In 1990, a needle exchange program was founded in the South Bronx to distribute clean syringes to heroin users in order to reduce the spread of blood-borne HIV and other STIs. At the time, the program was controversial, but now, a quarter-century later, the exchange has helped reduce disease and even lift users out of addiction. Similar programs have cropped up across the country. The needle exchange program demonstrates a more effective drug policy, one that places treatment and care ahead of punishment and elimination.
Needle exchange programs were a direct response to the AIDS epidemic. As one article in the American Journal of Epidemiology put it, “The process of needle exchange program development and expansion is due in part to epidemiologists who helped to frame a controversial topic in the scientifically grounded area of infection prevention.” “Epidemic” is hardly an exaggeration: A research paper published in the late 1990s estimated that nearly one-third of all AIDS infections were a result of drug-related injection. Government-sponsored studies into needle exchange programs revealed consistent declines in HIV infection; in the first government study into one such program, HIV infections declined by 33 percent. Time yielded greater results, as a 2010 CDC study linked the consistent success of needle exchange programs to the nearly 80 percent reduction in HIV incidences among injecting drug users over a 15-year period.
Detractors have often argued that public safety measures which reduce risk only encourage riskier behavior. It is a cautionary gripe with implications beyond drug treatment. Efforts to provide greater access to contraception have been combatted by claims that it will only encourage riskier and more promiscuous sex. These dire warnings have proven unfounded, and the stronger trend associated with greater access to contraception is a downward spiral of STIs. Likewise, needle exchange programs have faced criticism for providing drug users fuel to feed their addiction without concern for consequences. But evidence seems to show that needle exchange programs, which usually provide some sort of drug treatment program, are associated with a reduction in injections and more time spent in treatment.
The claim that needle exchanges support drug use is dubious, but what is indisputable is the sharp reduction of HIV and other STIs as a result of needle exchanges. Condemning the addicted to a lifelong illness to serve as a deterrent for others encapsulates the callous approach that characterizes so much of U.S. drug policy. The needle exchange typifies an increasingly favored approach which chooses treatment over punishment. Just this January, Congress effectively lifted a ban on federal funding for certain operations of needle exchanges. National support for exchange programs lends hope to a future where society treats the ill with care instead of punishing the victim and labeling caregivers as accessories to addiction.
Opinions expressed on the editorial pages are not necessarily those of WSN, and our publication of opinions is not an endorsement of them.
A version of this article appeared in the Monday, April 18 print edition. Email Abraham Gross at [email protected]