The Marion County Health Department is declaring an epidemic of hepatitis C—an often-deadly liver disease linked to injection drug use and dirty syringes—and is proposing the first-ever syringe exchange program in Indianapolis.
The rate of reported acute hepatitis C in Marion County rose from 0.6 to 7.6 per 100,000 population between 2013 and 2017, much of it due to the opioid epidemic, Dr. Virginia Caine, the county’s health director, said Thursday morning.
She said those figures are likely underestimated, pointing out that the Centers for Disease Control and Prevention estimates that the true number of acute hepatitis C cases are nearly 14 times what is reported. That translates to approximately 1,000 new cases in Marion County in 2017 alone.
“The proposed syringe exchange program is medically necessary and will save lives by reducing the transmission of hepatitis C and HIV,” she said. “Both are growing national problems brought on by the widespread increase in opioid addiction.”
In at least 86 percent of the new cases in 2017, patients reported injecting drugs within the last six months, and at least 58 percent reported sharing drugs and paraphernalia, the health department said.
Declaring a public health epidemic is the first step required by Indiana law for a county to implement a syringe program. The second step is approval by the City-County Council.
Vop Osili, president of the City-County Council said he supported the needle-exchange program, saying it would save lives and tax dollars by reducing the “burdensome health care costs related to injection drug use and infectious disease.”
He said he would introduce the needle exchange program for consideration at council’s next meeting on May 21. He said the program would require no additional public investment.
The health department said the program would operate initially as a mobile unit, choosing sites based on overdose deaths and the recommendations of the Indianapolis Metropolitan Police Department. Services would include drug and disease screenings, wound care education, immunizations and referrals to substance-use disorder and mental-health treatment.
Indiana began to allow syringe exchanges in 2015, but only with state approval, after the state's worst-ever concentrated HIV outbreak, which was centered in Scott County in the south of the state. More than 200 HIV cases have been reported in the county in recent years.
The Indiana General Assembly passed a law last year to streamline the process and give local governments more freedom to decide whether to create their own exchanges.
Federal studies have found that such programs cut down transmission of HIV and do not cause increases in drug use.
Hepatitis C is a virus that can lead to loss of liver cells, irreversible scarring of the liver and even liver cancer. It can be fatal if an infected person doesn’t get treated with drugs that often have complex dosing regimens.
Symptoms of hepatitis C can include yellowing of the skin and eyes, loss of appetite, nausea and vomiting, fever, tiredness and stomach pain. Hepatitis C is spread primarily through contact with human blood.
The health department will host three public meetings to discuss the needle-exchange program: 5:30 p.m. on May 22 at the City-County Building; 6 p.m. on May 31 at the health department offices; and 6 p.m. on June 13, also at the health department. The health department is at 3838 N. Rural St.