Inside Appalachia: In-depth Look at Needle Exchange Programs Fighting the Opioid Crisis

Jan 11, 2019

The opioid crisis is one of the biggest public health challenges in our region today. One strategy that’s been proved to help curb the epidemic’s worst effects is to implement harm reduction programs. These generally offer a variety of services but the most controversial component is often the needle exchange. Just because something is  proven effective, doesn’t mean the public has bought into the idea.

This week we’re taking an in-depth look at needle exchanges -- and what they can mean for their surrounding communities.


Geared toward people with intravenous drug use disorders, evidence shows implementing needle exchange programs improves public health and helps combat the substance use disorder epidemic. We reported last year on a program that was shut down amid public outcry. After that episode aired, we began to hear that people in other communities were questioning the need for similar programs around the state.

West Virginia Public Broadcasting’s Kara Lofton did some digging and produced a five-part series about not only the program in Charleston, West Virginia, that shut down but also other programs in West Virginia. That entire series is included in this episode. 

To recap: In December of 2015, with support from the city of Charleston, the Kanawha-Charleston Health Department launched a harm-reduction program, including a needle exchange. The primary goal was to reduce the risk of needle-born diseases. The secondary goal was to connect illicit drug users to treatment and recovery services. The program closed a little more than two years after it opened, amid controversy.

Credit West Virginia Department of Health and Human Resources

Dr. Rahul Gupta, the former West Virginia State Health Officer, said closing harm reduction programs hurts the local community because it increases the risk of spreading needle-borne illnesses. It also affects public perception and support for other harm reduction programs across the state that are trying to open or stay open.

Research shows that in addition to reducing the incidence of blood-borne pathogens in the community, effectively run programs help remove potentially infectious syringes from distribution.

The science behind harm reduction programs is pretty unequivocal -- these initiatives help save lives and prevent the spread of disease. In order for harm reduction to be successful, however, most public health experts say the residents in the community have to support the program.

Virginia has passed legislation allowing needle exchange programs as part of harm reduction efforts, but so far there are only three in the state. Mallory Noe-Payne, brings up the story of one in Wise County that has met with success in its first few months and interviews local law enforcement that is behind the program.

Credit MADDIE MCGARVEY / WYSO

For perspective, we will also hear folks in Dayton, Ohio, talk about their stories of loss, love, hope and recovery as we include two Recovery Stories produced by Jess Mador as part of a six-part series by WYSO.

We had help producing Inside Appalachia this week from West Virginia Public Broadcasting’s health reporter, Kara Lofton, and WYSO’s Jess Mador, along with Mallory Noe-Payne, from Virginia Public Radio.

Roxy Todd is our producer. Eric Douglas is our associate producer. Our executive producer is Jesse Wright, who also edited our show this week. Our audio mixer is Patrick Stephens.