I was at the Grand Traverse County Board of Commissioners meeting on April 18, 2019, when three Commissioners voted against the Harm Reduction Syringe Service grant (grant information starts on page 132 of the meeting packet). The grant would provide funding, at no cost to the County, for staffing, HIV/Hepatitis C testing, gas, travel, mobile units, supplies and testing kits, education, syringe disposal service and outreach. The County funding cannot be used for needles, syringes or injection equipment, although groups that are not part of the Grand Traverse County Health Department would provide sterile needles and syringes in exchange for used ones.
The three Commissioners that voted against the grant, Rob Hentschel, Ron Clous and Brad Jewett, should be respected for their votes. However, I believe that they are unaware of several important aspects of the program. These commissioners, and the public as well, need to be educated about the benefits of such a program. I suspect that the lack of advance information, as well as the name of the grant itself, “Syringe Service”, may have influenced their votes.
Here are some important points that need to be considered:
Hepatitis C is transmitted through contact with the blood of an infected person, primarily through sharing of contaminated needles and other drug equipment. It is also spread through needlesticks, something that can happen in health care and law enforcement settings. As well, it can be spread by sexual contact and other incidental blood contact, such as sharing personal care items like razors and toothbrushes. This means that innocent health care and law enforcement bystanders, if they are accidentally infected, can unwittingly spread the disease to loved ones.
While the primary method of transmission is by blood-to-blood contact, it’s wrong to assume that this has to be by immediate contact with an infected person’s blood. Hepatitis C is infectious outside the human body for two weeks and 64 days inside the chamber of a syringe, although other studies have shown that the virus can remain infectious outside of the body for up to 6 weeks.
What do the research data on needle exchange programs show? The results are mixed, yet most articles on the subject say that there is a need for more research. A program in New York City showed a reduction to 56% prevalence, down from 91% prevalence prior to implementation of the program.
The Michigan Department of Health and Human Services tracks Hepatitis C prevalence by county, as can be seen in the report that is cited above.
I understand some people’s reluctance to commit to a program that includes needle exchange. It might give the appearance that we as a county are lending support to illegal IV drug use. But we need to keep in mind that:
1) the Syringe Service program is primarily focused on education, intervention and treatment, not needle exchange;
2) no county funds and no county employees would be involved in exchanging needles;
3) we would be taking tangible steps to reduce the prevalence of Hepatitis C in Grand Traverse County; and
4) after the program has been in effect for a period of time, we will have data that will show whether or not it’s been effective.
The jury may be out on the efficacy of needle exchange programs, but the facts about the Hepatitis C epidemic and its impact on our society, and on Grand Traverse County, are known. Hepatitis C is highly contagious. It can easily spread outside the IV drug-injecting population. We have a big problem. We need to do something about it.