Government-funded needle-exchange programs have always been a topic of contention. On the surface, it’s exactly as it sounds: when implemented, abusers of narcotics—in this case, we’re mostly talking about heroin—can walk into any clinic or over-the-counter drugstore, and trade out used needles for clean ones. The reaction most of us have is why; why would we support a program that enables others to continue a habit that is not only destructive to themselves, but the community around them?
According to the National Institute on Drug Abuse, in 2011 it was reported that 4.2 million Americans aged 12 or older had used heroin at least once in their lives (it is estimated that about 23% of users become dependent, so you do the math). The question we should be asking ourselves is what exactly changes if clean needles become readily available throughout the U.S.? If the departments of the Infectious Diseases Society of America (IDSA) and the HIV Medicine Association (HIVMA) have anything to say about it, a lot.
In a recent joint statement released by these two heavy hitters, IDSA and HIVMA both expressed heavy support for clean, sterile injection equipment and drug replacement therapy (for example, methadone clinics). The main reason for this is that both see drug addiction involving needles—that is, the sharing and re-sharing of unclean injection tools—as one of biggest causalities of HIV-infection in the U.S. They wouldn’t be too far off either; according to a government AIDS website, injection drug users represented 8% of new HIV infections in 2010 and 16% of those living with HIV in 2009; since the epidemic began, nearly 182,000 injection drug users with an AIDS diagnosis have died, including an estimated 4,218 in 2010.
And it’s not just HIV. Injection drug use is a major route of transmission for viral hepatitis and other blood-borne pathogens.
According to Barbara Murray, MD, FIDSA, and president of IDSA, via Medical News Today:
“In addition to contributing to a decrease in incidence of HIV and viral hepatitis, syringe exchange programs also provide a point of access to healthcare for underserved populations. By providing condoms, counseling, testing, and entry into drug abuse treatment, syringe exchange programs do much more than provide clean needles. They are a critical component of an effective response to a major public health crisis that continues to increase.”
It’s true that as many as 46 other countries and regions have introduced needle-exchange programs since the first one opened up in Amsterdam in 1984, but evidence as to the effectiveness of the treatment has been spotty—what everyone seems to agree on is that there are, at the very least, some positive results. The World Health Organization even stated in a 2004 report that there is “compelling evidence” that the programs reduce HIV infections [Reuters].
Are we willing to give needle exchange programs a chance? What do you think?