After three years, central Indiana's Madison County might have to end its needle exchange.
It was the second county to establish an exchange after the state worked to get one off the ground in Scott County in 2015 to slow the spread of HIV tied to injection drug use.
For years, the city of Anderson has struggled with addiction.
Health Department: Syringe Exchanges Save Lives
"We have a community that is probably the most troubled community in the state of Indiana for heroin," says Madison County Prosecutor Rodney Cummings.
Cummings says 700 people in his county have died from overdoses in the last three years. That's an average of one fatality every day and a half.
Drugs, including heroin, meth and crack cocaine have become commonplace, and the search for a solution is dividing people in the community.
"We want our county to see what we're doing, the importance of what we're doing," says Stephanie Grimes, the public health coordinator for Madison County. "We want to work together we all want to be on the same page."
Every day, Grimes takes to the streets on a mission to help addicts in the community.
Through her work with the Madison county needle exchange program, she distributes clean syringes and works to educate users about safety and disease testing.
"That syringe is like a dangling carrot to get people to come start to have conversations about testing, taking control of their own health," Grimes says.
The Madison County needle exchange program relies on grants and donations to operate, as well as money from the county's general fund.
"I think people believe that ... we are allowed to use state and or federal tax dollars to fund the program, meaning to purchase syringes and the harm reduction kits supplies, which is absolutely false," she says.
The county's commissioners voted unanimously in May to extend the program through 2018 and put up about half of the $54,000 needed to run the exchange for another year.
But, that funding could now be in jeopardy.
County Council: County Money Shouldn't Fund Exchanges
Cummings is supporting an effort by some county councilors to pass an ordinance that would bar the county from giving any money for the purchase of needles or drug cookers.
The council will hear the ordinance next month and it would take away the money the commissioners already approved.
"It's illegal to give these...why does a government entity think they're above the law?"
"I think our county commissioners are still supporting it, but our county council are not going to fund it," Cummings says. "They're not going to fund it and I think we're headed for a pretty serious battle right now and I think the health department's probably going to lose a lot of funding from the county if they continue to do this."
The proposal would also bar the exchange program from using grant money to purchase syringes.
"It's illegal to give these, it's paraphernalia. If you stand on the corner and you give these kits away, you get arrested by the police if you sell them at a convenience store you get arrested by the police," Cummings says. "Why does a government entity think they're above the law?"
A new state law gives counties the authority to establish exchanges without going to the state for approval, but the law doesn't address funding or allocate any money for the exchanges.
Experts: Exchanges Help Slow Spread Of Disease
Medical experts say exchanges reduce the spread of HIV, hepatitis and other diseases and don't cause increases in drug use.
"There have even been numerous studies showing that even prisons have had to institute syringe exchange programs inside those walls," says Carrie Lawrence, a public health researcher and fellow at the Rural Center for AIDS/STD Prevention. "I think the ongoing stigma and misinformation is really causing there to be a threat the public's health."
In a letter the state's health commissioner Jerome Adams penned last week, he acknowledged exchanges make some people uncomfortable. But Adams wrote, without needle exchanges, the opioid epidemic will continue to spread.
"Ultimately we just want to do what's right for our community and that is the prevention of disease," Grimes says.
Critics of Madison County's exchange say money that currently goes to buying needles would be better spent on treatment and education.
Grimes agrees those things are necessary, but space in treatment centers is limited. And studies show people who go to a syringe exchange are up to five times more likely to enter a treatment programs than those who don't' participate in an exchange.
