What do you think when you hear the phrase “needle exchange program”? For many, a myth has circulated spooking folks into thinking of needle exchange programs in a rather negative light. As with almost everything else that has served as controversial– legalization of marijuana, gay marriage, or abortion – people always think that once these initiatives are established, these social issues will sweep up the nation and cause some sort of drastic increase in use, or participation of the issue. For example, some people argue that once marijuana is legalized, more people will be inclined to use it… Others say that if gay marriage is legalized, then everyone will become gay… etc. The same logic tends to serve as the pivotal point of argument for people who are against the promotion of needle exchange programs. Many citizens feel that if needle exchange programs were to begin to operate in their communities, then there would be an increase in drug use and drug related crimes. However, there is countless research to argue exactly the opposite. In my personal opinion, needle exchange programs should definitely be implemented in communities all along the United States, and elsewhere throughout the world. In fact, research from Schechter, Kaplan, Tookes and many others have shown that these programs actually prevent blood borne diseases, keep needles off the streets, and even serve as a fantastic opportunity to help the homeless and lesser privileged individuals of a society.
On one side of the argument, people have said, and wisely so, that needle exchange programs could encourage individuals to create new needle sharing networks. This essentially means that participants of such programs will be encouraged to form close bonds with other injecting drug users, and perhaps engage in harmful needle sharing practices. This in turn, as some researchers argue, produces more harm than good for a community. To explore the validity of this viewpoint, a study was conducted by Schechter and colleagues (1999). After following nearly 700 drug using participants for fifteen months, these researchers determined that there was no evidence to suggest that needle exchange programs promoted the formation of newer needle sharing networks and there was no evidence of riskier practices among those who attended needle exchange programs. Another study compared a city with multiple needle exchange programs (San Francisco) to another city that did not have a single available program (Miami). It was found that even though Miami had significantly less injection users than San Francisco, there were nearly eight times more discarded needles found on the streets of Miami (44 syringes per 1000 block in San Francisco, to 371 syringes per 1000 blocks in Miami).
Furthermore, if we let the needles “do the talking”, clean needle exchanges have been shown to reduce the rate of HIV infection when clean needle exchange was being promoted in an area. In the 1990s, Connecticut (as well as many other areas) saw a rapid increase in the spread of the AIDS virus. In an attempt to prevent the spread of this virus, Connecticut implemented a needle exchange program. A rather simple tracking and testing system found that the clean needle exchange program reduced the HIV infection rate by a significant 33%. The study had such profound implications that more needle exchange programs were created in surrounding cities. In addition to all of this, and perhaps most important, is that needle exchange programs have found that attendees tend to reduce risky injection drug use behaviors. Studies done in Baltimore, as well as other cities, have found that the behaviors of these drug users tend to become less risky and less harmful (Kaplan 1993). If this is truly the case, this is incredible news for society. If the drug users themselves are being more careful, one can only imagine the implication that would have for our communities.
The research is strong in this area and more often than not, it points in favor of the necessity of needle exchange programs and the promotion of clean needle exchange. Not only do these programs help promote safer needle sharing between users, but it also keeps used syringes off the streets which thereby reduces the prevalence of blood borne diseases in the general public. Clean needle exchange programs have been used in the United States since 2009 and most evidence suggests that these programs work to promote good in society. Through this program, society can reach the unreached and make a positive impact on them. If we can positively appeal to known injecting drug users, then they themselves can go out and reach unknown injecting drug users. This community based approach, rather than a treatment based approach, can make a world of a positive difference in our society.
References:
Kaplan, E. & Keefe, E. Evaluating the New Haven Needle Exchange. Interfaces, vol. 23, issue 1, pp. 7-26. http://pubsonline.informs.org/doi/abs/10.1287/inte.23.1.7
Schechter, M., Strathdee, S., Cornelisse, P., Currie, S., Patrick, D., Rekart, M., & Shaughnessy, M.Do Needle Exchange Programs Increase the Spread of HIV among Injection Drug Users? Official Journal of the International AIDS Society, vol. 13, issue 6, pp. 45-51. http://journals.lww.com/aidsonline/Fulltext/1999/04160/Do_needle_exchange_programm es_increase_the_spread.2.aspx
Tookes, H., Kral A., Wenger L., Cardenas G., Martinez A., Sherman R., Pereyra M., Forrest D., LaLota M., & Metsch L. (2012). A Comparison of Syringe Disposal Practices Among Injection Drug Users in a City with Versus a City without Needle and Syringe Programs.US National Library of Medicine, vol.123, pp. 255-259. http://www.ncbi.nlm.nih.gov/pubmed/22209091
Vlahov, D., Junge, B., Brookmeyer, R., Cohn, S., Riley, E., Armenian, H., & Beilenson, P. Reductions in High-Risk Drug Use Behaviors Among Participants in the Baltimore Needle Exchange Program. Journal of Acquired Immune Deficiency Syndromes, vol. 16, issue 5, pp. 400-406. http://journals.lww.com/jaids/Abstract/1997/12150/Reductions_in_High_Risk_Drug_Us e_Behaviors_Among.14.aspx