Whether it be willful ignorance for the sake of scoring political points or a genuine misunderstanding of the strategies necessary to tackle a dual public health crisis in Appalachia, elected officials and policymakers are handicapping efforts against one of the major dangers spawned by our region’s substance abuse epidemic.

A KFF Health News report followed up on federal health officials’ effort a few years back to assess an outbreak of HIV in central Appalachia. The outbreak has been fueled by shared use of needles among those who inject opioids or methamphetamine. But syringe exchange programs became an easy target for politicians who chose to put crippling restraints on them.

The U.S. Centers for Disease Control and Prevention called a 2021 outbreak centered in Kanawha County, W.Va., that spread to surrounding counties and across the Ohio River, “the most concerning HIV outbreak in the United States.”

Despite scientific evidence that such programs can slow the spread of HIV and Hepatitis C as well as prevent cases of endocarditis, provide testing, AND keep syringe-users in touch with those who can connect them to resources for overcoming their addictions, very few programs have been able to survive restrictions by cities, some counties and the West Virginia legislature.

Policymakers at all levels must take another look at how better to support prevention efforts such as syringe exchange programs and work together to develop a testing program that will give us a more accurate picture of the monster we are battling.