needle exchanges

S

swatiraohnlu

Swati Rao
Many illicit drug abusers inject drugs such as heroine directly into the blood stream with syringes or needles. For many users, sterile syringes are not readily available and drug paraphernalia laws in some countries make it an offense to distribute or possess syringes for non-medical purposes. As a result, many drug users share needles, which contributes to the spread of diseases such HIV and Hepatitis C, which have become near pandemics in countries and communities around the world. The spread of these diseases among drug users has become so concerning that, starting in the 80s, some activists and cities began opening needle exchanges. These government funded programs supply clean needles to drug addicts, so that they are at a lower risk of sharing needles and spreading diseases. Opponents argue that needle exchange programs condone illicit and immoral behavior and that governments should focus on punishing drug users, discouraging drug-use, and providing treatment for quitting.

Are needle exchanges a good idea? Do they improve public health/safety?
 
Needle exchanges are favored by many publics "Survey finds most voters favor needle exchanges." AIDS Policy Law. May 30, 1997: "AIDS: A poll conducted in April 1997 by the Human Rights Campaign indicates that a majority of Americans favor needle-exchange programs to curb the spread of HIV. Thirty-two percent of those interviewed strongly favor needle exchanges and 23 percent somewhat favor the strategy. Support for such programs was found in every region of the United States. Republicans were split but strong majorities of independents and Democrats were in favor of needle-exchange programs."
 
Needle exchanges should not be forced on communities David Noffs, Founder and Executive Director of the Life Education Center. "Should needle exchange be publicly funded?". PBS: "Lastly, many needle exchange programs have been introduced without the support of those communities where they set up shop. [...] Needle exchange program operators have arrogantly set up these illegal operations while self-righteously declaring that anyone who opposed them was either not compassionate to the plight of AIDS sufferers or homophobic. This condescending attitude has not helped their public relation efforts and has probably already determined their ultimate fate."
 
Needle exchanges are cost-effective HIV prevention "Does HIV Needle Exchange Work?". Center for AIDS prevention studies. November 1998: "Is needle exchange cost-effective? Yes. The median annual budget for running a program was $169,000 in 1992. Mathematical models based on those data predict that needle exchanges could prevent HIV infections among clients, their sex partners, and offspring at a cost of about $9,400 per infection averted. 16 This is far below the $195,188 lifetime cost of treating an HIV-infected person at present. 17 A national program of NEPs would have saved up to 10,000 lives by 1995." Needle exchanges decrease infections and therefore costs "Are Needle Exchange Programs a Good Idea?" by Jenny Murphy, Bryan Knowles;Thursday, June 15, 2000": "An article in the medical journal Lancet estimated that 4,400 to 10,000 HIV infections among U.S. intravenous drug users could have been avoided between 1987 and 1995 if the federal government had implemented syringe exchange nationally, saving over $500 million in health care costs. Action taken in early 1997 could have prevented an additional 11,000 infections by the year 2000, saving over $600 million."
 
Needle exchanges help bring addicts into treatment programs Needle exchanges are valuable in bringing addicts into a formal, institutional system, through which they can be connected to various treatment and job-search mechanisms. Social services for addicts can be centered around needle exchanges "Needle exchange options; pros and cons". Canada.com. March 21, 2008: "Pros: The St. John Ambulance building on Pandora Avenue is only about two blocks away from the current Cormorant Street needle exchange, meaning drug addicts are already in the area. The St. John building is, however, considerably larger and beside the new Our Place, which offers transitional housing, outreach programs, social services, and amenities like washrooms for people living on the street. The new building will also house health professionals to diagnose, test and treat this sickly population. The building will house about 50 health care and social service providers including Assertive Community Treatment outreach teams, doctors, nurses, addiction counsellors, social workers and street nurses. Police would also have a presence inside and outside the building to maintain public order. More flexible hours of operation, and the possible use of a courtyard, mean drug users won't congregate all at once outside the building." Needle exchanges can help create treatment awareness "Are Needle Exchange Programs a Good Idea?" by Jenny Murphy, Bryan Knowles;Thursday, June 15, 2000: "Needle exchange programs not only stem the transmission of disease by providing addicts with otherwise difficult-to-obtain sterile needles, but these programs provide support and information that can lead addicts into treatment. An addict might visit a needle exchange just to get clean needles to use to inject drugs, but they might also pick up free condoms or talk to a drug counselor about treatment options."
 
Needle exchanges benefit their areas of implementation. William Martin. "Other Countries Have Demonstrated Benefits of Needle Exchange Programs." OpposingViews.com. "While opposed by some on the grounds that it seemed to be condoning drug use, needle exchange programs (NEPs) quickly proved to be an effective means of reducing the incidence of blood-borne diseases in both countries and have been widely recognized as a valid part of a good public health policy and practice in many other parts of the world. In such programs, addicts receive a clean needle for every used one they turn in, thus limiting careless or dangerous disposal of needles. In some locales, syringes can also be easily obtained from pharmacies or even from vending machines. These are not only more convenient, but encourage the use of clean needles by IDUs who may be reluctant to signal their addiction by going to an NEP."
 
Needle exchanges protect public from disposed needles Alan Franciscus. "Needle Exchange - A Matter of Public Health". Hepatitis. April/June 2003: "Most needle exchange programs operate on a one-for-one basis, so they also reduce the presence of infected needles in playgrounds, streets, and trash receptacles, thus protecting children, sanitation workers, and others from accidental needle sticks." Needle exchanges help protect families of drug-abusers. I believe we have an obligation to permit people who inject drugs to have access to sterile needles so they can protect their health. Injection drug users are also God's children. And, like the reckless driver in the example above, people who inject drugs have wives, husbands, and babies. When we abandon the person who injects drugs to HIV/AIDS, we are abandoning their non-drug injecting partners and babies as well. God has given us knowledge with which to slow the spread of HIV/AIDS to all these people. Let us use it."
 
* Needle exchanges do not increase drug use Karthik Reddy. "The Case for Needle Exchange". October 25, 2007: "The opposition to needle exchange programs would have us believe that such programs encourage drug use. Studies of the Amsterdam program, however, demonstrate that drug use does not increase; the programs generally only attract those who have already become intravenous drug users. The implementation of the San Francisco program actually resulted in decreased drug use, as the program established much-needed links with the drug-using community."

"Interventions To Prevent HIV Risk Behaviors". National Institutes of Health, Consensus Development Conference Statement". February 11-13, 1997: "A preponderance of evidence shows either no change or decreased drug use. The scattered cases showing increased drug use should be investigated to discover the conditions under which negative effects might occur, but these can in no way detract from the importance of needle exchange programs. Additionally, individuals in areas with needle exchange programs have increased likelihood of entering drug treatment programs.On the basis of such measures as hospitalizations for drug overdoses, there is no evidence that community norms change in favor of drug use or that more people begin using drugs. In Amsterdam and New Haven, for example, no increases in new drug users were reported after introduction of a needle exchange program."
 
Needle exchanges rightly place harm reduction over all else. Harm reduction holds that the health and well-being of the individual is of primary concern; if individuals are unwilling or unable to change addictive behaviors at this time, they should not be denied services. Attempts should be made to reduce the harm of their habits as much as possible. This approach to addiction is viewed by some as compassionate and pragmatic; by others as selfish and dangerous.Needle exchanges don't condone drugs; they offer care. Providing clean syringes and needles to intravenous drug users does not say that we condone their behavior: it says that we still care about them and that we want them and their partners to be healthy as a first step in becoming a productive member of society again. Needle exchanges protect public, not just drug addicts. While opponents may argue that drug-abusers must live with the consequences of their decisions to use dirty needles, the issue is not just about helping drug-addicts avoid diseases. It is also about protecting the public from the consequences of the spread of these diseases. The consequences include higher risks of infection as well as higher taxpayer costs in providing the health care for more sick people. Also, needle exchanges help protect the families of drug-addicts from the possibility of their loved-one acquiring a potentially fatal disease such as HIV.
 
Needle exchange harm-reduction puts expediency over principle. There are certain principles that should not be sacrificed to expediency. The individual choice to do drugs should be met sternly with the principle that it is wrong and that an individual that chooses to do drugs should suffer the consequences on their own, without burdening other taxpayers. The idea of needle exchange harm reduction sacrifices these principles to the expediency of reducing harm to the individuals involved. Such infractions on principle fore expediency's sake are inappropriate. Needle exchanges involve state in drug paraphernalia distribution Atlantic City judges ruled in 2005 against Needle Exchanges on the basis that: "Atlantic City and its employees are not exempt from the (criminal) code provisions prohibiting the possession, use and distribution of drugs and drug paraphernalia simply because they adopted a needle-exchange program for beneficent reasons.
 
A needle exchange has a positive effect now, but not later. Some studies have shown that needle exchanges no effect on drug use, or a small deterring effect. These studies however tend to focus on the short term, what isn't looked at is the mass effect, on a large population scale, as well as over a very long period time. Any sort of needle exchange is a step towards condoning drug use, or at least accepting it. To eradicate drugs you never want to have any sort of acceptance of the substance. Also some studies talk about how needle exchanges give drug users, networks and a chance to get better. It would probably be a lot easier and more beneficial to simply set up networks specifically for helping people who have drug addictions.
 
If you can't find a needle exchange program, please dispose of your used needles responsibly. Don't put them in the trash. Give them to your local pharmacy, doctor's office, or hospital, who may provide you with a sharps container. If a disposal container is not available, many U.S. states recommend using a bottle with a screw-top cap (carefully marked as containing needles). Please note that people often collect used bottles and cans to collect recycling fee refunds, so be sure to dispose of the bottle in a location unlikely to be accessed by the public, and choose a bottle that cannot be pierced and does not have a recycling refund. Soda bottles are particularly risky because they are attractive to bottle collectors.
 
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