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What It Is

Syringe exchange programs (SEPs) have existed and been studied extensively in the United States since 1988. SEPs are community-based programs that provide access to sterile needles and syringes free of cost, facilitate safe disposal of used needles and syringes and offer safer injection education. SEPs in Kentucky also provide linkages to critical services and programs, including substance use disorder treatment programs; overdose prevention education; screening, care and treatment for HIV and viral hepatitis; prevention of mother-to-child transmission; hepatitis A and hepatitis B vaccination; screening for other sexually transmitted diseases and tuberculosis; partner services; and other medical, social and mental health services.

In direct response to Senate Bill 192 enacted during the 2015 regular legislative session, the Kentucky Department for Public Health has published guidelines for local health departments implementing harm reduction and syringe exchange programs.

SB 192 impacts KRS 218A.500

KY SEP Guidelines (Long Version)

KY SEP Guidelines (Short Version)

Why Does Kentucky Need Syringe Exchange Programs? 

Syringe exchange programs are designed to mitigate a number of public health issues, including emergence of a new HIV epidemic. An Indiana town near Louisville recently had an HIV outbreak among people who inject drugs. Austin, Ind. now has HIV rates comparable to those in sub-Saharan Africa. Undoubtedly, this outbreak will cost Indiana millions of dollars to treat the new HIV infections. 

Nearly half of Kentucky’s counties are at risk of an HIV outbreak
Recently the CDC analyzed every county in the United States to determine how vulnerable others might be to an HIV outbreak like the one in Indiana. Of the 220 counties across the US identified as highly vulnerable, 54 are in Kentucky (see map below). Kentucky also had had among the highest rates of hepatitis C in the nation for several years. This is foretelling, because most of these new hepatitis C infections are from people who inject drugs and share needles, cookers and other contaminated equipment. Hepatitis C rates like those in Kentucky are seen as the canary in the coal mine for an HIV outbreak. SEPs have proven capable of reducing the chance of an outbreak.

HIV map

Printable KY SEP Map formats: PDF, PNG, and PPTX 

Facts about Syringe Exchange Programs 

  • SEPs do not encourage the initiation of drug use nor do they increase the frequency of drug use among current users. (1)
  • SEPs reduce the spread of infections like HIV and viral hepatitis. (2)
  • SEPs do not increase community crime. Community residents may worry that syringe exchange locations will increase theft, sex trades, assaults, and an increase of contaminated needles on the street. However, studies have shown that syringe exchange programs actually decrease crime in the area they are located. (3)
  • SEPs increase community safety. Research shows that SEPs promote public health and safety by taking syringes off the streets and protecting law enforcement personnel from needle stick injuries, which can result in the transmission of diseases such as HIV/AIDS and hepatitis B and C. (4)
  • SEPs connect people to treatment. One study found that SEP participants are five times more likely to enter a drug treatment program than nonparticipants. (5)

Recommended Best Practices for Effective Syringe Exchange Programs in the United States 

Syringe exchange programs are central to reducing disease and other health burdens among people who inject illicit drugs. Three decades of research has demonstrated the effectiveness of SEPs in preventing HIV and other blood-borne infections, as well as connecting people who inject drugs with a range of vital medical and social services and supports. The Recommended Best Practices report from the New York City Department of Health and Mental Hygiene with the Drug Policy Alliance summarizes the consensus among United States SEP experts of the underlying principles and programmatic elements that enable or constrain SEP effectiveness. Effective SEPs have the support of local governing bodies and match sound operational characteristics with responsiveness to the unique features of their host communities. New or expanding SEPs may benefit from technical assistance from the considerable expertise of those experienced in operating SEPs around the country. The panel highlighted operational characteristics that are critical for effective SEPs, and measures to be avoided because they undermine the primary goal of SEP: to make new, sterile syringes available to PWIDs.

Characteristics of Effective SEPs (6

Promote secondary syringe distribution

  • Train and support peer educators
  • Do not impose limits on number of syringes (doing so promotes sharing of needles)
  • Maximize responsiveness to characteristics of the local PWID population
  • Adapt planning activities and service modalities to subgroup needs
  • Provide or coordinate the provision of other health and social services
  • Include diverse community stakeholders in creating a social and legal environment supportive of SEPs
  • SEP Practices to avoid (6
  • Supplying single-use syringes
  • Limiting frequency of visits and number of syringes
  • Requiring one-for-one exchange (results in sharing of needles)
  • Imposing geographic limits
  • Restricting syringe volume with unnecessary maximums
  • Requiring identifying documents
  • Requiring unnecessary data collection Hours and Locations of Syringe Exchange Programs

Kentucky Syringe Exchange Programs Locations and Hours

 Printable KY SEP Hours Schedule (three pages)

Image of KYSEP Hours page 1

Image of KYSEP Hours page 2

Image of KYSEP Hours page 3

Naloxone (Narcan) Availability

Single Signature Naloxone Prescription: Purpose 
Pharmacists are uniquely positioned to help reduce morbidity and mortality associated with opioid overdose by dispensing naloxone to at-risk patients or their friends and family members, and educating them on the proper use of these products. This non-patient specific prescription (standing order) authorized by the Kentucky Department for Public Health (KDPH) establishes the protocol that allows Kentucky-licensed naloxone protocol trained pharmacists to dispense naloxone to at-risk patients and third parties in pharmacies located in Kentucky.

Process 
Print the form below and fax to (502) 564-9377 to be registered in the KDPH program.
This non patient-specific prescription is valid for one year from the date authorized.
Download and Print the Single Signature Prescription Form

Naloxone
Naloxone (Narcan) is a prescription medication that can reverse an overdose that is caused by an opioid drug. When administered during an overdose, naloxone blocks the effects of opioids on the brain and restores breathing. It can be given as an injection into a muscle or as a nasal spray.

Where to get Naloxone in Kentucky 

Don't Let Them Die

Lethal overdoses claimed more than 1,400 lives in Kentucky last year, a 7.4 percent increase from 2015. Fentanyl, a synthetic opioid up to 50 times more potent than heroin, was a factor in 623 deaths, while heroin contributed to 456 deaths. The highest number of fatalities occurred among people ages 35 to 44, followed by ages 45 to 54. Kentucky currently has the third highest overdose rate in the country and a recent study showed 80 percent of heroin users start with prescription opioids.

"We don't have the luxury of pretending there isn't a problem," said Gov. Matt Bevin. "Every life is worth saving. There is not a person we would not want to see redeemed and removed from this addiction and it is up to all of us to work together and find solutions." 

The governor's office has established a website with information about opioids, treatment and the overdose antidote, naloxone. Officials plan to continue updating the website as new initiatives are announced.

Documentation