The ink from Gov. Steve Beshear's signature had barely dried on anti-heroin legislation Wednesday when Lexington leaders said their city might go first in establishing one of the bill's key provisions, a needle-exchange program for drug addicts.
Senate Bill 192 allows local health departments to give clean needles and syringes to intravenous drug users in exchange for their used paraphernalia, with no criminal penalty for the drug users.
Under the new law, the Lexington-Fayette County Board of Health and the Urban County Council must authorize the program. Leaders of both bodies said Wednesday that they plan to push for the program in coming days.
Dr. Rice Leach, commissioner of the county health department, said he watched the heroin bill's progress through the legislature and he welcomes the chance to launch a needle exchange.
"We're going to be looking at this very closely over the course of the next week, to study the statute and see what we'd have to deal with," health board chairman Scott White said. "Of course, it's a board decision. But I'm going to be advocating for it as board chairman. At the end of the day, it's a positive public health development."
Lexington Vice Mayor Steve Kay, who presides over the Urban County Council, said he will put needle exchanges on the council agenda for discussion when it returns from a break in two weeks.
"I would personally be interested in getting this into place as soon as possible. From what I understand about these programs, they're beneficial for the community," Kay said. "I can expect that all council people would be interested in having this discussion."
Like the rest of Kentucky, Fayette County has experienced a surge in heroin overdoses over the past five years. A report last summer from the Kentucky Office of Drug Control Policy showed that the state's largest increase in the raw number of overdose fatalities occurred in Fayette County, with 86 deaths in 2013, up from 74 in 2012.
Supporters of needle exchanges say they bring drug users into the public health system, where they can get addiction counseling and medical care; reduce the transmission of blood-borne diseases like HIV and hepatitis C among addicts; and cut down on the number of contaminated needles littering parks, streets and other public places.
Some conservative lawmakers in the General Assembly said they were uncomfortable with the idea of a public program helping people to use illegal drugs. But the House and Senate ultimately passed a compromise bill that left the decision up to local governments.
As of last year, nearly 200 cities in 33 states operated needle exchanges. They include Cincinnati and Portsmouth, Ohio, along Kentucky's state line, and Nashville and Indianapolis.
Scientific research tends to support the programs' value. A 1997 study, published in the British medical journal The Lancet, examined HIV infection rates among intravenous drug users in 81 cities around the world. Cities with needle exchanges saw a 5.8 percent drop in annual HIV infections compared with a 5.9 percent increase in cities without the programs, according to the study.
White, at the board of health, said Lexington officials first would want to answer certain questions, including how the health department should dispose of the contaminated drug paraphernalia and whether its current liability insurance is adequate for accidental needle sticks or overdoses by addicts using a provided needle. Other communities have resolved those issues, White said. "This is of the utmost priority to me," White said. "I know of two people who OD'd and died just last week."
In addition to the needle-exchange program, Senate Bill 192 includes tougher prison sentences for heroin dealers; greater access by emergency workers to naloxone, a drug that can reverse the effects of a heroin overdose; more state funding and Medicaid support for addiction treatment programs; and "Good Samaritan" language that would protect drug users from criminal charges if they report an overdose to the authorities.
The bill contained an emergency clause, which means it became law as soon as Beshear signed it Wednesday morning.