WHEELING — Ohio County’s needle exchange program, shuttered earlier this year in the face of new regulations, remains on ice while the health administrator continues to catch up on outstanding matters delayed due to the COVID-19 pandemic.
Health Administrator Howard Gamble said that the department has not yet been able to fill out the paperwork to be licensed to operate, which became necessary after a law was signed into effect last year. In addition to trading dirty needles for clean ones, the program also distributed medical information, condoms, alcohol pads and other basic health items.
When the needle exchange program was created, Gamble said, the county designed its program from scratch, taking inspiration from other programs.
“When we first started the program several years ago, there were no templates, no how-to manuals; you learned from other states and municipalities on how to set up a needle exchange,” Gamble said. “They were relatively simple. You did a 1-for-1 exchange, a hauler to haul off products, agreements with folks to do mental health evaluation or testing, counseling if necessary, so we set out to create that program ourselves.”
With the new law, Gamble said, several measures were required to be in place which the homegrown needle exchange did not have, such as specific tracking of unique needles, and a new licensing process. Due to the pandemic, the health department prioritized COVID care over the continued operation of the needle exchange, sidelining it earlier this year.
“When the new legislation passed, it had specifics in there we need to do, and if we don’t meet those, you’re out of compliance or you’re not eligible to be considered a program, so all those had to be created new,” he said. “… You have to have in there, as if you’re setting up a whole new program, from scratch, based on what someone created at the state level.
“… On our level, my role is still with COVID and getting back the financial status of the county, before I can jump into finishing the needle exchange program, with the paperwork and documentation that’s necessary. Some of it’s been developed and reviewed, but we haven’t officially submitted to approve a new needle exchange.”
Gamble said the program hasn’t been paused indefinitely, and that he expects the program will be back up and running at some point over the summer.
“It’s not an indefinite hold. Public health saw this as a viable program many years ago, and it worked very well at what it was supposed to do,” he said. “… It still has a viable public health basis. Unfortunately, what it also needs to do is have all these other components that the state said, ‘If you want a needle exchange, you have to do the following.’
“Those are the ones that are a little more difficult to have in place, or to make sure you have the agreements,” Gamble continued, “and it takes a little manpower to put those all together, make sure you’re ready and functioning, and as an administrator, I have to pick and choose what I can do. If COVID’s still it, … and finances, some things have to be put on hold for a couple more months until my time’s freed up.”
The county began its needle exchange program in 2015 in response to an HIV epidemic in southern Indiana, which was linked to the sharing of infected needles. In 2021, Gamble had voiced concerns that discontinuing the local needle exchange may cause issues, as dozens came to exchange their needles on a weekly basis.
While Gamble hasn’t seen a corresponding increase in health problems linked to the pausing of the program, he said that some diseases may go unnoticed until the person gets an exam. Such diseases, he said, can spread rapidly.
“When we started back in 2015, it was done to head off a potential explosion of cases as we’d seen in Indiana with HIV,” he said. “It was being seen in the community that individuals were sharing drugs and items. … The idea was put in place to hopefully control that.
“We haven’t seen that, but an outbreak of that magnitude can happen very quickly. It’s not a trickle of cases, but rather something where you’re like, ‘Where did these cases all come from?’”
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