State and federal public health officials agree Iowa needs a syringe exchange program to slow the spread of hepatitis C and prevent a possible HIV outbreak among Iowans who inject opioids and meth.
In a letter to the Centers for Disease Control and Prevention (CDC) dated Nov. 1, 2017, the Iowa Department of Public Health writes, "Iowa is currently experiencing significant increases in hepatitis infections among people who inject drugs, and is therefore at risk for an HIV outbreak related to injection drug use."
From 2009 to 2016, hepatitis C infections among Iowans under 30 increased 375 percent. The IDPH attributes much of that increase to injecting drugs.
The IDPH also cites recent increases in treatment admissions for people who inject opioids and meth, and increasing overdoses related to heroin and meth as evidence for the need for syringe exchange programs.
Syringe exchange programs cannot move forward because supplying needles and syringes for drug use is illegal in Iowa.
Randy Mayer with IDPH says the department is taking steps to prepare to make the case for syringe exchanges to lawmakers.
"The most important one was to get this determination of need approved by the Centers for Disease Control and Prevention, which we’ve just recently done," Mayer says.
State lawmakers considered a bill last year to decriminalize distribution of needles and syringes through public health programs. The bill didn't pass.
Federal funding could be used to support a syringe exchange program in Iowa, but the CDC prevents states from using that funding to directly purchase needles and syringes. Funding for needles and syringes would have to come from the state or private organizations.
Mayer says the state has not seen HIV diagnoses increase recently among people who use drugs, but IDPH is watching that closely.
"What we have is an avenue for that to occur," Mayer says. "So it really just takes the right person to get into that population with untreated HIV infection and that could allow that to happen. So having a syringe services program is one way to avoid that."
Sarah Ziegenhorn, executive director of the Iowa Harm Reduction Coalition, says the CDC's letter is both frightening and reassuring.
"Frightening in that if the legislature fails to pass legislation this session to legalize syringe exchange programs, we may see a rapid increase in new HIV cases," Ziegenhorn says. "But the approval for Iowa to use federal funds for syringe exchange implementation should be reassuring to legislators in light of the state's budget deficit."