The Mahoning Valley has been one of the hardest hit areas in the state by the ongoing opioid crisis. As local officials continue to struggle to find ways to reduce the number of fatal overdoses, one program being tried in other parts of Northeast Ohio may provide some relief.
County and municipality needle exchanges – six are operating in Ohio – allow addicts to get clean syringes free of charge and free from potential arrest.
Summit County has had one of the programs since last year. Health commissioner Donna Skoda says it is helping to stop the spread of disease, which will help get addicts into treatment and on a path back to health.
“A substance-use disorder is a chronic disease,” Skoda says. “Individuals who are users wanting recovery recover their whole lives. It’s like diabetes; it doesn’t just go away. And the last thing we want is for individuals wanting recovery and wanting to get well have another chronic disease to deal with, like Hepatitis-C or HIV/Aids or both.”
Canton started its own needle exchange several months ago. Diane Thompson with the city health department says reducing the use of dirty syringes can head off a potential “secondary epidemic” of communicable diseases that would dramatically worsen the problem of dealing with addiction.
“In Stark County, our HIV rates historically have not been tied to injection drug use,” Thompson says. “But just this past 2016, we started seeing that. Not as much as the outbreaks in Scott County, Ind. But that is what we’re trying to prevent. They had, I believe, over 200 individuals test positive for HIV, and it was all linked back to injection drug use. So, we’re in a position to prevent that.”
In Indiana, the infection outbreak was so dramatic that in 2016 then-Gov. Mike Pence, a longtime opponent of the philosophy of needle exchange, issued an executive order to begin syringe distribution.
Cuyahoga, Summit, and Stark counties have needle programs. Trumbull and Mahoning do not.
In Trumbull, the county prosecutor cautions that while a 2015 change in state law does relieve local jurisdictions of criminal liability for providing needles for illegal drug use, it does not protect them from civil actions.
Jonathan Entin, a law professor at Case Western Reserve University, says that is an accurate assessment, in context.
“If you are extremely risk-averse, if you do not want to be sued at all, then maybe you shouldn’t have the health department participating in the needle exchange,” Entin says. "But, just because you can’t guarantee that the county will be immune from lawsuits doesn’t necessarily mean that the county would lose. And it doesn’t necessarily mean that participating in the needle exchange program is somehow bad public policy.”
Skoda says she understands why, in general, there are concerns.
“I get the criticism. I mean, if you just look at the surface, it probably seems like you’re just helping people use drugs,” Skoda says. “But these folks are going to get needles anyway. They’re going to get out and they’re going to do it. You’re just preventing the spread of communicable disease. ”
A Chance For Intervention
Skoda says the needle exchange provides a larger opportunity, too. It creates a safe point of contact for drug users to find help in overcoming their addictions.
“We get an opportunity to talk with them about treatment, how to stay clean, about other health services,” Skoda says. “We can offer testing for Hep-C as well as HIV. And therefore it’s easier to impact and start to chip away at the addiction, and have them want to get healthier and sober.”
Amanda Archer, who oversees Canton’s program, says the safe contact aspect of it has been showing traction with the exchange participant.
“Almost 100 percent,” Archer says. “None of them are interested in living in this world of addiction. They talk about treatment options every week that they come.”
Archer says this is because needle exchanges offer an “out” from the isolation that accompanies addiction. And she and fellow needle exchange advocates in Stark and Summit Counties agree connecting addicts with treatment resources can reduce the number of opioid overdoses and overdose deaths.