Cecil County Health Dept. Considers Addicts’ Needle Exchange, After 3 Years of Talk; County Council Politically Wary but County Exec Backs Effort

But, as a consultant outlined the grim statistics of the opioid crisis to the County Council on Tuesday (8//14/2018), members of the Council sought to avoid any political responsibility for making a decision on whether to create such a program here.

However, the pioneer of needle exchange programs in the state, Baltimore City, has shown extraordinary reductions in HIV infection rates due to its program, city officials told Cecil Times.

Councilor Jackie Gregory (R-5) said the County Council does not have “a lot to say” about drug policy and it was up to the Health Department to decide. She said the real problem was that addicts were getting “a lot of bad drugs,” including heroin laced with the deadly fentanyl, not infections from re-use of needles. She also said she was concerned that addicts would be getting “free needles “at taxpayer expense. She added that she thought the Health Department could decide the issue on its own and that the County Council should not have to vote on the matter.

Councilor Dan Schneckenburger (R-3) said that the “general public… is not going to be responsive” to such a program although “first responders,” such as ambulance crews and law enforcement officers who face risks of infections from dealing with addicts, would probably support such a plan.

Councilor Bob Meffley (R-1) said that most county residents would oppose such a program, and might think that “next we’re going to give them drugs.” He said the Health Department needed to create a PR campaign to “sell it” as a policy.

As Council members looked for ways to avoid any political responsibility for creation of such a program, County Executive Alan McCarthy stepped forward at the worksession to say he supported it.

“I’m very much in favor of this program,” McCarthy told the Council. “The benefits outweigh the problems,” he said. After the meeting, McCarthy told Cecil Times he was very concerned about addicts dumping used needles in parks, school playgrounds and other areas where children and innocent citizens might come into contact with needles and risk infection with HIV or Hepatitis C. “This is really a public health problem,” he said.

Health officials said that state health programs were stepping up aid for initiatives to address the opioid crisis and that if a needle exchange program were initiated here, it would most likely be paid for with state aid. Currently, the Cecil County Health Department, which is an official state agency, still gets over 25 percent of its annual budget from local Cecil County taxpayer-provided funds.

Meanwhile, Sonia Pandid, a consultant to the local Health Department, outlined a study she conducted of local drug addicts and their habits regarding needles, and reported that Cecil County had the highest Hepatitis-C rate in the state in 2015. She said that a needle exchange program, coupled with treatment services and “intervention” initiatives, was part of a “harm reduction strategy.”

She said her survey, including interviews with drug addicts, found that local addicts re-used needles or shared them with others as much as 12 times—thus increasing the risk of blood-borne infections.

The county Health Department, which is currently in a state of transition since Health Officer Stephanie Garrity announced her retirement as of September and has been on leave for most of the summer, did not put forward an agenda or official plan for adopting a needle exchange program. Garrity, who held a business degree and no professional medical or public health credentials and often appeared before the County Council without knowledge of data on the opioid crisis, will be replaced by the state, but with significant input and review by the County Executive.

Whoever replaces Garrity might be well advised to look for guidance to the Baltimore City Department of Health, whose Health Commissioner, Dr. Leana Wen, is a medical doctor and a leading force in the state on drug addiction and public health issues.

Baltimore City, which has consistently had the highest drug overdose death rate in the state, was a pioneer in needle exchange programs, which began there in 1994. A key result of the program has been a stunning reduction in HIV/AIDS infections among drug users, dropping from 54 percent of new HIV cases related to intravenous drug usage in 1994 to just 8 percent in 2017, according to Dr. Patrick Chaulk, assistant commissioner for HIV and sexually transmitted diseases at the Baltimore City Health Department.

(Medical treatment for an HIV-positive patient, an addict or sexual partners infected by a drug user, can cost as much as $400,000 over the course of a lifetime, the health consultant told the Cecil County Council.)

In an interview with Cecil Times, Dr. Chaulk outlined the extensive needle exchange program that has been expanded under the leadership of Dr. Wen. The city uses a system of 15 mobile vans to reach addicts where they live in the most drug-addicted neighborhoods. In addition, a church in the Hampden neighborhood—a formerly working-class area that has in recent years become “trendy” with many boutiques and restaurants—recently volunteered to host a needle exchange program along with social services outreach efforts. The city has plans to open another five new sites soon.

The city’s needle exchange program, which includes information on treatment programs and counseling services, operates every day, except Sunday, and visits locations morning, afternoon and evening to reach out to drug users, Dr. Chaulk said. Some mobile sites reach 100 to 200 people per day, he said, and they include overdose prevention information and training.

Since Dr. Wen is a medical doctor, the city was the first jurisdiction in the state to have broad access to Narcan—a medication which reverses a drug overdose and saves lives—because Dr. Wen was able to issue a broad prescription for the drug for her “patients”—all city residents.

Last year, the city’s needle exchange program reached out to over 3,500 patients, and 950 lives were saved with administration of Narcan to overdose victims, Dr. Chaulk said. There were 1.4 million needles distributed, and 78 percent of them were covered by exchanges of used needles.

Key to the success of the program, Dr. Chaulk said, is that health workers develop relationships with addicts, encourage them to seek treatment, and interact with them in a positive fashion. “They are not low-lifes, they are not just ‘junkies.’ They are people, with a disease, and they need help.”