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HUNTINGTON - Kathleen Napier and her staff have been training for a long time, but really no one knows what to expect when the doors to a small, first-floor room at the Cabell-Huntington Health Department open Wednesday at 1 p.m.

No matter what, it will be a historic day for the city and county.

That's when the health department will host its first needle exchange clinic, part of an overall harm reduction plan to reduce the spread of disease and get addicts into treatment as the regional heroin epidemic continues to surge.

Napier, director of nursing for the health department, will be on hand to supervise as used needles are disposed and addicts are given clean ones.

"We have no idea what we're going to experience," Napier said. "We could have as few as five to six (addicts), or as many as 75 to 100."

The latter estimate was given from numbers seen at a similar program in Lexington, Kentucky, when it opened for the first time, Napier said.

The advertised time for the exchange is from 1 p.m. to 3 p.m., but Napier said workers will stay as long as needed.

"If there's still a line out the door at 4, we'll be here," she said.

The exchange room will be manned by three nurses. Napier said they will not have any contact with used needles. Those who come in with the needles will place them in a biohazard bin.

The service is anonymous, though Napier said workers will ask for a zip code and the month and year of each person's birth to collect some basic data on regional heroin use.

Clean needles will be distributed to people who arrive with no needles for exchange as well, she said.

"The goal is a one-for-one exchange," she said. "But if someone shows up with more, we might supply them with more. If someone shows up with none, they're going to be grabbing (a needle) any way they can. They need help, too."

The planned operation of the clinic is every Wednesday afternoon in that 1 p.m. to 3 p.m. time window, Napier said, though the program will adapt as needs arise.

Originally proposed by the Huntington Mayor's Office of Drug Control Policy, the syringe exchange program on its surface is aimed at stopping the spread of bloodborne illnesses like Hepatitis B and C and HIV.

West Virginia typically places at the top of the country in Hepatitis B and C rates.

Dr. Michael Kilkenny, director of the Cabell-Huntington Health Department, said he expects to see an immediate impact on disease rates as a result of the program - the first of its kind in West Virginia - but added the harm reduction effort is more about getting addicts on the path to treatment and recovery.

When the program was first pitched, the Office of Drug Control Policy placed heavy emphasis on having peer counseling available, along with information on treatment programs so that addicts were offered more than just a clean syringe. Other aspects of the program include education on drugs that can reverse an opiate overdose, like Naloxone, and making those drugs available.

"(The program) gets the addict in the system, gets them engaged and shows them someone cares about them," Kilkenny said.

Napier said she hopes addicts will use the harm reduction program just like any other service the health department offers, and not view it with any stigma.

Recovering heroin addict Sally Johnson, of Proctorville, Ohio, who is hoping to work as a peer counselor through the program, said it's something she would have used had it been available when she was battling addiction.

A typical criticism of syringe exchange programs is that they enable users to continue using, and Johnson said that might be true at first.

"There's the selfish part of it, you know, instead of using these dirty rigs, let's go here where we can get fresh and clean (needles)," she said. "New and free. That's the initial thought. It's not, 'Oh, let me go get some help.'"

She also said there might be some fear from addicts that they will be turned over to the police, something Kilkenny addressed in a press conference Tuesday morning, saying no one would be arrested or targeted by police for use of the program.

"There would be some fear, just don't cough up any information if you don't have to," Johnson said. "That might be what we see in the beginning."

That's why peer counselors are so important, Johnson said.

"We've been there, we've been in their shoes," she said. "We've been through the trust issues and lived the way they've lived."

The main thing counselors can relay, Johnson said, is that there is a life outside of addiction.

"They need to know this is a safe place, and there is a life better than what you're doing," Johnson said. "If nothing else, we can give them that hope."

About 200 communities in the U.S. have some form of a harm reduction program centering on a needle exchange, Kilkenny said.

A program recently put in place in Portsmouth, Ohio, saw 50 percent of addicts who used the exchange enter treatment in the first six months of operation, he said.

Follow reporter Ben Fields on Twitter @BenFieldsHD.


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