Senate committee wrong to limit needle exchanges

Lexington’s needle-exchange program provides needles such as these.
Lexington’s needle-exchange program provides needles such as these. palcala@herald-leader.com

Ironies abound whenever the General Assembly meets, but Sen. Ralph Alvarado, R-Winchester, a physician, endorsed one of the most profound and disturbing of this session.

Alvarado voted to assure that more dirty hypodermic needles will be in circulation, spreading deadly blood-borne infections. He did this by supporting a noxious change in the Senate to a simple bill that had easily passed the House.

House Bill 160 instructs the Department of Public Health to set up guidelines for proper disposal of needles and other sharp devices used to self-administer medications and to promote “flexible and convenient disposal methods.”

Rep. Mike Denham, D-Maysville, sponsored the bill at the request of landfill operators, who said workers risk being stuck by dirty needles. Denham also said transportation workers are “finding hypodermic needles everywhere.”

A committee substitute — presented by Sen. Julie Raque Adams, chair of the Senate’s Health and Welfare committee — scratched an itch that has been bothering some legislators since last year’s landmark heroin legislation. The heroin laws included a provision allowing local communities to establish, at their own expense, needle exchanges.

These exchanges, operating in many states for years, give IV-drug users clean needles, usually in exchange for dirty ones. They also typically provide free testing for hepatitis and HIV, treatment for those who test positive, referrals for drug treatment, and containers for safely disposing of dirty needles.

What’s disturbed Raque Adams, Alvarado and others is that the exchanges are not all 1-to-1; some give out more clean needles than the dirty needles turned in, even though the Kentucky Attorney General has issued an opinion saying a 1-to-1 exchange isn’t required.

When Denham’s bill came up in the Senate’s Health and Welfare Committee, where Alvarado is co-chair, language had been added to require that needle exchanges be done only on a 1-to1 basis. Alvarado said in an interview with Kentucky Health News after the committee action, that the intent last year was to have 1-to-1 exchanges.

The new version of Denham’s benign bill returned to the House this week for consideration but is unlikely to, and shouldn’t get, any traction there. Eight counties have established needle-exchanges in the last year. Some do require 1-to-1 exchanges, but Jefferson County doesn’t.

Since it became the first exchange in Kentucky last June, the rate of clean needles distributed to dirty collected has dropped from almost 8-to-1 to about 1.3-to-1. There are fewer dirty needles in homes, by the sides of roads, on playgrounds and in landfills.

As admirable as Denham’s bill is, the needle exchanges can’t be sacrificed to pass it. Kentucky leads the nation in the incidence of hepatitis C. Exchanges have been shown to limit the spread of this serious and expensive disease. Dirty needles shared with other drug users or discarded endanger anyone who comes into contact with them.

As Sen. Denise Harper-Angel, D-Louisville, said as she voted “no” on the committee substitute, “the effort here is to diminish disease.”

This editorial has been updated to clarify that the needle-exchange limit was not an amendment sponsored by Sen. Ralph Alvarado. It is part of substitute legislation by the Senate Health and Welfare Committee, which Alvarado co-chairs.