Chesterfield County Sheriff Karl Leonard seeks help with his phone from participants in the Chesterfield jail's Heroin Addiction Recovery Program (HARP) in June. (Photo by Julia Rendleman)

Chesterfield County Sheriff Karl Leonard sees firsthand the devastation that the ongoing opioid epidemic wreaks in his county, as more and more people enter his jail with an addiction and a hepatitis C infection.

He’s been openly supportive of starting a needle-exchange program, otherwise known as comprehensive harm reduction, for the past year because they can help prevent the spread of hepatitis C and HIV and they offer direct links to treatment for injection drug users.

But the rest of the county doesn’t seem ready to move forward.

Over the summer, Chesterfield’s Opioid Steering Committee decided to, “table that and not pursue the needle exchange program,” Leonard said. He added that the committee knew his position on the topic.

“My concern is this is still a very critical crisis we’re in,” he said.

In a statement, Sarah Snead, deputy county administrator for health services and the committee’s chair, said the group decided to “continue to watch what’s happening in other localities.

“The county is committed to a long-term, measured approach to fight this nationwide epidemic,” the statement reads. “A subcommittee was established to develop an implementation plan related to harm reduction, including HIV and tuberculosis testing, counseling and education, and referrals to community resources.”

Without the committee’s support, there isn’t much hope of starting a program, Leonard said.

The law on Virginia’s books that legalizes needle exchanges says that support from local law enforcement agencies — which has so far been the sticking point in other localities — and from the locality’s governing body is required before launching one.

“I am disappointed,” Leonard said. “It’s one of those things that I felt passionate about and I still do. But it brought a quick halt to my actions and I respect the committee and their decisions.”

He added that he doesn’t have much hope that the committee’s decision will change.

The law legalizing the program is due to expire in 2020.

In an interview last week, Elaine Martin, director of HIV prevention services with the state’s Department of Health, said the department is putting forward a legislative proposal for this upcoming General Assembly session to extend the sunset provision in the law, but that it has not put forward a proposal to change the law so organizations do not need letters of support to apply to start a program.

The programs not only offer injection drug users a safe place to dispose of their needles, they also offer clean equipment so that they don’t spread bloodborne diseases while using. Public health officials laud the programs as gateways for addicts looking to seek treatment.

Even though Virginia legalized needle exchanges nearly 18 months ago, only two have opened in the state: in Wise County and just last month in Richmond. The Department of Health is hoping to announce a third program in Smyth County in the coming weeks.

The number of Chesterfield inmates who test positive for hepatitis C has steadily increased.

So far this year, 27 inmates in Chesterfield County tested positive for the bloodborne disease, compared to 28 for the whole of 2017, according to data provided by Dr. G. Mantovani Gay, the medical director for sheriff’s office.

In 2013, only two inmates tested positive. Then, the numbers doubled from 7 to 14 between 2015 and 2016.

Gay noted in an email that the jail does not automatically test everyone for hepatitis C, but that inmates request to have the test performed.

The steady uptick in hepatitis C has been matched by the levels of addiction Leonard said his jail sees. This past month, the number of detainees with a heroin addiction was higher than it’s been any month in the past three years, with 54 entering the county’s jail, according to data that Leonard provided.

“It’s still on the rise, it hasn’t even started to level off yet,” Leonard said. “We just want to see people do well. We don’t want to see people harmed and ultimately we want to see everybody come off of the drugs. We’re not asking for this drug use to be perpetuated by use of free needles. Our goal is to see all addiction end.”

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Katie O'Connor
Katie, a Manassas native, has covered health care, commercial real estate, law, agriculture and tourism for the Richmond Times-Dispatch, Richmond BizSense and the Northern Virginia Daily. Last year, she was named an Association of Health Care Journalists Regional Health Journalism Fellow, a program to aid journalists in making national health stories local and using data in their reporting. She is a graduate of the College of William and Mary, where she was executive editor of The Flat Hat, the college paper, and editor-in-chief of The Gallery, the college’s literary magazine.