unanimously passed the House Committee on Public Health last week and on Tuesday, passed a third House reading 93-1. It was referred Wednesday to the Indiana Senate.
At a weekend panel as part of Clark County CARES Drug Facts Week, Clere gave credit to the Clark County Health Department for its work in establishing a syringe services program here, which opened in January 2017.
The program, which provides intravenous drug users with clean needles in exchange for used ones, also provides access to health care that clients may not usually get and provides HIV and Hepatitis testing and resources for substance-use-disorder treatment.
The work was started by former Clark County Health Officer Dr. Kevin Burke, who passed the torch to Health Officer Dr. Eric Yazel several years ago at Burke’s retirement. Clere said he had seen how the program has expanded, “and we’re seeing not only the impact that it does in terms of harm reduction but we’re seeing the connections that you guys are making to treatment and recovery,” he said to Yazel, who was also on the Saturday panel.
In 2020, the program had 896 participants, supplied 89,957 syringes and received 80,448 by participants or community returns, according to numbers provided by the Clark County Health Department. There were 2,299 times a person visiting the syringe exchange program received harm reduction education; 2,271 wounds were treated. The program provided PrEP (Pre-exposure prophylaxis) to protect against HIV 2,248 times.
“For someone who this may be the first time you’re hearing about this, it’s more than just syringes,” Yazel said. “It’s relationship-building, it’s advocacy, it’s access to the health care system...a lot of people who use IV drugs, they’ve had negative experiences in health care so this is the point to build trust.
“From a humanity standpoint, it’s the right thing to do.”
He added that there’s been an estimated $2 million to $5 million saved each year just through education and testing.
Yazel also gave credit to the staff who were able to keep the critical program running even through the thick of the COVID-19 pandemic, which he said “shows a lot of bravery and dedication.”
But he added that this and other programs are needed to help the progress of helping those with substance use disorder and other addictions, especially with the rise in overdoses seen this year during the pandemic.
Heroin overdoses reported in the Clark Memorial ER in 2020 reached 186 in 2020, a sharp rise after dropping to 103 in 2018. The last highest number was 182 in 2016, which was also before the syringe exchange program was in place in Clark County.
Overall drug overdoses seen in the ER also showed in record numbers in April, May and July — May’s 62 topping the previous record of 37.
“COVID-19 shows just how fragile that balance is,” Yazel said. “Any disruptions to any routines and programs that are out there can lead to devastating results and we’ve seen some resurgence.
“For the last few years our numbers were improving so rapidly, which is wonderful but it may lead to some complacency where people say hey maybe it’s not so much of a problem.
Lawmakers on the panel — Clere, Fleming and Sen Ron Grooms, R-Jeffersonville — agreed that work toward legislation that can improve services and much-needed treatment options should remain at the forefront.
“I think one of the things we have to be very mindful right now is that even though substance abuse continues to be part of the daily reality for far too many Hoosiers, it seems to have receded somewhat as a top legislative priority,” Clere said. “I don’t see it at the top of the list like it was a few years ago...and we need to keep it at the top of the list because our work is far from finished.”
Fleming said she also wants legislators to take a look at providers and identify best practices because while most have reined in prescribing patterns due to increased education and policy, there may still be outliers overprescribing.
“Because we know that oftentimes, sending a patient home with 30 Percocet or whatever after surgery is far too much for most procedures,” she said. “And that’s where addiction starts for so many.
“People don’t set out to be drug abusers, but they may have some factors that make them more susceptible and then we’re not helping by not being innovative in managing their problem.”
Grooms said that while there was great progress in programming and resources over the past several years, with the pandemic, “it is certainly going the other way.”
“We have a tremendous challenge in Indiana to develop treatment centers ... we also need more education,” he said. “We need to find a way to get into the schools early... to make children understand what this does to our society and how much it costs society to treat and maintain people that have an issue with overdosing and addiction.
“We have a major challenge but we’ve faced those before.”