Stimulant Abuse

unning head: PROS AND CONS OF THE ADOPTION OF NEEDLE EXCHANGE

Pros and Cons of the Adoption of Needle Exchange as Related to Intravenous Drug Users

Nicole C. O'Connor

University of South Florida - Tampa

Pros and Cons of the Adoption of Needle Exchange as Related to Intravenous Drug Users

Heroin is an illegal, highly addictive drug which poses special problems because of the transmission of HIV and other diseases that can occur from sharing needles and other injection equipment. It is the most abused and the Infection of injection drug users with HIV is spread primarily through reuse of contaminated syringes and needles or other paraphernalia by more than one person, as well as through unprotected sexual intercourse with HIV-infected individuals (Heroin, n.d., para. 2). Injection drug use is also the most common risk factor for persons with hepatitis C infection. Up to 90 percent of IDUs are estimated to be infected with hepatitis C, which can be easily transmitted (Lurie & DeCarlo, 1998).

So, what is being done to put a halt to the spread of these infectious diseases? The U.S. Public Health and several institutions and governmental bodies have recommended the use of sterile syringes as an important reduction strategy. These are more widely known as needle exchange programs, which make sterile needles available to intravenous drug users for free, in exchange for old, shared needles. Based on the assessment that it is impossible to completely eliminate intravenous drug use in society, needle exchanges were first instituted in Amsterdam in 1983 (Fuller, 1998). Since then, many countries have adapted these programs, including the United States. More than 100 needle exchanges have now been established in the United States (Fuller, 1998). However, as opposed to their fairly widespread acceptance in many other countries, needle exchange programs have encountered considerable resistance in the U.S. and have since been a controversial component in the war on drugs. There are numerous arguments proposed on both sides of the issue of needle exchange, which will be outlined and analyzed throughout the rest of this paper.

"Increasing the availability of sterile syringes through needle exchange programs, pharmacies, and other outlets reduces unsafe injection practices such as needle sharing, curtails transmission of HIV/AIDS and hepatitis, increases safe disposal of used syringes, and helps injecting drug users obtain drug information, treatment, detoxification, social services, and primary health care" (Needle Exchange, n.d., para.1). Needle exchange programs serve a diverse population of drug users. One-third to one-half of NEP clients have never been in drug treatment, have reported needle sharing in the past, and are primarily regular to frequent injectors that are at substantial risk for HIV infection (Lurie & DeCarlo, 1998). By supplying IDUs with clean, sterile syringes and needles, it is helping to decrease the likelihood that disease, such as HIV, will be transmitted to other users. By decreasing the link between injection drugs use and HIV, it is possible that the number of children born with HIV could also decrease, seeing as more than 75 percent of babies diagnosed with HIV/AIDS were infected as a direct or indirect result of injection drug use (Fuller, 1998). Needle exchange programs don't just pass out needles to drug users and send them on their way. Needle exchange programs also hand out condoms, promoting safe sex, and give out alcohol wipes, bleach and other tools to disinfect any other needles that may be used. Between 1991 and 1997, the U.S. government funded seven reports on clean needle programs for persons who inject drugs. The reports are unanimous that clean needle programs reduce HIV transmission (Murphy & Knowles, 2000). Needle exchange programs can also act as bridges to public health systems and drug treatment facilities to help IDUs get clean. NEPs have contact with drug users with limited or no prior experience with drug treatment. The needle exchange programs give out referrals not only to drug treatment facilities, but also to HIV counseling and testing, primary medical care, sexually transmitted disease screening and treatment, and psychological counseling and support. Also, needle exchange programs are relatively inexpensive to fund. Needle exchange programs have a median annual budget of $169,000. Since the yearly cost of treating one person with AIDS is $38,300, each needle exchange program would more than pay for itself by preventing the transmission of HIV/AIDS to just five people (Murphy & Knowles, 2000).

However, will needle exchanges really make that much of a difference? A recovering addict simply stated in one article, "The only needle any heroin addict is interested in is the one with the heroin in it. You can have 50 clean needles in a 'shooting gallery' and the addicts will wait for the one filled with heroin to be passed with no thought of who used it last" (Needle Exchange, n.d., para. 4). By supporting needle exchange programs, people are saying that IDUs are rational thinkers, while years of studies show otherwise. While there are few exceptions, the majority of addicts are not likely to be thinking about anything