The Indiana State Department of Health (ISDH) recently approved a syringe exchange program (SEP) in Lawrence County on the heels of the county declaring a hepatitis C health emergency. Lawrence county joins 6 other counties in Indiana to have completed the needed steps outlined in SEA 461 to operate a SEP in Indiana. Scott County, the epicenter of a HIV/HCV outbreak in 2015, was the first county in Indiana to approve a SEP.
If you’re unfamiliar, SEPs are places where persons who inject drugs can go to dispose of used syringes and get new sterile ones, as well as counseling, education and treatment referrals if they so desire. SEPs are proven to reduce the number of people contracting HIV/Hepatitis C as well as the occurrence of overdose and other poor health outcomes like endocarditis (heart infection) and abscesses (pus filled infections) while also increasing retention in abstinence based substance treatment facilities.
In Vanderburgh County, where I reside, a SEP has yet to be approved. This is in part because the county health commissioner feels as though we have not yet reached high enough levels of HIV/HCV occurrence to warrant declaring a health emergency. This is important because per SEA 461 each county health commissioner must move the first lever of approving an SEP by declaring a health emergency. Vanderburgh county has yet to move forward with even beginning the process of applying for a SEP despite the fact that we have 3x as many confirmed overdoses this year as we had all of last year, and relatively clear indicators of rising HCV occurrence.
As we continue to address policy issues around HCV + people accessing medical care and ramp up efforts at removing restrictions on insurance approval of medications that result in rationing, we must also remain steadfast in the effort to embed harm reduction prevention strategies in high risk communities. Where high rates of hepatitis C occur often high rates of HIV will follow. Prevention means being pragmatic and proactive. A handful of other counties throughout Indiana have pending applications for SEPs. Vanderburgh county is not one of them, but it needs to be and sooner rather than later.