Last week, the Harm Reduction Journal published a report by Johns Hopkins University critical of the decision last year to shut down the Kanawha-Charleston Health Department’s (KCHD) needle exchange program. The report concluded that the suspension “should be viewed as a call to action for sustained evidence-based interventions in the face of sociopolitical forces that attempt to subvert public health.”
The report’s authors try mightily to make out those critical of the program as ill-informed health Luddites who followed a political agenda while sacrificing best practices in dealing with the drug crisis.
“The (program) was widely viewed among (IV drug users) as a trustworthy harm reduction program that provided infectious disease and overdose prevention services in a destigmatizing manner,” the report said. “However, the suspension of the program fundamentally changed the public health landscape for (addicts) ushering in a new era of increased risks of blood-borne infections and overdoses.”
The report prompted a panicked Charleston Gazette to opine, “Now, Charleston can see where going with fear and prejudice, rather than medical science and basic human decency, lands you.”
This story badly needs some perspective.
The researchers based these sweeping, doomsday conclusions on interviews with 27 drug addicts, six of whom had never even used the KCHD needle exchange program. The report barely mentions the reasons why it was shut down. The syringe exchange and harm reduction program was a mess.
Here were some of the key findings in a 2018 report by experts at the state Department of Health and Human Resources Bureau of Public Health.
–The Health Department’s needle return rate was only 66 percent. Between 2015 and 2018, the program gave out 221,000 more needles than it collected. That contributed to an increase in syringe litter, prompting concern among the public and first responders.
–Patients could receive needles for not only themselves but other drug users as well. The proxy pick-ups were not outlined in the health department’s program procedure manual and it created a missed opportunity to make direct contact with addicts for treatment.
–The program had serious record keeping issues which, among other things, made it possible for patient identification numbers to be shared.
State DHHR made several recommendations at the time, including the suspension of the program’s certification [emphasis added].
Needle exchange programs are controversial. Opponents view them as enablers for addicts. However, when executed properly they can reduce the spread of blood-borne diseases from needle-sharing and serve as a contact point for those who want to get into treatment.
The problem with the KCHD program was not that “sociopolitical forces” were trying to “subvert public health,” as the Johns Hopkins researchers concluded after interviewing 27 addicts. City and county officials shut it down because it was riddled with problems and not working as intended when it was launched with considerable stakeholder support.