ANDERSON — Through an agreement between the Madison County Board of Health and Prosecutor Rodney Cummings, the county's controversial needle program will be modified to a true "one-for-one" exchange.
The board of health voted Thursday to make adjustments to the local program, including tighter controls over the distribution of clean needles to drug addicts to stanch the spread of HIV and hepatitis C.
Under the new policy, drug addicts will receive clean needles to match the number of used needles they return. For instance, if a participant is given 40 needles on an initial visit and then returns just 20, the participant will receive only 20 new needles.
Before the policy revision, addicts could receive more clean needles than the number returned.
In another change, the health board agreed to return the “cooker” to the kits being distributed but, addressing concerns raised by Cummings, removed tourniquets from the kits. The cooker is a metal bowl, a little larger than a quarter, used for cooking drugs.
In June, the health board voted to remove the cooker from the needle exchange kits after Cummings raised concerns. But on Thursday, the prosecutor requested — and the board approved — the return of the cooker to the kits.
"The cooker is as important as the needle,” Cummings said, alluding to the possibility of disease transmission through a shared cooker. “I’m going to support the cooker.”
Cummings said he couldn’t support the inclusion of tourniquets in the kits, since tourniquets typically don't contribute to the spread of disease.
“I waited two years to say anything,” Cummings said. “It has not been a needle exchange program, it has been a needle giveaway. People are finding needles in the parks and parking lots.”
Previously Cummings maintained the health department only has legal authority to distribute the needles but not other items in the kits that were being distributed.
Stephenie Grimes, who oversees the program, said the exchange rate in the county is approximately 42 percent and in the past three months has been in the 90 percent range.
“I’m trying to be as accommodating as I can to the medical community,” Cummings said. “There are some benefits. But you have to look at what is happening in our community. Syringe possession charges have increased from 70 to 262, and the jail is overcrowded.”
Grimes said 500 people are signed up as participants in the local program with an average of 120 visits per month.
“There needs to be better education,” board member Carol Purdy said. “There needs to be more cooperation among those on the front lines, including law enforcement and the medical community. My concern is we’re not working together.”
Dr. Phil Goshert, a board member, said data show the needle exchange program doesn’t increase drug use but it does prevent the spread of hepatitis C and HIV.
“It’s an emotional issue,” he said. “The reality is if there is one needle all the abusers will use it. This is a safe venue for them.”
Goshert said the community needs treatment programs.
The Madison County Council is expected to consider a proposed ordinance introduced by councilman Brent Holland to prohibit the use of money from grants or donations of monetary value to be used to fund the syringe exchange program.
Holland was given an additional month in July to get a second legal opinion on whether the ordinance was legal or allegedly usurped power from the county commissioners.
The council tabled the request in June, and it appeared a majority of the council was opposed to the health department using a $15,000 donation to purchase syringes, but thought it was OK to accept donations of syringes.
At its June meeting, the health board voted to establish set hours and locations for the exchange of needles.