TIME FOR A NATIONAL CLEAN NEEDLE EXCHANGE PROGRAM

Intravenous (IV) drug use is not the subject of casual conversation; often, it is stigmatized or not even acknowledged. However, the fact is that there are an estimated 350,000 people who inject illicit drugs living in the United States — a number not to be ignored.

Drug addiction is a disease that takes more than mere willpower to combat. Will shaming or disregarding an individual living with addiction help the person recover? Is it going to help greater society?

Throughout the country, HIV/AIDS, hepatitis C and other infectious diseases, as well as bacterial and fungal infections, are spread due to the sharing and/or reuse of syringes. Out of the 950,000 people in the United States living with HIV/AIDS, over one-fourth of the AIDS cases are found in people who inject drugs aged 13 or older; that number is even higher when linking IV substance use with infectious disease transmission through sexual intercourse or pregnancy. Hepatitis C is the most prevalent blood-borne illness in the U.S.; in parallel, IV drug use and the sharing of used needles is the leading mode of hepatitis C transmission. Thus, injection drug use is not a personal problem but a public health issue that can affect us and the communities in which we reside.

So what can we do? Do we continue to turn the other cheek? Do we continue to discriminate? There is another way. And the other way is through a harm reduction approach.

Instilling a national clean needle exchange program has the potential to increase the number of individuals who utilize drug rehabilitation services; with an increase in drug treatment, there will be a decrease in communicable disease statistics. Similarly, clean needle exchange programs directly decrease transmission through the disposal of contaminated syringes, while providing access to clean and safer means. These programs may also offer education, vaccinations, and testing for communicable diseases and sexually transmitted diseases, as well as referrals to health care and prevention services. Attendants of needle exchange programs disclose less risky drug use behaviors of up to 80 percent, including acquiring and using clean syringes and paraphernalia, and not sharing equipment.

Although drug use is often — and perhaps inappropriately — associated with crime, the establishment of clean needle exchange programs are not correlated with an increase in crime statistics. In fact, with the increase in drug rehabilitation for needle exchange program participants, less criminal activity for profit has been reported. Likewise, there is not a connection between needle exchange programs and an increase in inadequately discarded syringes.

Our country has been fighting a losing war — the war on drugs. The criminalizing policies enacted by government and law enforcement are causing increases in overdoses, violence, crime and death. The punishment versus treatment approach is leading to overcrowded prisons and recidivism.

While in theory a prohibitionist approach to illicit substance use may sound promising, the fact is that the war, so to speak, is doing more harm than good. People have used drugs since the beginning of civilization and will continue to. However, now one often must go through unsafe means to acquire the substances, and harmful modes of use of the substances that are of impure quality.

With the ban on drugs in place, the U.S. government prohibits the allocation of federal funds toward clean needle exchange programs. Despite this harm-inflicting policy, the 38 states that have chosen to employ 185 needle exchange programs report the removal of approximately 25 million contaminated needles within neighborhoods, a five-time increased rate in utilization of drug treatment services, as well as reductions in HIV transmission up to two-fifths. While the total cost to implement a needle exchange program in an average city is approximately $160,000, this is drastically lower than the cost to society without these resources, both fiscally and medically, as the programs aid in the decrease of “infectious disease, addiction, mental health issues, poverty and homelessness.”

Though it is true a harm reductionist approach is not a do-no-harm approach, medical practitioners and researchers assess the pros and cons of policy implementation, with the intent to produce a positive outcome of possible benefits compared to imposed harm. Although instilling a national clean needle exchange program would not eliminate injection drug use, it would benefit greater society, outweighing the risks of harm. The execution of these programs shows that people who inject drugs will use clean syringes when accessible. Since the utilization of sterile equipment reduces disease transmission, the administration of a national clean needle exchange program is a well-grounded harm reduction proposal.