In December 2015, the Kanawha-Charleston Health Department began a Harm Reduction Syringe Services Program (HRSSP). Health officials and city leaders supported the program as a way to slow the spread of serious diseases among drug addicts who share needles and as a contact point to try to get addicts into treatment.
However, the well-intended program got off the rails, devolving from a needle exchange and addiction treatment program to simply a way for addicts to get nearly unlimited access to needles.
Charleston Mayor Danny Jones and Police Chief Steve Cooper, who initially supported the idea, grew increasingly frustrated and publicly aired their discontent. They argued the program drew drug users to the city, increased crime and led to thousands of needles being discarded on the Capital city’s streets and in abandoned structures where drug users shot up.
Jones and health department Interim Health Officer Dr. Dominic Gaziano requested an evaluation of the program by the state Department of Health and Human Resources Bureau for Public Health. That report is in and it reinforces many of the complaints made by Jones and Cooper.
The report says the program was not operating as a one-for-one exchange. “KCHD was distributing more needles than were returned to meet their goal of assuring that IDUs (intravenous drug users) always had a clean needle available for use.”
That contributed to a dramatic increase in dirty needles in the city. According to the evaluation team, “Increase in syringe litter is viewed as a threat to public safety. With over 421,000 syringes reportedly dispensed in 2017 and a return rate of 66 percent, it is plausible that much of the syringe litter were ones that were dispensed by KCHD HRSSP.”
All those dirty needles posed a health risk to first responders. They have had to worry about safely clearing drug debris as well as treating an overdosed patient, fighting a fire or investigating a crime.
Additionally, since the program was more about needle access than exchange, the health department was missing opportunities to screen drug users for hepatitis, HIV and other serious health problems and to get them into treatment programs. The report found that because of “data quality issues” in record keeping there was no way to know for sure how many drug addicts actually got into treatment.
Based on these and other failures, the evaluation team recommended that the state suspend the KCHD harm reduction’s certification. (The program has been on hiatus since March.) The report also makes a series of recommendations for changes to be made before there is any attempt to restart the program.
It’s worth noting that the evaluation team makes clear it believes needle exchange programs help to reduce the spread of disease and create a contact point to get addicts into treatment. The report also says, “However, it is important that these programs are of high quality, well managed, and have good administrative oversight.”
As the evaluation makes clear, the KCHD needle exchange program was failing in all those critical areas.