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The subject of needle exchanges for IV drug users has been controversial since Tacoma, WA, adopted the first such program in 1988. Advocates urged local governments to allow people who inject drugs to get fresh needles as a harm-reduction approach to HIV and other epidemic diseases. Opponents resisted legitimizing the IV drug lifestyle and generally urged rehabilitation based on total abstinence models. Tempers still flare on both sides of this emotionally wrought topic, which could probably benefit from people impartially assessing the benefits, if any, of needle exchange programs on IV drug users’ health.
What the Research Says
The use of a syringe exchange program (SEP) has shown some benefits in various scenarios. According to a study published by the U.S. National Institute on Drug Abuse (NIDA), these programs are effective at reducing HIV transmission rates among those who inject drugs. However, many people worry that these programs encourage the continued abuse of drugs. Some believe they could be undesirable within communities. What’s the truth?
Understanding the Risks
Needle exchange programs aren’t designed to treat people with addiction. Rather, their specific goal is to address the ongoing spread of life-threatening conditions such as hepatitis C and HIV. According to the U.S. National Institutes of Health, IV drug use is a leading cause of HIV transmission, and the rate has increased since 2020. Injected drugs are also responsible for much of the 2020s-era increase in acute hepatitis C infections.
What Are the Benefits of SEPs?
There are several key benefits of implementing needle exchange programs in communities.
They Reduce Needles in the Community
Safe injection points create areas where people can go to use needles in a safe, sterile environment without legal or other repercussions. They also facilitate a safe place to dispose of biohazardous products. This (in theory) helps prevent used needles from winding up in public locations. The idea is for safe injection sites to create safer environments for all people.
They Connect Addicts With Community Programs
Many of these needle exchange programs take place within community social service programs. This provides an opportunity for a person who’s using drugs to interact with and potentially gain access to the support they need to stop using. Though there isn’t a strong push toward requiring them to use these services, knowing that free testing, diagnostic services and even treatment services are available can be a motivating factor to getting clean.
They Reduce Drug-Related and Sexual-Risk Behavior in the Community
People who have a physical dependency on a drug will do anything they can to gain access to it. This often creates high-risk scenarios not only for those people but for the community as a whole, including drug-related behaviors such as stealing and overdosing in parks. It also reduces the amount of sexual-risk behavior present, such as using sexual trafficking to support an addiction.
They Create Educational Opportunities
By implementing these programs in all communities, it’s possible for individuals to gain access to educational materials and supportive guidance. This may include accessing prevention services for the next generation. It may also include helping children and teens understand the risks of drug use, even if their parents have an addiction.
They Create Protection for Support Networks
Many men and women who use drugs have families that are involved in the drug lifestyle as well and may be isolated from the support and care they need for health, education and mental well-being. These programs put families in a position to get help from other support networks. This may help prevent the spread of disease, and it ensures children receive the services they need.
What Are the Cons of SEPs?
It’s true these programs work. However, there are some negative viewpoints about them that some people may have trouble overcoming.
They Enable the Use of Illicit Drugs
From a treatment perspective, we understand that drug users can’t simply stop using. Yet the prospect of giving someone the equipment they need to do a destructive act is understandably difficult to accept. Providing access to free needles can be considered enabling the continuation of this abuse. Moreover, providing an area for injection of illicit substances can be a violation of the law. In some cases, this may seem to increase the amount of illicit drug use happening in communities. Without an in-depth knowledge of the community and the results to back it up, it seems counterintuitive that this has a net-positive gain.
They Don’t Provide Treatment
To be clear, needle exchange locations may offer a safe place to use drugs, but they don’t provide ongoing substance use disorder treatment. This is perhaps the most important disadvantage: They can’t force people who need help to get it. They also can’t provide support for complications such as HIV or other diseases present. While they may offer referrals to services, people aren’t walking into a treatment center for help.
They Introduce Contaminated Needles Into the Community
The use of needle injection sites like this does concentrate the number of needles being used to a smaller area. This is positive in that they are less spread out but may be viewed as a negative by neighbors of the safe location. It can lead to more drug use in their neighborhood.
There Is a Cost
It’s important to note that these programs must be paid for by someone. Whether the funds come from government programs or nonprofit organizations, there is a cost. More so, many communities simply don’t want the presence of such programs in their area for fear of reducing home values or creating unsafe communities for families. This “cost” of the program is often seen as a deterrent for programs in affluent communities, but drug use in those areas may still be significant.
Seeking Help From FHE Health
If you’re looking for a needle exchange program, it’s likely an indication you need help. If you or a close family member is using drugs, it’s time to seek help with direct treatment of the addiction. FHE Health offers comprehensive programs to address and treat the underlying causes of addiction.
