UC Professor Receives Grants to Fight Spread of HIV, Hepatitis & Drug Abuse

CINCINNATI - A syringe exchange and drug education program spearheaded by a University of Cincinnati (UC) professor will begin offering services in Hamilton County on Feb. 10 in an effort to combat the spread of HIV and hepatitis C among drug users.

The public health initiative is known as the Cincinnati Exchange Project and will operate from a medical RV initially at Olde Gate Plaza, 290 Northland Blvd. in Springdale, with hopes of traveling to other locations in Hamilton County once community approval is secured, said Judith Feinberg, MD, professor of internal medicine at UC.

"I know from my previous work with HIV that there are proven methods of keeping drug users safe and free from HIV infection, and also from hepatitis C infection, if you provide them with sterile syringes, cotton and the other items,” says Feinberg. "We don’t want people using heroin, and we certainly want to encourage them to enter drug treatment. If they’re not yet ready for recovery, then we want to keep them healthy and alive until they are. Our ultimate goals are to see them clean from drugs and disease free.”

Springdale officials approved the program in 2013. This is the first syringe exchange program in Hamilton County and only the third in Ohio, with programs operating in Cleveland and Portsmouth. The exchange project will operate initially on Mondays from 10 a.m. until 2 p.m. and Thursdays from 3 to 7 p.m.

"Our eventual plan is to go to multiple locations,” says Adam Reilly, project director for the Cincinnati Exchange Project. "In other cities brick-and-mortar sites have become outdated and aren’t the best model for helping drug users in Greater Cincinnati because our epidemic is so dispersed; it really affects suburban and rural areas.”

The Cincinnati Exchange Project partnered with Interact for Health to move the syringe exchange program forward. Interact for Health provided a $50,000 one-year grant to fund a project coordinator and pay for supplies to allow a one-for-one exchange of sterile syringes for used ones and to provide sterile cotton and other items to area drug users.

"Reducing infections caused by using dirty needles is one step in battling our heroin epidemic,” says Ann Barnum, senior program officer at Interact for Health. "Syringe exchange programs are a proven method of saving lives and engaging people into treatment. Our goal is to help people now and to prevent future use of injection drugs.”

Feinberg explains that clean syringes may prevent HIV, but more is needed to stop hepatitis C from spreading. "You also have to give people clean cotton and other items used for injection,” says Feinberg, who notes that the cost of treating hepatitis C can be as much as $100,000 per patient.

"They need clean injection supplies because hepatitis C can remain infectious on inanimate surfaces like cottons for up to nine weeks. This makes it is easier to spread hepatitis C from injecting, and like HIV, it is an expensive and difficult infection to control,” says Feinberg, who is also medical director of the Cincinnati Exchange Project.

A $48,000 two-year grant from the Ohio Department of Health will allow the exchange project to provide nasal naloxone to drug users and their families to prevent fatal drug overdoses, says Feinberg. Injected naloxone has been used for many years in hospital emergency rooms to revive people who have overdosed on narcotics.

Training drug users and their loved ones to administer nasal naloxone could save lives, says Feinberg.

"The project’s initial work in Springdale is the result of the efforts of the Springdale Board of Health, health commissioner, mayor and city council and we want to thank them for their support of this public health initiative,” says Feinberg. "Creating a syringe exchange program is never easy in any community, but Springdale stepped up to the task and is showing the difference one jurisdiction can make in an epidemic.”

Springdale Health Commissioner Cammie  Mitrione says the Cincinnati Exchange Project’s infectious disease mobile unit will provide an important public service.

"This initiative will provide the opportunity to inform drug users about the risks and alternative options available to them and can be a first step in the recovery process,” said Mitrione. "As more funding, more treatment facilities, and options such as the infectious disease mobile unit become available to people caught in the cycle of addiction, more lives will be saved.”

Cincinnati Exchange Project staff and volunteers will also offer on-site rapid HIV, hepatitis C and pregnancy tests and will provide referrals to drug treatment programs and medical care, including mental health and infectious diseases services, says Feinberg.

"If we identify pregnant addicts we can refer them to programs that can get them into treatment right away, so immediate care is available for the newborn,” says Feinberg. The exchange project is also working with local drug treatment programs to get non-pregnant addicts into treatment as soon as possible.

Providing clean drug paraphernalia is important to halt the spread of disease not only among users but to the general public, says Feinberg.  Law enforcement officers, sanitation workers, children and others who come in contact with used syringes left in public places could be at risk of acquiring hepatitis C. An exchange program gives value to discarded used syringes; drug users will bring these items to the program for exchange rather than leave them in public areas like parks

Feinberg says heroin addiction has grown significantly in greater Cincinnati during the past decade spurred by a spike in the cost of illegally distributed prescription drugs. Heroin is a much cheaper option, but injecting it puts drug users at risk of endocarditis, a serious heart infection, says Feinberg.

A cluster of endocarditis cases in 2005 tipped Feinberg off to heroin becoming a problem locally.

"Through the repeated interaction between syringe exchange program staff and injection drug users, sooner or later a proportion will come to trust you,” says Feinberg.  "Some will come in and say, ‘I’ve got to get off this stuff’ and then we are there to help them.”

"The idea is to keep users healthy, and to keep them alive, until they are ready for a drug recovery program,” says Feinberg. "Will that be 100 percent of the people? No. It won’t be 100 percent of anybody with any substance abuse problem.”

"But there are a significant number of people whose lives we can help improve and return them to their families as productive citizens,” says Feinberg. "Every addict is someone’s child, parent, sibling or spouse.  It’s a terrible problem that can destroy families.  We want to prevent that as much as possible.”

Feinberg says that the Cincinnati Exchange Project is operating on a modest budget and hopes to secure future grant funding and donations to remain viable.

For more information about the Cincinnati Exchange Project please call 513-584-5349 or visit www.CincyEP.org.