Syringe exchanges provide intravenous drug users with clean needles to prevent the spread of bloodborne diseases like HIV and hepatitis. (Getty Images)

Attorney General Russell Coleman issued details Thursday of more than $12 million in grants from the state’s opioid settlements for prevention, enforcement, treatment and recovery.

One of the grants will expand a syringe exchange, and was not supported by Coleman’s appointees to the commission. He confirmed at an event Thursday that he opposes the exchanges.

“I’m extremely concerned that needle exchange further perpetuates drug use, and it will not be supported by me or this administration,” he said in response to questions at an event he held to highlight the grants.

Coleman said the 51 grant recipients, chosen from 160 applicants, represent “bold ideas” aimed at trying to “save lives and tackle this crisis,” with a focus on the three-legged stool of prevention, treatment and enforcement.

“We’re building programs and services that help Kentuckians for the next generation,” he said.

The announcement was made at DV8 Kitchens in Lexington, which employs people in recovery and is getting a $151,730 prevention grant to establish an employee-success mentorship program.?

“By connecting those in recovery with meaningful employment, we can give them a second chance at success,” DV8 owner Rob Perez said in a news release from Coleman’s office.?

At the event, Perez stressed that while DV8 is “for people,” its success is also good for the community. “Every time one person doesn’t return back to addiction, we saved $37,000 as a community,” he said.?

Coleman’s office oversees the Kentucky Opioid Abatement Advisory Commission, which the legislature created in 2021 to distribute the state’s portion of the $900 million in settlements with opioid manufacturers and distributors. The money is being paid in installments. The commission has awarded $55 million in 110 grants, including $10.5 million the legislature allocated in 2022 for behavioral-health treatment as an option to incarceration in 11 pilot counties.?

Coleman said it’s important to remember where this settlement money comes from. “This is blood money, purchased by pain and devastation of families across this commonwealth, which is why we must be such stewards of this money,” Coleman said. “We’re honoring those we’ve lost by our stewardship and how we use this money effectively.”?

Half of the settlement money goes to the state and the other half goes to cities and counties. The commission is housed in the attorney general’s office and is headed by Chris Evans, a former chief operating officer for the U.S. Drug Enforcement Administration.

Syringe exchanges

Evans was one of the Coleman appointees who did not support a grant to the Boyle County Agency for Substance Abuse Prevention at the June 4 commission meeting. In passing on the vote, he revealed Coleman’s position on syringe exchanges.

The grant was approved by a majority vote. Coleman took office in January and has not yet made all of his five appointments; those members serve two-year terms. The other voting members are appointed by the University of Kentucky or serve by virtue of their office, including Coleman, who has designated Evans to hold his seat.

Two of the five positions that are appointed by Coleman were reappointed in June 2023, before he took office, with their terms expiring June 30, 2025. They included Karen Butcher and Von Purdy, both representing citizens at-large. Coleman appointed Darren “Foot” Allen, representing law enforcement, in February and that term will expire June 30, 2025. The other two positions to be appointed by Coleman expire at the end of this month. At this time Van Ingram, representing the drug treatment and prevention community, and Jason Roop, representing victims of the opioid crisis, fill those positions.

Asked if Coleman will make decisions about future appointments to the commission dependent on the person’s view of syringe exchange programs, spokesperson Kevin Grout answered “No” in bold letters in an email.

Kentucky Health News asked Coleman if his lack of support for syringe exchanges for intravenous drug users, which are supported by research, could put a chilling effect on future applications for these programs.

He replied, “There’s been no grant that has been blocked because of my personal opposition.” He went on to say, “I don’t support needle exchange. I support very robustly prevention, treatment and enforcement.”

Asked if he had research to support his opinion, he said, “I’m a strong proponent of Narcan [an anti-overdose drug] and I’m a strong proponent of prevention. I’m very concerned that particularly when there’s not a one-to-one ratio, a one-to-one return on needles that it is an enabler versus the harm reduction that we’re actually seeking.”

Some syringe exchanges have a one-for-one requirement, but regional health official Scott Lockard said in 2016 that most exchanges at that time used a “patient negotiation model,” giving the user as many needles as they need for one week to assure they use a clean needle each time, often up to a capped number.

“The goal is that they use a clean needle for each time they inject,” Lockard said then. He said it is impossible to adhere to a strict one-for-one requirement. For example, he said users don’t always keep up with their syringes or sometimes will tell you they are sharing them.

Coleman said he is a very strong advocate for wide distribution of Narcan, “given the nature of the threat we’re seeing. … Narcan needs to be as ubiquitous as a fire extinguisher given this threat. But it always has to be Narcan plus a pathway to treatment, Narcan plus education. Because Narcan itself can be an enabler in some contexts. We want to make sure it’s always coupled with treatment, coupled with prevention.”?

Coleman also talked about his plans to build a statewide drug prevention program, with a goal of rolling it out this next school year.?

“We exist in a commonwealth where as little as one pill can and is taking our sons and our daughters,” he said. “But yet we lack a statewide prevention effort in our commonwealth. That will change.”

Coleman’s office declined to release details of the grants until Thursday’s event.

Here’s a summary of how the 23 new prevention grants will be used:?

Anderson County Agency for Substance Abuse Prevention, $171,100 for expansion of school-based prevention efforts and law-enforcement training.

Appalachian Research & Defense Fund (Legal Aid), $125,000 for legal support and wraparound services that help stabilize people in recovery by addressing employment barriers and other destabilizing civil legal issues.

Big Brothers Big Sisters of the Bluegrass, $185,301 for a high-school mentoring program, to empower high school students to become positive role models for younger students.

Boys and girls Clubs of Kentuckiana, $200,000 for an innovative program aimed at opioid prevention for youth aged 6-18.

Carter County Public Library, $101,500 to hire resource specialists to prtovide greater access to recovery-oriented programming.

Covington Partners, $225,450 for prevention programming that includes out-of-school-time programs, school-based health services, mentoring, drug and violence prevention and family engagement.

Cumberland Trace Legal Services (Legal Aid), $125,000 for legal support and wraparound services that help stabilize people in recovery by addressing employment barriers and other destabilizing civil legal issues.

DV8 Kitchen Vocational Training Foundation and DV8 Kitchens, $151,730 for the mentorship program, which will focus on removing barriers, supporting career-path development and job readiness while supporting recovery and wellness.

Girl Scouts of Kentucky Wilderness Road Council, $59,052 to launch the Building the Bridge to K-12 Girls Leadership Project, a community-based prevention program that focuses on increasing girls’ positive childhood experiences.

Jewish Family and Career Services, Louisville, $77,207 for enhancement of wraparound services for youth, to include opioid addiction screening and active prevention.

Legal Aid Society, $125,000 for legal support and wraparound services that help stabilize people in recovery by addressing employment barriers and other destabilizing civil legal issues.

Legal Aid of the Bluegrass, $125,000, same as above.

Mercy Health – Lourdes Hospital, $76,552 for a hospital-based, pharmacy-led tapering program, which slowly resudes doses of a drug over time to reduce withdrawal symptoms.

Operation Parent, $87,011 for prevention education of parents of 4th, 6th and 9th grade students in several Kentucky counties.

The Safety Blitz Foundation, $126,335 for a pilot version of The Coaches vs. Overdoses program, which addresses youth opioid misuse, the proliferation of synthetic opioids including illicit fentanyl, through prevention, education, awareness and community drug-disposal programming.

Scott County Sheriff’s Office, $91,847 for Drug Abuse Resistance Education in 5th and 9th grades.

Taylor County Schools, $208,824 for a school-based prevention program.

Three Rivers District Health Department, Owenton, $320,803 for a partnership with the Planet Youth program to implement a population-wide primary prevention process designed to take informed actions to increase protective factors, decrease risk factors and ultimately change the environment of children and youth.

University of Kentucky Research Foundation, $380,572 for development of prevention coalitions in Fayette County, educating 4th through 12th grade students and building community capacity and engagement around prevention efforts.

Operation UNITE, $751,850, for continuation and expansion of its Educate. Empower. Prevent. Program, which provides prevention training to students from 4th through 12th grades.

Wanda Joyce Robinson Foundation, Frankfort, $90,472 to start a youth substance intervention and prevention program that prevents substance use and abuse and promotes positive youth development and stronger families. The foundation helps children with incarcerated parents.

WestCare Kentucky, $100,404 for Camp Morilla, a free addiction prevention and mentoring day camp program for youth ages 9-12 and their families who have been impacted by family opioid use.

Young Men’s Christian Association of Greater Louisville, $248,487 for the YNOW Mentoring Program, which focuses on helping youth develop healthy drug-and violence-free lives.

Here is a summary of how the 28 new treatment and recovery grants will be used:?

Appalachia Regional Healthcare, $94,572 for expanding its peer recovery team so peer recovery coaches can be placed in four more hospitals.

Backroads of Appalachia, $167,025 for women in recovery with workforce training and employment opportunities.

Boyle County ASAP, $282,610 for expansion of its harm reduction program (including a syringe exchange), resilient-kids programming and case management efforts.

Celebrate Recovery Fairdale, $30,004 for weekly recovery meetings.

Center for Employment Opportunities, $255,109 for expansion of employment services for justice-impacted individuals in treatment or recovery.

Chrysalis House, Lexington, $227,273 for treatment for pregnant and parenting women.

Comprehend, Inc., $426,087 for opening a buprenorphine clinic in a community mental health center.

Eastern Kentucky Concentrated Employment Program, $450,000 for career and support services for people who are in recovery and comorbid polysubstance use who are interested in entering or re-entering the workforce.

Family Nurturing Center of Kentucky, $221,937 for services to children impacted by their caregiver’s opioid use and provides needed support to parents in recovery.

Family Scholar House, $245,110 for a five-step approach revolving around wrap-around services during and post-treatment to progress individuals from ‘crisis to stability’ targeting single parents, foster alumni, individuals facing reentry and post-secondary students.

Grin Grant, Lexington, $361,251 for expansion of dental restoration scholarships and peer support services and launch of a new recovery program.

Hope Center, $680,280 for in-patient, residential treatment for men.

Hope Springs Church, $50,462,Supports regular recovery support meetings and events.

Horsesensings, Inc., Bagdad, $115,219 for therapeutic job training in the horse industry and housing for those in recovery.

Isaiah House, $250,000 for recovery housing and job training aftercare opportunities for those in long-term recovery.

Kentucky Hospital Research and Education Foundation (Ky. Hospital Assn.), $250,000,Supports expansion of a program that ensures patients have 24/7 access to care.

Lake Cumberland Area Development District, $277,552 for case management and supportive services to individuals in recovery seeking to re-enter the workforce.

Life Learning Center, Covington, $498,500 for “a cutting-edge, technology-enhanced system designed to fill existing gaps in recovery services by providing continuous, real-time data, support and accountability.”

Mercy Health-Marcum and Wallace Hospital, Irvine, $179,834 for recovery services for individuals with criminal justice involvement.

Natalie’s Sisters, $88,356 for expansion of services for women who have been sexually exploited or trafficked.

Northeast Kentucky Regional Health Information Organization, $331,997 for the Career Ready Workforce Project, which will focus prevention efforts on high-school students preparing to enter the workforce, individuals struggling with addiction ,and local agency staff members seeking to increase employable skills.

Ramey-Estep Homes, Rush, $222,801 for teen prevention-education programming, expansion of first-responder trauma-treatment programming and expansion of treatment and recovery access.

Recovery Café Lexington, $276,278 for expansion of recovery support model to a third location in Frankfort.

Transitions, Inc., Covington, $156,000 for expansion and enhancement of treatment services, as well as expansion of community education and prevention activities in the African American community.

Voices of Hope-Lexington, $538,021 to increase the quantity and quality of recovery support services for people in or seeking recovery.

Volunteers of America Mid-States, $664,587, for two recovery community centers in Lincoln and Pulaski counties.

Four Rivers Behavioral Health, Paducah, $232,251 for a mobile recovery support vehicle program that provides services to adults.

Young People in Recovery, Louisville, $301,440 for peer-led chapter and life-skills curriculum programs for people seeking recovery and a youth prevention program for middle- and high-school-aged children and their parents in five communities.

This story has been updated with information from Kevin Grout, spokesman for Attorney General Coleman.

This article is republished from Kentucky Health News, ?an independent news service of the Institute for Rural Journalism in the School of Journalism and Media at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.