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Debate: Needle exchanges

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Revision as of 15:34, 1 July 2009

Are needle exchanges a good idea? Do they improve public health/safety?

Background and context

Among the drug users all over the world,they usually share needles,for many users sterile syringes are not readily available and drug paraphernalia laws in some countries make it an offense to distribute or possess syringes for non-medical purposes.These needle exchange programs availing the sterile needles to intravenous drug users for free have been a complete controversial hook for the war against drugs.As the count of people diseased of hepatitis,AIDS etc has been constantly hiking such programs have sprung up as a noble attempt to waive off the further spread of such diseases.While others argued that needle exchange programs condoned illicit and immoral behavior and that government should focus on punishing drug users or making them drug-free.Several Questions that rise up in this context are:Does needle exchange or easy availability of needles hike up the drug-use? Is needle exchange a more economic measure than treating those who are already affected with such diseases? Does government refusal to needle exchange programs a wise decision?Do these programs increase awareness about these diseases? Is halting the use of drugs the only way to halt the spread of disease among drug users?

Write Subquestion here...

Yes

  • Needle exchanges do not increase drug use Karthik Reddy. "The Case for Needle Exchange". October 25, 2007: "The opposition to needle exchange programs would have us believe that such programs encourage drug use. Studies of the Amsterdam program, however, demonstrate that drug use does not increase; the programs generally only attract those who have already become intravenous drug users. The implementation of the San Francisco program actually resulted in decreased drug use, as the program established much-needed links with the drug-using community."
  • Needle exchanges help fight HIV/AIDS, save lives "Build on success of needle exchange." Delaware Online. June 26, 2009: "the department wants to reduce the harm of more addictions. And it has some evidence of success to back the plan. [...] During its two years of operation, the pilot Needle Exchange Program enrolled more than 440 clients and tested 1,000 for HIV. These numbers are part of the often-untold good news of AIDS prevention in Delaware. [...] They are also useful in tracking the spread of AIDS and coordinating private services with state resources to reduce the costs of the spread and treatment of the disease. [...] Even without an $800 million budget shortfall to stare down, the General Assembly budget writers have a stake in controlling the spread of HIV/AIDS through intravenous drug use. The Centers for Disease Control and Prevention estimates that 20 percent to 25 percent of those with HIV do not know they are infected. This group is responsible for as much as 53 percent of new infections. [...] It's understandable that legislators who represent this part of New Castle County want to review this plan more thoroughly. [...] But harm reduction is at the core of their responsibility as crafters of bills for the public good."
  • Needle exchanges help fight the spread of many different diseases. Mark Cichocki. "Why Do We Need Needle Exchange?". About.com. September 3, 2007: "Needle exchange programs have also achieved reductions in the rate of hepatitis infection, which can also be spread through sharing needles. In Tacoma, WA, clients of a needle exchange program were up to eight times less likely to contract Hepatitis B or C than non-client IVDUs."
  • Needle exchanges are favored by many publics. "Survey finds most voters favor needle exchanges." AIDS Policy Law. May 30, 1997: "AIDS: A poll conducted in April 1997 by the Human Rights Campaign indicates that a majority of Americans favor needle-exchange programs to curb the spread of HIV. Thirty-two percent of those interviewed strongly favor needle exchanges and 23 percent somewhat favor the strategy. Support for such programs was found in every region of the United States. Republicans were split but strong majorities of independents and Democrats were in favor of needle-exchange programs."
  • Needle exchanges ensure used needles are appropriately disposed. Needle exchanges are a place where drug users can take their used needles and dispose of them, in exchange for new needles. This helps ensure that individuals do not simply throw away their used needles in parks and elsewhere.
  • Needle exchanges can help bring addicts into treatment regimens. Needle exchanges are valuable ways to bring addicts into a formal, institutional system, through which they can be connected to various treatment and job-search mechanisms.
  • Social services for addicts can be centered around needle exchanges. "Needle exchange options; pros and cons". Canada.com. March 21, 2008: "Pros: The St. John Ambulance building on Pandora Avenue is only about two blocks away from the current Cormorant Street needle exchange, meaning drug addicts are already in the area. The St. John building is, however, considerably larger and beside the new Our Place, which offers transitional housing, outreach programs, social services, and amenities like washrooms for people living on the street. The new building will also house health professionals to diagnose, test and treat this sickly population. The building will house about 50 health care and social service providers including Assertive Community Treatment outreach teams, doctors, nurses, addiction counsellors, social workers and street nurses. Police would also have a presence inside and outside the building to maintain public order. More flexible hours of operation, and the possible use of a courtyard, mean drug users won't congregate all at once outside the building."


No

  • Needle exchanges increase crime Toni Meyer. "Making the case for opposing needle exchange". New Jersey Family Policy Council. November 16, 2007: "Crime Increases in Area of Needle Exchanges: - Crimes Due to Drug Use: When a needle exchange program (NEP) moves in, associated crime and violence follows, including prostitution which contributes to the spread of AIDS. A spokesperson from the Coalition for a Better Community, a NY City based group opposed to NEPs, visited the Lower East Side Needle Exchange with a NY Times reporter. Their conclusion: “Since the NEP began we’ve seen an increase in dirty syringes on our streets, in schools yards, and in our parks…Brazen addicts shoplift, loot, and steal to buy drugs."
  • Needle exchanges create the open injection of drugs surrounding NEPs. Toni Meyer. "Making the case for opposing needle exchange". New Jersey Family Policy Council. November 16, 2007: "Increased, Open, Injection drug Use in Areas surrounding NEP’s due to influx of users. In Downtown Eastside (Vancouver BC), police estimate there are 7,500 to 8,000 addicts, and users shoot up on the streets because the injection site has waits of up to 45 minutes5. More police had to be assigned to the area to try and minimize the number of users who were shooting up outside the NEP area."
  • Needle exchanges create undesirable and unsafe communities.
  • Needle exchanges increase discarded needles on streets. Toni Meyer. "Making the case for opposing needle exchange". New Jersey Family Policy Council. November 16, 2007: "Discarded Needles: Reports of discarded needles in public places outside of NEP sites abound from cities with NEP’s. Here is just one example. In Cairns Australia, City Place has been revealed as Cairn’s biggest drug shooting gallery with 1000 syringes discarded since January in toilets and streets surrounding the inner city mall. Addicts are also dumping hundreds of used syringes at many of the city's other popular public places, including the Esplanade near Muddy's playground, the city library, in gardens and in various other public places. The figures were released by Cairns City Council after a recent audit of its sharps disposal bin program7."
  • Needle exchanges fight disease at expense of bigger drug problem. Aaron Lawrence. "Why a Needle-Exchange Program is a Bad Idea". Record. August 26, 2005: "The drug problem is arguably bigger and more threatening to public health and stability than disease problems. And, yet, needle exchanges seem to place the interests of fighting diseases over the interests of fighting drugs, in so far as needle exchanges actually enable drug-use, in order to reduce the spread of disease."
  • Referrals to treatment are sometimes very low at needle exchanges. "Report: Needle Exchange Program Finds Mixed Success in Atlantic City". Join Together. January 22, 2009: "Atlantic City, N.J.'s needle-exchange program -- the state's first -- has succeeded in its primary mission of collecting dirty needles from drug addicts in exchange for clean ones but has had less success getting addicted individuals into drug treatment, a new report concludes. [...] the Atlantic City program ranked last among the state's four needle exchanges in terms of referrals to drug treatment, with only 74 referrals made. Program coordinator Therese Wilkerson said that staff must walk a fine line between wanted to get clients into treatment and scaring them off by pushing too hard."
  • Needle exchanges give tacit approval to drug use. Toni Meyer. "Making the case for opposing needle exchange". New Jersey Family Policy Council. November 16, 2007: "Due to their potential to take more risks, young people must receive a clear 'NO' on Drugs: Harm reduction campaigns like NEPs send the wrong message to the community and to young people. Rather than supporting the 'zero tolerance' message that they are most likely receiving from home and currently in school, NEPs send the message 'if you do decide to take drugs, we’ll help you with clean needles'. A report by Columbia University published in September 2001 is the most exhaustive study ever undertaken on data on substance abuse in schools and among students. The report’s data illustrates that even one exposure or an early pattern easily becomes an addiction in young people. One of the key findings states, 'relatively few students who experiment with a substance discontinue it’s use. Among students who have ever tried cigarettes, 85.7 percent are still smoking in the 12th grade, of those who have ever been drunk, 83.3 percent are still getting drunk in the 12th grade, and of those who have tried marijuana, 76.6 percent are still using in the 12th grade.'"
  • Needle exchanges illegally distribute drug paraphernalia. Atlantic City judges ruled in 2005 against Needle Exchanges on the basis that: "Atlantic City and its employees are not exempt from the (criminal) code provisions prohibiting the possession, use and distribution of drugs and drug paraphernalia simply because they adopted a needle-exchange program for beneficent reasons."[1]
  • General statements against needle exchanges Dr. David Murray, chief scientist at the Office of National Drug Control Policy: "Needles are not the magic bullet. We are being politically pressured to make this decision (in favor of needle exchange). But it's time to rethink if there's a more humane, effective public health response than continuing to support injection drug use."[2]
  • Addicts choose to take drugs; must live with disease risks. While it is true that individuals that do drugs and share unclean needles face a greater risk of HIV/AIDS.


Is needle exchange program more economic than treating the affected patients?

Pro

  • Needle exchange Program has a strong fiscal imperative "Are Needle Exchange Programs a Good Idea?" by Jenny Murphy, Bryan Knowles;Thursday, June 15, 2000":"An article in the medical journal Lancet estimated that 4,400 to 10,000 HIV infections among U.S. intravenous drug users could have been avoided between 1987 and 1995 if the federal government had implemented syringe exchange nationally, saving over $500 million in health care costs. Action taken in early 1997 could have prevented an additional 11,000 infections by the year 2000, saving over $600 million."


Con

Do needle exchange program increase/decrease crime rates?

Pro

Con

Do needle exchange programs increase the drug use?

Yes

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No

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Pro/con sources

Yes


No


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