Mina "Mike" Kalfas

Community Recorder guest columnist

It’s been 10 months since Gov. Steve Beshear signed the heroin reform bill, Senate Bill 192, into law. One measure of the law was to allow, for the first time ever in Kentucky, operation of syringe access exchange programs to reduce the threat of infectious diseases spread by intravenous drug use.

In the 10 months since the law was passed, staff at the Northern Kentucky Health Department have brought together partners from the community and resources from across the country to develop a model syringe access exchange program. The proposed program is both efficient and optimizes the public health impact of such services – their ability to connect IV drug users to the health care system and addictions treatment. It would operate with existing staff at the health department’s county health centers.

It received unanimous approval from the District Board of Health. The program has funding in place for its first year of operation and staff have received much of the required training.

In the 10 months since the law was passed, elected officials in Louisville, Lexington and Pendleton County have approved such programs in those areas, and public health officials have implemented them. Louisville’s program opened in June, Lexington and Pendleton County’s began in September.

In the 10 months since the law was passed, Northern Kentucky’s IV drug users have continued to share needles. A survey conducted by the health department over the summer found that more than 85 percent of users surveyed share needles at least some of the time. Even more concerning, local IV drug users indicated that they often share needles until they break or are too dull to use.

Since the law was passed, almost 800 people in Northern Kentucky have been diagnosed with hepatitis C and more than 100 have been diagnosed with hepatitis B. Northern Kentucky was featured in a New York Times article in July about its hepatitis C rates, which are the highest in the nation. While a syringe access exchange program won’t eliminate these viruses, it can reduce their spread.

In the 10 months since the law was passed, we have not seen a rise in HIV cases, as happened in Scott County, Indiana, last spring. But the threat exists. Our window of opportunity to prevent such an outbreak could close at any time.

In the 10 months since the law was passed, the health department has educated elected officials in several Northern Kentucky cities and counties about this issue. The approval of both the city and county is required for a program to operate. Only one group –Willliamstown City Council – has considered syringe access exchange program and voted in favor, unanimously. Without Grant County’s approval, though, a program can’t operate.

It seems that a public health issue, protecting Northern Kentuckians from the spread of infectious disease, has become political. That’s a shame.

Syringe access exchange programs have been operating in other parts of the country for almost 30 years. Time and again, they have been shown to positively impact the health of the community. Such programs do not encourage people to start using drugs or increase their use. They do not increase crime in the neighborhoods in which they operate, either.

These programs are a tried and true public health intervention to reduce the burden of IV drug use. Besides stopping the spread of disease, syringe access exchange programs can connect IV drug users with treatment programs. They can provide other health services like immunizations, pregnancy testing and overdose prevention kits. Syringe access exchange programs are cost effective. For every $1 invested, up to $7 is saved in prevention of HIV treatment costs alone.

When faced with outbreaks of communicable disease, public health officials look to interventions to stop the spread. With the passage of SB 192 last March, we now have access to a tool to stop some of the horrendous impacts of the heroin epidemic on our community. It’s a tool we desperately need in Northern Kentucky. After 10 months of education and discussion, it’s time we put public health first and implement a syringe access exchange program in Northern Kentucky.

Raised in Campbell County, Dr. Mina “Mike” Kalfas is a family medicine practitioner who received his medical degree at the University of Kentucky College of Medicine and completed his residency at Bethesda Family Practice Program in Cincinnati. He is board-certified by the American Board of Family Medicine. He is a fellow of the American Academy of Family Practice. He joined The Christ Hospital Physicians after practicing in Pendleton County for 15 years as a primary care physician and as the medical director of the Alcohol and Drug Treatment Center. He is certified by the American Board of Addiction Medicine.