Why this KY heroin needle exchange has no takers

Posted at 6:16 AM, Nov 13, 2015
and last updated 2015-11-13 06:16:31-05

FALMOUTH, Ky.  — A needle exchange-program in rural Pendleton County has been open for nearly two months, yet not a single heroin user has gone there.

“We really anticipated that on the first day (we opened), the media would show up, and there would be a line out the door for people to get these needles,” said Jim Thaxton, coordinator for the Northern Kentucky Heroin Impact Response Task Force.  “It never happened.”

That was in September. The Three Rivers District Health Department in Falmouth, Kentucky hasn’t had an needle-exchange client since.

“It’s frustrating,” Thaxton said. “We’re not trying to be in the needle-exchange business. We’re trying to be in the helping people get healthy and find recovery business."

The Kentucky General Assembly passed a law in March that allows local governments to create needle exchanges to cut down on blood-borne diseases that heroin addicts spread by sharing needles — like Hepatitis C and HIV. The needle exchange component of the state's heroin bill was one of the sticking points that kept it from passing until the final moments of the Assembly. Because county and city governments must approve them, setting up the exchanges can sometimes come with a fight.

The Pendleton County program, open from 1 to 3 p.m. on Mondays, is one of just three in the state that allows heroin users to swap out dirty syringes in exchange for free clean ones. Lexington and Louisville also have needle-exchanges. Lexington’s program has collected more than 2,000 dirty needles, and Louisville's has had more than 1,000 participants since opening last fall. 

So Why Is No One Biting?

Lexington and Louisville are much larger than Pendleton County, which has nearly 15,000 people. Falmouth has just over 2,100 residents. But this rural community does have a heroin problem.

The absence of clients has shocked Thaxton and others, including Falmouth Police Chief Benny Johnson.

Johnson knows his community has addicts that could benefit from the sterile needles, and like many small-town police chiefs, he knows most of them by name.

“This is one of those things that I thought would be a huge success,” Johnson said. “It seems as though we’re right in that pipeline where (heroin is) cheap and accessible and easy to get."

Thaxton, who helped launch the program, said he thinks addicts aren’t coming to the exchange because they’re afraid of leaving in a police car.

“If you understand rural Kentucky, everyone knows what everybody is doing. They’re all on social media. It was unfortunate that right as the exchange was beginning to get going, there was a lot of chit chat and topics on Facebook and Twitter that this was just a scam to get people arrested and that there would be police waiting outside in the parking lot to pick these people up,” Thaxton said.

That’s a battle that many needle exchanges encounter right off the bat, including the Cincinnati Exchange Project.

Libby Harrison runs that program, which has exchanged almost 19,000 syringes to the nearly 1,500 people since it opened in February 2014. But in the first month the Cincinnati exchange was open, only one person showed up to the RV where the program is housed, Harrison said.

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“It is totally normal,” Harrison said. “People will be driving by and checking it out, looking to see if there are any cops near it. They're probably being watched at this point."

Despite fear from addicts that the Falmouth needle-exchange is a ploy to land them in jail, Johnson said the police department is on board with the exchange and won’t get in the way of addicts who want to trade in their needles.

“We’re not going to sit there and watch the needle drop off points. For the most part, in all reality, we know who the users are. This is about a quality of life — not just for the drug users, but for the people who live in the city where drug users are discarding their needles in unsafe places,” said Johnson.

“If we catch them on the street with drugs, we are going to deal with it. However, for them to exchange needles, I’d highly recommend that they do."

Just like most needle-exchanges across the country, the Pendleton County program isn't designed to encourage drug use. Thaxton said the goal is to get needles off of playgrounds and sidewalks and to introduce addicts to recovery resources while health professionals have a chance to captivate them.

“The needles are a small part of it. It’s like encouraging a kid have his tonsillectomy because he’s going to get ice cream. It's an enticement,” he said.

No Clients: What's Next? 

It only takes one person to make or break a needle-exchange program's success, experts said.

“As long as they get there safely and they get home safely, they will tell their friends everything was fine. If they get pulled over once they are leaving — even if it’s three miles away and has nothing to do with the exchange — they will tell everyone they were followed for three miles and they got pulled over,” Harrison said.

Thaxton plans to propose a list of changes to program leaders that might solve the problem. He said those changes likely will include a new time the needle-exchange is open for business and a peer-to-peer approach, where the health department would recruit a recovering addict to talk to current users about the exchange.

He said that's how the Pendleton County Health Center and Northern Kentucky People Advocating for Recovery had success with a program where they gave out Naxalone, the drug that’s used to treat overdoses in emergency situations.

“It was a gentleman in recovery who went out and said, ‘You need to have this,’” he said, adding that it took three months to get anyone to show up. 

How to Get Clean Needles in Pendleton County:

Visit the Three Rivers District Health Department on Mondays from 1 to 3 p.m. 

Address: 329 Highway 330 West Falmouth, KY 41040

Phone: (859) 654-6985

*You do not need to live in Pendleton County to use the free needle exchange program.