The benefits of syringe exchange programs (SEPs) have been widely known since 1997 when a Report to Congress concluded that they could greatly reduce the transmission of HIV. However, laws prohibiting the sale of syringes without a prescription and a ban on government funding of exchange programs, the intervention could not be implemented. While the funding restrictions have been repealed, the legality of a syringe is still an issue in a few states.
Over one million Americans are living with AIDS with approximately 50,000 new infections each year. 34% of those new cases are due to needle sharing by intravenous drug users (IDUs). Among women and children, 75% of these new cases can be attributed either directly or indirectly to the sharing of needles. As the second highest cause of HIV, and 100% preventable, these statistics are simply unacceptable. With statistics as disheartening as mentioned, it is easy to imagine that effective interventions have not yet been found to combat the problem. This however is not the case. The data is quite the contrary, with countless studies worldwide proving the benefit of syringe exchange programs (SEPs). Risk behavior is shown to decrease by up to 80% while HIV transmission rates are shown to decrease by at least 30%. These numbers seem promising, so there must be economic reasons to not implement SEPs right? Wrong. An average syringe distributed to a user costs $0.97. With IDUs injecting on average 1,000 times per year, the cost for a year’s supply of clean syringes would cost the government in the ballpark of $970 per user. This may seem expensive until you compare it to the cost of medication, hospital visits and lab tests of a person infected with HIV/AIDS, which can cost upwards of $190,000.
So why aren’t there needle exchanges everywhere? As Elizabeth Pisani explains in her TED talk, it is all about rationality (Click here to watch) Government officials are driven by what will get them re-elected. People will not vote for someone who puts the well being of a druggie above education for their children. Voters complain that enabling a junky’s habit sends the wrong message to kids. On the IDUs side, there is also the rationality of using their own needles. In many states, it is illegal to be carrying a syringe without a prescription. To them the reality of being arrested in the near future is much more of a threat than the reality of contracting HIV and being sick in ten years. Once the two sides come together rather than fight each other, SEPs can start making a difference on a much larger scale.
The benefits of syringe exchange programs go beyond conversations of budget and HIV/AIDS prevention. In addition to providing clean needles, SEPs provide free condoms, general health services, education, references to rehabilitation centers and most importantly, people a drug user can trust. A recent study published in the Drug and Alcohol Review examined what needle exchange programs meant to the users who frequented them. The findings attributed much of the drug use to traumatic experiences resulting in mistrust of others. While redeveloping trust may seem inconsequential to most, to a junkie who is homeless and living only to get a fix, it is one of the first steps to recovery. Once relationships between clinic workers and injectors are formed, there is a greater chance the user will find help and stay sober. The Harm Reduction Coalition asked IV drug users how needle exchange programs impacted their lives. One man said, “I found a local underground needle exchange. They helped me kick heroin the first time by checking up on me and referring me to a non-judgmental medical doctor.” By coming in constant contact with people who are simply there to help and not judge, drug users can find help when they are ready. Another man said, “The people at exchange helped us to use safely and talked with us about treatment when we were ready. Because of them we were able to quit with knowledge about what was going to happen and how to make a plan for stopping.” It is clear that syringe exchange programs work, now we must simply make it easier for injection drug users to have access to them.
Sources
“Fact Sheet: Drug-Associated HIV Transmission Continues in the United States | Factsheets | CDC HIV/AIDS.” Centers for Disease Control and Prevention. Web. 20 Feb. 2011. <http://www.cdc.gov/hiv/resources/factsheets/idu.htm>.
“Harm Reduction Coalition : Our Stories: How Needle Exchange Impacted My Life.” Harm Reduction Coalition : Index. Web. 20 Feb. 2011. http://www.harmreduction.org/article.php?id=924
“Sterile Syringe Access (Needle Exchange).” Drug Policy Alliance: Alternatives to Marijuana Prohibition and the Drug War. Web. 20 Feb. 2011. <http://www.drugpolicy.org/reducingharm/needleexchan/>.
Pisani, Elizabeth. “Elizabeth Pisani: Sex, Drugs and HIV — Let’s Get Rational | Video on TED.com.” Lecture. TED International. TED: Ideas worth Spreading. Web. 20 Feb. 2011.<http://www.ted.com/talks/lang/eng/elizabeth_p isani_sex_drugs_and_hiv_let_s_get_rational_1.html>.
Thought I’d also add that research says providing sterile equipment has been found to increase the likelihood of drug users to initiate drug treatment, and does not increase drug use (National HIV AIDS Strategy).
It is discouraging to see politicians deny the proven benefits of such programs. Like Pisani says, in the end, it may be up to us (the voters) to persuade our politicians to advocate for SEPs.
I was completely unaware that these types of programs existed. I imagine voters too are not aware of the benefits these programs can have for society. Unlike Willis’ comment that voters need to change the minds of politicians, I feel it is going to take advocating from public figures for SEPs to make a large scale impact. Even if that means putting them at risk for backlash from the public. I feel like voters are just unlikely to fully educate themselves on this issue, simply because on the surface SEPs appear to be promoters of drug use.