With the recent signing of a comprehensive law to address the growing heroin epidemic in Kentucky, legislators acted decisively in support of policies that are critical to improving public health in Kentucky and the lives of Kentucky residents affected by addiction, including many of our patients at the Bluegrass Care Clinic.
Our state legislators and governor are to be applauded for letting public health and science drive them in negotiating and ensuring immediate implementation of this important law.
Kentucky has one of the highest rates of acute hepatitis C in the country. According to the Centers for Disease Control and Prevention, we have seen a dramatic increase in hepatitis C infections, with a majority of them occurring in young people who live in non-urban areas, with a history of injection drug use, and who have used opioid agonists such as oxycodone.
In our infectious diseases practice, hepatitis C and other infections such as endocarditis, have compromised the lives of too many Kentuckians. Until now, we have been frustrated by our inability to employ the full range of effective tools available to prevent infections and help patients address their addiction.
The new law emphasizes medical interventions that include expanding access to medicine to reverse heroin overdoses and increasing access to addiction counseling and treatment. It also includes a needle exchange program provision — a well-proven tool for preventing the spread of viral hepatitis, HIV and other infections. The provision will allow local jurisdictions to establish programs that provide clean needles and syringes in exchange for used ones.
The importance of that intervention has been illustrated most recently by new data from the Centers for Disease Control and Prevention highlighting links between HIV infection and injecting drug use, while also showing how this affects us all.
The data, published in the agency's Morbidity and Mortality Weekly Report (the publication that 34 years ago recognized the beginnings of the epidemic that would come to be known as AIDS) was gathered from 20 U.S. cities in 2012. It showed that of more than 10,000 injecting drug users tested for HIV, 11 percent are living with the virus that leads to AIDS.
Of those who answered interview questions, 30 percent reported injecting themselves with a syringe that was shared with other people. The risk this data illustrates is not restricted to people who inject drugs; the great majority of those interviewed also reported having sex without using condoms.
While the new law is comprehensive and ambitious, it will be up to policymakers at the local and federal levels to ensure it benefits those at risk. Local jurisdictions need to seize this opportunity and implement these programs.
Funding to support the continuum of services from syringe exchange to substance use treatment will be critical to stop this epidemic, and Congress should permit federal funds to support all of these services, including syringe exchange programs. It is now up to state and federal policymakers to consider the data and our state's public health.