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LOUISVILLE, Ky. (AP) — Swaps of old needles for new ones aren't required for participation in local needle-exchange programs in Kentucky, Attorney General Jack Conway's office said in an opinion requested by a top state lawmaker.
Local health departments participating in the programs have the latitude to provide syringes even if participants don't bring in old needles, said Assistant Attorney General Matt James, who wrote the opinion dated last Friday.
The opinion was requested by Kentucky Senate President Robert Stivers, R-Manchester.
Needle exchanges surfaced as a contentious issue when Kentucky lawmakers worked on sweeping legislation this year to combat the state's heroin scourge. The final product passed into law allows local governments to set up needle-exchange programs.
The new law also toughened penalties for heroin dealers of at least 60 grams and increased spending on substance abuse treatment programs.
The goal of needle exchanges is to prevent the spread of HIV and hepatitis C and to steer drug users toward treatment.
Kentucky has had the nation's highest rate of acute hepatitis C.
The AG's opinion delved specifically into the needle-exchange program in Kentucky's largest city.
The program in Louisville allows syringes to be provided to participants regardless of whether they exchange old needles.
The attorney general's office was asked whether such a program is consistent with provisions of the state's anti-heroin law.
James wrote that "as applied in this context, 'exchange' does not require a quid pro quo exchange of syringes; it only requires a benefit to the party promising or a loss to the party to whom the promise is made."
Therefore, a needle-exchange program "may exchange the loss of a needle for a promise to participate in the program, and that is sufficient for an exchange in the ordinary sense of the term," he said.
James added that if the state General Assembly had wanted to limit needle exchanges to a specific type of program, it could have done so.
Stivers did not comment immediately on the AG's opinion.
Dr. Sarah Moyer, Louisville's interim public health and wellness director, said the city's needle-exchange program is following a model that has proven effective across the country in reducing the spread of HIV and hepatitis C.
"Our goals are to prevent the spread of those diseases in our community and to stop people who inject drugs from sharing and reusing needles," she said Monday. "The program is working."
Since June, when Louisville's needle-exchange program started, more than 1,500 people have participated, Moyer said. Participants can be tested for hepatitis C, and people testing positive are connected with treatment. Participants also can be referred to drug treatment.
In Louisville, the exchange ratio is down to two syringes handed out for every old needle turned in, she said.
As expected, the ratio was much higher early on — about eight or nine syringes provided for every old needled turned in, health officials said.
"It was a brand new program, and you're reaching people who have not had access to it before and may not have had any syringes whatsoever to bring in," said Kathy Harrison, a spokeswoman for the city's public health and wellness agency.
In Kentucky, needle-exchange programs also are operating in Lexington and Pendleton County in northern Kentucky, state health officials said.
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