Key Ingredient Removed From Harm Reduction Kits In Indiana County

By Zachary Siegel 07/12/17

Public health officials fear that removing the item from the kits may lead to more outbreaks of hepatitis C and HIV. 

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two large containers filled with harm reduction kit materials
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Under pressure from community critics and law enforcement, Indiana’s Madison County Board of Health voted to remove “cookers” from harm reduction kits distributed by a local syringe exchange program. 

Cookers are metal bowls slightly larger than the size of a quarter. People who inject drugs typically pour powder into them, then add water and apply heat to turn the substance into an injectable solution. It’s a key ingredient in reducing the spread of blood-borne disease, which can be transmitted when people share cookers. 

The kits in question contained materials recommended by the Centers for Disease Control and Prevention (CDC). In 2015, the CDC responded to Indiana’s largest HIV outbreak, which was triggered by needle sharing. The outbreak forced Vice President Mike Pence, then Governor of Indiana, to lift the ban on syringe exchange programs. 

But now public health officials fear that removing cookers from the kits may lead to more outbreaks of hepatitis C and HIV. 

Paula Maupin of nearby Fayette County Health Department told the Herald Bulletin that without including a cooker, a syringe exchange program isn’t addressing the entire problem of spreading infection through drug use.

“First off, this is sad for a Board of Health to vote for (the removal of the cooker),” she told the local newspaper. “Cookers are second only to the syringe in the ability to spread hepatitis C through IV drug use.”

Stephenie Grimes, who oversees the syringe program for the health department, said the kits include the cooker because, like clean needles, cookers help prevent the spread of disease. 

“It’s an important piece,” she said. “People may use separate needles but are using the same cooker. We modeled our kit after Scott County, which followed a recommendation by the CDC.”

Madison County’s Prosecutor Rodney Cummings, along with law enforcement and members of the Madison County Council, are lobbing moral criticisms at the syringe program, despite evidence that they reduce the spread of disease. 

“Madison County Sheriff Scott Mellinger said the removal of the cooker was a smart move by the Health Board,” according to local news reports

“The only concern I had was the perception of the kit,” he said. “The cooker is readily available to drug users, but I realize in the kit there were sterile products to use. The concern that is alleviated for me is the perception of the kit.”

The health department faced similar moral criticisms when it started issuing free condoms, said Dr. Stephen Wright, a Madison County health officer. 

There was a total of 1,480 visits to syringe exchanges since the end of June, according to Madison County’s health department. 

"That’s 1,480 times that we have been able to meet with someone to talk about treatment, testing, overdose, all those things, which is huge," Grimes said.

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Zachary Siegel is a freelance journalist specializing in science, health and drug policy. His reporting has also appeared in Slate, The Daily Beast, Salon, Huffington Post, among others. He writes often about addiction, sometimes drawing from his own experience. You can find out more about Zachary on Linkedin or follow him on Twitter.

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