ICBioethics Blog 

Follow-Up on Needle Exchange Program in Indiana

Written by: Leah Jeunnette, Ph.D(c)

Much has transpired since I wrote about the public health emergency in Scott County, Indiana.  Governor Pence had made an executive order in March establishing a 1-month needle exchange program, which extended for an additional month, to combat the high HIV rates transmitted via intravenous drug use. Although Indiana had banned needle exchange programs, and their governor had previously opposed them, the issue was reconsidered and one implemented out of necessity.

While the needle exchange program was found to be effective, the rates of HIV are still high. As a result, the state Congress passed a new law allowing temporary, 1-year needle exchange programs when specified criteria are met. Pence signed it into state law on May 5th.

In my initial blog, I questioned why an executive order could override legal prohibition of needle exchange programs. But now we need to turn our attention to the law itself.

This law is designed to combat the HIV transmission among IV drug users. However, the law focuses mainly on the set-up of the needle exchange programs (called syringe exchange programs in the Indiana law); it does not address what happens after the year ends . . . certainly worth pondering well in advance.

What about those intravenous drug users still at risk for HIV who have become accustomed to getting clean needles?

Will the needle exchange program stop completely, only to be re-implemented?

Will transmission rates have declined, but user numbers increased?

Is there any organized push in the works to help addicts enter treatment or rehab?

And what is an “acceptable” rate of HIV transmission for intravenous drug users—not high enough to qualify for a program — somewhere between ____ (fill in a number!) and an all-out emergency?

I’m interested to see how this unfolds. Stay tuned.

Mitch Gennuso