Officials see benefits, drawbacks to needle exchange programs

May 06--Indiana law now allows local governments to set up needle exchange programs but Northwest Indiana officials have mixed opinions on the programs, some seeing the need to block a public health problem and others saying they promote drug use.

Lake and Porter counties' prosecutors, sheriffs and coroners agreed that more needs to be done to fight the opioid epidemic in the area but they differed about whether needle exchanges were part of that path.

"If we don't tackle it right now, it's going to come back and bite us," said Lake County Sheriff John Buncich.

As the epidemic does not showi any signs of slowing down, Lake County Coroner Merrilee Frey said it's becoming a public health emergency, and any sharing of needles can lead to the rapid spread of infectious diseases.

In 2016, 114 people died of drug overdoses in Lake County, and 47 fatally overdosed in Porter County. Lake County is on track to surpass last year's numbers in 2017, with 55 confirmed drug overdoses by the end of March, according to the coroner's office.

The opioid problem isn't going to be solved overnight, said Porter County Coroner Chuck Harris, but dealing with issues like this that come along with it take "big bites out of it" and get "it down to a manageable level."

Porter County Sheriff David Reynolds said he wonders what the "endgame" is with needle exchanges.

"The No. 1 problem is we need to, somehow, we need to minimize the demand for the drug," Reynolds said. "Until then, naloxone, needle exchanges, they're not even remotely the answer to what we need."

Lake County Prosecutor Bernard Carter said he understands the public health concerns, but he said he has seen exchange kits that include needles, cooking devices, tourniquets and other materials used for drug use, which "sends the wrong message" when the goal is for people to get off drugs.

But Harris said that needle exchanges could also be an opportunity to provide people with information about treatment options and any chance to get people help is "a great thing."

Frey noted the topic is controversial, and other counties in Indiana also have struggled with it. Madison County extended its needle exchange program Tuesday for a third year to fight the spread of hepatitis C, while the Delaware County prosecutor urged county officials last month not to support needle exchange programs there, The Associated Press reported.

At the end of April, Gov. Eric Holcomb signed a series of bills aimed at fighting Indiana's drug epidemic, including limits on the amount of opioids prescribed to a patient for the first time; enabling the local creation of needle exchanges; and elevating the level of felony for robbing a pharmacy or pharmacist.

"The opioid crisis is negatively impacting the lives of Hoosiers, their families, our communities -- even our economy," Holcomb said, in a statement. "I commend lawmakers for supporting my initiatives and delivering a package of legislation that provides a holistic framework for us to attack this epidemic."

Until Holcomb signed the bill giving local communities the green light to start their own needle exchanges, the state held all the control to set up those programs.

State law then said that a local agency must first declare a public health emergency, get approval from the lead government entity in the area and lastly get approval from the state for the program to start, according to a fact sheet from the Indiana State Department of Health. A local municipality could not use state funds to buy syringes under the old law.

In recent years, area health officials said there hasn't been a need for needle exchanges in Lake and Porter counties. Porter County Prosecutor Brian Gensel said in an email that needle exchange programs, "should be viewed as an extreme measure to deal with dire and immediate health emergencies," such as Scott County having a public health emergency after an HIV outbreak. But Gensel said Porter County hasn't had a problem that would warrant the need for the program.

Buncich also pointed to Scott County, saying he's in favor of moving forward with a needle exchange program so Lake County doesn't end up with the same level of problems. Scott County is a county of 23,000, north of Louisville, Ky.

In Lake County, both the coroner's office and jail are in the midst of programs to address the opioid epidemic and assess the prevalence of HIV and hepatitis C.

The coroner is leading the county's effort to battle the opioid epidemic through the prescription for action plan, an initiative to promote prevention, education and treatment programs.

The Lake County Jail recently launched a program in partnership with Indiana University to track the number of inmates coming into the facility with HIV or hepatitis C.

Buncich said inmates are coming into the facility with drug addiction issues and some have infectious diseases, which the program is trying to identify. Once those inmates leave the facility and go back into the community, Buncich said, services need to be available to deal with infectious diseases.

If the county decides to start a needle exchange program, Buncich said, it will take a lot of planning and coordination to get it up and running.

"It's a step in the right direction," Buncich said.

While treatment and law enforcement are important in tackling the issue, Reynolds said the biggest and best thing is education and prevention.

"That's where the attention and resources should be located, not needle exchanges," Reynolds said.

Carter pointed to a video Reynolds has brought to area schools to teach students to make better choices and say no to drugs.

"I think we need to focus on the reality of how bad this drug is," Carter said.

rejacobs@post-trib.com

clyons@post-trib.com

Twitter @craigalyons

The Associated Press contributed.

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