County data show 61 percent of new hepatitis C cases last year occurred in people who had injected drugs, an increase from 50 percent in 2014, and 37 percent in 2013.
Year-to-year data for 2016 suggest the trend is continuing. However, the county has not seen a spike in HIV cases.
Dr. Adler says the first steps to quell the spread of hepatitis C will include substance abuse counseling, testing, vaccinations and access to medical and mental health care to help people stop abusing drugs.
After the support services are in place and funding is secured, he expects the county will seek approval for a syringe exchange program.
That process requires Adler to declare an epidemic of hepatitis C or HIV exists, that the primary mode of transmission is through intravenous drug use, and that a syringe program is a medically appropriate component of the county’s public health response plan.
The county commissioners must then hold a public hearing, affirm the health officer’s emergency declaration and request a public health emergency declaration from the state, along with approval of a syringe exchange program.
Commissioner Tracy Brown, the county’s former sheriff, says some members of law enforcement may object to providing a device that will be used for an illegal activity.
“There will be folks on both sides of that debate, but that debate won’t make the problem go away,” Brown says. “We have to look at what is in the best interest of everybody in the public.”
The local infection rate has not yet reached the crisis levels of the 2014-2015 HIV and hepatitis C outbreak in Scott County that motivated the General Assembly to create a state-authorized syringe exchange program.
But Brown says the time to plan and act is now.
“We have a population that is, that may be infected with hep-C and not receiving treatment,” Brown says. “And if they are using syringes or sharing syringes, it can grow and can absolutely become an epidemic in your community.”
Adler says syringe exchanges have existed in the U.S. for about 25 years, and are scientifically proven to reduce the spread of HIV and hepatitis C in people who inject drugs without increasing drug use in a community.
Four Indiana counties – Scott, Monroe, Madison and Fayette – currently operate state-authorized syringe exchange programs.
Adler says the programs encourage drug users to seek treatment and properly dispose of needles, reducing the risk of needle stick injuries to police officers, emergency responders and the general public.