A nonprofit publication of the Kentucky Center for Public Service Journalism

KY has 59 operating syringe exchanges and six in the wait; public-health advocates credited for increase


By Melissa Patrick
Kentucky Health News

Kentucky is lauded nationwide for its embrace of syringe exchanges to thwart the spread of HIV and hepatitis C among intravenous drug users, but getting them approved locally continues to be a challenge and generally only happens after months, or even years, of educating the public.

Van Ingram, executive director of the Kentucky Office of Drug Control Policy, attributed the success of Kentucky’s syringe exchanges to the ongoing efforts of the state’s public health workers, who promote the exchanges as “harm reduction programs.”

“It’s just great public health advocacy at the local level, who just wouldn’t give up,” Ingram said July 11 at a health-related forum in Covington.

He was speaking broadly about the state’s many efforts to battle the opioid epidemic, including a 2015 law that allows syringe exchanges with approval of the county health board and fiscal court and the legislative body of the city where the exchange is to be located.

Kentucky has 59 operating syringe exchange locations in 52 of its 120 counties, with six more approved but not operational. Since mid-February, when Kentucky Health News did its last syringe exchange roundup, 11 additional counties have been marked on the state health cabinet’s map of exchanges.

Since February, Henderson, Hopkins, Taylor and Owen counties have been added to the map and are identified as operational locations. Magoffin County was also recently added.

Among the 54 Kentucky counties the federal Centers for Disease Control and Prevention has identified as being the most vulnerable to outbreaks of HIV and hepatitis C among IV drug users, 33 have approved an exchange, with 29 of them operational.

The vulnerable counties that have not approved an exchange are Allen, Bell, Breckinridge, Carroll, Casey, Clinton, Cumberland, Edmonson, Gallatin, Grayson, Green, Harlan, Hickman, Johnson, Lawrence, Lewis, Martin, Menifee, Monroe, Rockcastle and Wayne.

Bath, Estill, Knott, and Leslie counties, which are included on the list of 54, were recently added to the exchange map, as have Todd County in Western Kentucky and Scott County in the Bluegrass region. These exchanges are marked as not yet operational.

State Sen. Whitney Westerfield of Hopkinsville “still thinks some of his colleagues are uneasy” about syringe exchanges, Max Blau reports for Stateline. “But he’s still hopeful that the results will mirror that of the CDC’s research, which shows that injection drug users who have access to syringe exchanges are five times more likely to get treatment than those who don’t.

“There’s not universal support, but we’ve moved in that direction,” Westerfield said. “I don’t see the people who hated [syringe exchanges] filing bills to reverse it. With harm reduction, there’s more general acceptance of it.”

Western Kentucky has been slow to adopt such programs, but that could be changing; three of the eight syringe exchanges west of Louisville are among the newest.

Henderson County’s exchange offers an example of the importance of persistent public health advocacy and education when it comes to getting these exchanges approved.

Clayton Horton, the health department’s director, told Charles Taylor of the National Association of Counties about the importance of getting buy-in from the community.

“That required us to do a lot of education and do some advocacy with local governmental bodies,” he said. “We weren’t asking for resources; we’re weren’t asking them to pay for it. But we were asking them to consent and agree and to trust us and to trust the evidence-based practice to set these up and run them.”

Taylor County approved its exchange in April. The Lake Cumberland District Health Department offers two educational videos about syringe exchanges to educate its community, one that addresses how syringe exchanges help with the cost of Hepatitis C and the other titled, “Why in the World Would You Give a Needle to a Drug Addict?” See below:

One of the more unique set-ups is the use of mobile exchanges, which Laurel, Knox, Clay and Jackson counties will share. Whitley County, which has a stationary exchange, was supposed to join the program, but has decided to not participate, according the county health department. 

Another evolution of these programs is that many of them now regularly distribute naloxone, a drug that can reverse an opioid overdose.

Click here to get a list of all the exchanges and their hours of operation, as well as a list of facts about syringe exchange programs.


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