STEVE INSKEEP, HOST:
Commissioners in Scott County, Ind., have voted to end a needle exchange program. That vote is news because of what that program did. It was credited with ending a major outbreak of HIV. Here's Mitch Legan of member station WFIU.
MITCH LEGAN, BYLINE: In 2015, tiny Scott County experienced what was called the worst outbreak of HIV in rural America. Then-Indiana Governor Mike Pence said he had no choice but to support what became the first needle exchange program in the state. County health administrator Michelle Matern says cases of HIV and other illnesses caused by dirty needles plummeted when the exchange opened.
MICHELLE MATERN: So in 2015, about 95% of the cases were also co-infected with hepatitis C. All those cases back then were linked to injection drug use, sharing syringes with each other.
LEGAN: In addition to providing IV drug abusers with the place to exchange their used needles for clean ones, the grant funded clinic provides other health services - the overdose antidote naloxone and a place for people with substance use disorder to connect with treatment for their disease. Rick Williams attended last night's meeting to say the program did just that for him.
RICK WILLIAMS: And you start to build a trust up to these people. If you're going to ask them for needles and stuff, you start to trust those ladies. And they've been there where you're at.
LEGAN: But like the rest of the United States, Scott County still has an overdose problem. Commissioner Mike Jones says the access to needles is leading to more overdoses in the county.
MIKE JONES: There's no bringing you back. I mean, there's - you can treat yourself for HIV, you can treat yourself for hepatitis C, but you can't treat yourself for dead.
LEGAN: Jones and the other commissioner who voted to end the exchange say they can't live with a program that makes it easier to abuse drugs.
JONES: I know people that are alcoholics, and I don't buy them a bottle of whiskey. And I have a hard time handing a needle to somebody that I know they're going to hurt theirself with.
LEGAN: Scott County health officials say they're dismayed at the decision, which requires them to phase out the needle exchange by the end of the year. But the commissioners have said they're interested in working with advocates to create a sort of drop-in center for users to visit at any time. It would provide similar service to the needle exchange, minus the needles.
JONES: If we're going to take something away, possibly we can give something back.
LEGAN: But health officials like Matern say that'll be a heavy lift, and funding for a center with all the necessary services would be hard to come by. And without a needle exchange, she says it probably won't be as effective.
MATERN: We hope we're wrong, but it's very, very likely. And the - you know, experts from all over the world tell us, you know, this is probably going to be another outbreak without a syringe service program.
LEGAN: The Scott County commissioners could reinstate the needle exchange program at a later date if HIV cases spike again. But Matern says by then, it'd probably be too late.
For NPR News, I'm Mitch Legan in Bloomington, Ind.
NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.