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Harm Reduction Programs

Dr. Christine Weyman, Medical Director

Lake Cumberland District Health Department

Like many other states, Kentucky is experiencing an epidemic of drug abuse with its associated consequences of spread of Hepatitis C and HIV, and drug overdose deaths. Kentucky has the highest rate of Hepatitis C in the nation: a viral disease which damages the liver and in most cases leads to cirrhosis and possibly cancer. It is spread via infected blood, most commonly through sharing contaminated needles and drug paraphernalia. Today we have very successful treatments for Hepatitis C, however, they are very expensive, and if everyone who had Hepatitis C was treated it would bankrupt Medicaid.

Obviously prevention of drug addiction and helping individuals get treatment for their addiction, are the best solutions but these are long term goals. Our Legislature has passed laws for immediate strategies to be implemented to prevent transmission of disease and prevent death from accidental overdose.

1. The use of sterile needle and syringe exchange programs to prevent disease transmission –   these can be initiated by health departments.

2. The use of naloxone by family and friends in the event of accidental opiate overdose. Naloxone which reverses the effects of opiates, is available by prescription, and from certain certified pharmacies without prescription.

Harm reduction programs which have already been established by health departments in several Kentucky counties (Jefferson, Fayette, Jessamine, Knox, Carter, Pendleton, Grant, Franklin, Clark, Harrison, Kenton and Boyd) work by providing sterile needles and syringes to those using IV drugs, and at the same time collecting used (dirty) ones, thus taking them off the streets.  During this interaction the user is counseled on prevention of disease transmission, safe sex and drug use, rehabilitation options and provided with free HIV and Hepatitis C testing. These programs, which have been utilized for many decades in other states and countries, have been shown to be cost effective in decreasing disease transmission and accidental needle stick injuries by police and emergency personnel. Furthermore studies also show that providing clean needles and syringes does not increase drug use in a community.

The Lake Cumberland District is no different, we too have these problems and it would behoove us to strongly consider implementing such Harm Reduction Programs to allow us to reach these individuals and offer rehabilitation options and at the same time prevent spread of disease.

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