A needle used for heroin injection lies in the woods off Jeff Davis Highway in Richmond, where a woman was spending the night. Photo by Julia Rendleman.

More than a year since they became legal in Virginia, the state’s second needle exchange program is scheduled to open in Richmond at the end of the month.

Health Brigade, formerly the Fan Free Clinic, in Richmond’s Museum District, will be the second in the state to open a comprehensive harm reduction program, also known as a needle exchange.

The first program in Wise County started this summer.

Needle exchanges provide injection drug users with clean equipment, such as needles and syringes, to prevent the spread of bloodborne diseases like hepatitis C and HIV, while also disposing of dirty needles. The programs have also been shown to successfully connect drug users with intervention services.

A Health Brigade news release states that the program will help to prevent the spread of HIV and hepatitis C, “through a variety of services including HIV testing, hepatitis C testing, providing and collecting syringes, referrals to substance use treatment and to other medical/social services.”

Cases of hepatitis C have skyrocketed in Virginia over the past five years, with nearly 11,500 cases reported last year compared to only about 6,400 in 2013, according to the Virginia Department of Health.

The surge in infections is largely driven by the opioid epidemic that continues throughout the country and Virginia, specifically by drug users sharing needles.

Reams of public health research has shown needle exchanges help prevent the spread of those diseases, but the programs have been slow to start in Virginia due in part to reluctance by law enforcement agencies. The legislation that legalized the programs requires organizations to receive the approval of their local law enforcement agencies before launching.

Public health officials argue that needle exchanges keep police safer because officers are less likely to come into contact with dirty needles if users have a safe place to dispose of them.

But some law enforcement agencies have said they shouldn’t be asked to condone illegal activity.

“If this becomes the norm perhaps our legislators in Richmond will direct law enforcement to hand out marijuana to school children on school property and see how that impacts our society,” Roanoke Police Chief Tim Jones told the Roanoke Times last month.

Not all police feel that way, though — Health Brigade secured the support of the Richmond Police Department in order to start its program.

Meanwhile, rates of hepatitis C continue to climb. Often, a hepatitis C outbreak will precede an HIV outbreak, and both state and federal health officials are concerned that the opioid epidemic might result in more HIV outbreaks, as it did in Scott County, Ind., in 2015.