PITTSFIELD, Mass. — City officials are looking into whether a needle exchange program will help halt the spread of infectious diseases.
In the face of a heroin epidemic, a needle exchange program is one way to help users stop a growing number of Hepatitis C cases.
Liz Whynott, director of the Syringe Access Program for Tapestry Health, said her organization currently runs two programs in Western Massachusetts — one in Holyoke and one in Northampton — and provides a way for users of injected drugs to have access to clean needles and to dispose of used needles.
"We are anonymous. There is so much stigma and shame. People are very uncomfortable to come into a place for the first time and share that information. So they don't have to give us any identifying information. But the first time they have to sit with us and we assess their risk behavior in a conversation about what is going on in their life," Whynott said.
The organization works on "harm reduction" in hopes that for those who are continuing to use, the health issues are minimized. For those who are not in rehabilitation programs, there is still tremendous risk.
"We really work with the users who come in and talk about how they can improve their health. Because even if somebody is not in treatment, they do have the ability to make positive decisions," she said.
The stopping of disease matters because Berkshire County has a seen a massive increase in Hepatitis C, according to Berkshire Opioid Abuse Prevention Collaborative Coordinator Jennifer Kimball.
"Hepatitis C rates in the county are staggeringly high. You can't look at things as a Pittsfield problem, that's not how this works. In the first seven months of 2016 without ready access to coordinated screening and testing in any setting, close to 150 new cases of Hepatitis have been reported," Kimball said.
She estimates that less than 50 percent of those with it actually know the status of it, meaning the confirmed number is low compared to actual prevalence of the disease. She said since 2010 in Berkshire County there have been 1,100 cases of Hepatitis C diagnosed translating to a countywide rate of 8.7 people per 1,000. To date this year, there have been 150 cases with 71 of them in Pittsfield.
But what is more notable for Kimball is the age group. Of those 71 in Pittsfield, she said 43 of them are under the age of 45. In 2015, there were 140 cases with 55 in Pittsfield and 36 of those under the age of 45.
"There is a large, large hepatitis disease burden here and a severe lack of services," Kimball said.
She says if the trends continue, there will be somewhere around 250 new cases identified in Berkshire County in 2016. Added to the number of those who have not have the RNA exam perform to confirm it, she estimates more than 2,000 people are infected, which is double the national average per capita.
"We have an abnormally high rate of deaths related to HIV and Hepatitis C," she added.
Whynott said the trend of the disease is growing everywhere and Tapestry provides testing and connects patients with referral to doctors and other treatment. But, many are not seeking treatment because of access issues. She said with the population of drug users, there are challenges with transportation and economics keeping them from pursuing the care further.
"There is a very worrisome growing trend for 15- to 24-year-olds. In that age group there is a lot of Hepatitis C and a lot of them are not accessing care," she said.
A needle exchange is one way to help reduce the spread of disease, she said, and is coupled with a growing Narcan program the organization runs. Tapestry has distributed some 112 Narcan kits and provided training of how to identify when to use it, how to use it, and spot signs of an overdose. Narcan is an overdose reversal drug and she said many of those who have taken kits in all of the areas the company operates have reported using them.
"We try to target drug users because drug users are the most likely, about 10 times more likely, to witness an overdose," Whynott said.
Tapestry doesn't run a needle exchange program in Pittsfield and only recently submitted an application for approval to run one in North Adams. The organization is hoping the Board of Health will approve one for Pittsfield so it can pursue opening the program here.
"In order to open a syringe exchange we have to get approval in each town. The body that authorizes syringe exchange is the local Board of Health," Whynott said.
The company doesn't have any specific plans but wants a letter from health officials to start the process. But, the Board of Health refused to put their support to a vote without having the input from other city officials. According to Director of Health Gina Armstrong, the administration is meeting with health, law enforcement, and Tapestry Health on Thursday to consider the option.
"The board is certainly open minded to it," member Jay Green said, but he added that he is reluctant to vote to support it until more information is provided.
The board would be asked to send a letter to the state Department of Health and without that letter and further details, none of the members felt confident in doing that.
"It should be a collaborative approach," Cynthia Geyer said, piggybacking on member Steve Smith's belief that such a program transcends just the health realm.
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