Mountains of need

Needle-exchange programs are critical to public health.

NEPs distribute sterile needles to drug users, often in exchange for dirty used needles. Rates of hepatitis B are rising in Appalachia due to intravenous drug use. Hepatitis B, however, is not the worst of our worries. Also on the rise are HIV and hepatitis C. These illnesses may be contracted through shared needles but spread to any sexual partners of the infected and cause health risks to countless others.

Exchanges have halted the rapid growth, with one particularly necessary site in Scott County, Ind., reporting a significant reduction in needle reuse and a leveling off of HIV cases.

NEPs have yet to be implemented in areas with some of the most devastating heroin and intravenous drug use, including Eastern Kentucky, perhaps because they are viewed as enablers or due to expense. Operating one NEP is cheaper than the lifetime treatment of one HIV case. Needles cost pennies, and the sites are usually within other agencies. Most important is the concept of harm reduction – decreasing the risk to public health and of contracting HIV or hepatitis when the cheap and responsible answer is available, if only we support it.

This story was originally published February 17, 2016 at 1:58 PM with the headline "Mountains of need."