Needle Exchange Program

Reducing Harm from Drug Injection

Needle exchange programs are among the most successful yet controversial harm minimization policies that reduce the spread of disease amongst injecting drug users. This program allows injecting drug users to have access to needles and associated injection equipment such as alcohol swabs and sterilized water at little or no cost. Some of these programs require that individuals bring dirty needles back and swap for an equal number of clean needles. The theory behind needle exchange programs is to reduce the preventable harm associated with drug use. It acknowledges that drug abuse occurs and aims to minimize the damage associated with the behavior of drug use. If an addict is condemned or the behavior ignored, the harm does not go away.

Needle exchange programs are not supported worldwide and there are some nations, including the United States and Singapore, who do not believe that they should support them. Critics believe that by providing clean injecting equipment to drug users that they are condoning the behavior of illegal drug use. It is thought that needle exchange programs can also increase the likelihood of someone progressing from other methods of drug use such as inhaling to injecting because needles are available. Sadly, the majority of critics and oppositions come from a basis of politics rather than public health reasons.

Needle exchange programs are not just needle distribution programs. They also allow injecting drug users to dispose of used needles appropriately, which reduces the risk of needle-stick injuries. Many of the programs are in health centers or pharmacies where users can have access to other health services such as methadone clinics or drug treatment referrals and health education. Some of the needle exchange programs give users a pack with three needles, which contains education information about drug use and contact numbers for health services.

Needle Exchange Controversy

Supporting needle exchange programs is something that some health workers and governments find morally difficult to do. There is a belief that this policy may have some influence on a person’s drug-taking behavior. A person may progress to injecting drug use or increase their drug use because they have access to new, clean needles. Additionally, there are questions concerning the appropriateness of supporting a program that encourages drug users to inject and cause themselves more harm. Most worldwide drug policies are based in prevention and education, prevent drug use from beginning and prevent drugs from being available. However, these policies ignore the statistics of drug use and fail to consider reducing and preventing harm associated with drug use.

Recent studies have shown that the success of needle exchange programs may be overvalued and the statistics are not as promising as first thought. It is known that some diseases like hepatitis which spreads through unsafe injecting, however the disease can be active outside the body for a long time. Infections may occur through other means such as unprotected sex. Some of the programs have also come under criticism for not evaluating and assessing disease risk properly and using anecdotal evidence for scientific research. However, it should be noted that the use of clean, new needles and injecting equipment every time will prevent and reduce the risk of harm associated with this type of drug use, regardless of the statistics.

Dangers of Injecting Drug Use

Intravenous drug use is the most harmful of all drug ingesting methods. It carries an incredibly high risk of adverse health problems such as abscesses, ulcers, collapsed veins, cellulitis, septis and other disease. Injecting drug users easily contract and transmit diseases to one another through unsafe and unsanitary injecting. HIV, AIDS and Hepatitis are the most common and most serious blood-borne diseases that are linked to drug use.

Injecting drug users are at a higher risk of contracting or transmitting diseases due to sharing of needles and other equipment associated with injecting. Infected blood can remain on or in the needle that is used by more than one person and injected along with the drug by the next user of the syringe. Blood may also be present on tourniquets or filters that are shared. Injecting a drug also bypasses many of the body’s natural filtering mechanisms that protect it against disease and bacteria. If a person smokes a drug, the substance will pass through the lungs before entering the blood stream. If they swallow a drug, it is metabolized in the liver and filtered before entering the blood stream. Injecting a drug means it simply enters the blood stream and the effects of the drug are stronger and take place more quickly.

HIV and Injecting Drug Use

Drug use has been long linked to the spread of HIV and hepatitis. Over 30 million people live with HIV/AIDS worldwide. Estimates by Avert suggest that one in five injecting drug users worldwide are infected by HIV. Of all HIV infections outside of Sub-Saharan Africa, around 30 percent are the result of injecting drug use. HIV is not just a disease that affects injecting drug users. It can be spread to non-drug users through unsafe sex or can even be transferred from infected mother to baby.

HIV, or Human Immunodeficiency Virus, is the virus that causes Acquired Immune Deficiency Syndrome, or AIDS. There is no cure for the disease, AIDS but there are some treatments available for the virus, HIV. Individuals infected with HIV are at risk of contracting other, life threatening diseases because the virus weakens a person’s immune system. Cancer, pneumonia, tuberculosis, gastrointestinal problems, neurological conditions and tumors are some of the known linked diseases. HIV is contracted when an infected person’s blood or other bodily fluid comes in contact with the blood, broken skin, or mucous membranes of an uninfected person.

HIV/AIDS is preventable, especially in relation to intravenous drug administration. Needle exchange programs significantly reduce the risk of an injecting drug user contracting or transmitting the devastating disease. By following safe injecting practices such as using a clean needle, not sharing equipment and cleaning the injection site every time.

Hepatitis and Injecting Drug Use

Hepatitis B (HBV) and hepatitis C (HCV) are viral diseases that destroy liver cells and can lead to cirrhosis and liver cancer. Over 2 billion people worldwide are infected with hepatitis. Hepatitis B is 50 to 100 times more infectious than HIV. Unlike HIV, the hepatitis virus can survive outside of the body for at least seven days, during which time the virus can still be contracted by an uninfected person Hepatitis is a common disease amongst intravenous drug users because of the infection rate and the chronic incidence of unsafe needle use. As with HIV/AIDS, hepatitis can be contracted and spread through the use of dirty needles and drug equipment.

The hepatitis virus causes severe inflammation of the liver which has long-term complications. The onset of the disease is insidious and often is undiagnosed for a long time. Passing the disease on to others is a serious risk, especially for those who are intravenous drug users. Research has shown that the risk of infection for hepatitis is extremely high in the first year of injection drug use.
