Pubdate: Mon,  5 Jan 2004
Source: Ocean County Observer (NJ)
Copyright: 2004 Ocean County Observer
Author: David G. Evans,
Bookmark: (Needle Exchange)


The New Jersey Legislature will consider bills to provide needles to
drug addicts and needle give-away programs called "needle exchange
programs." These programs give clean needles to addicts when the
addicts return dirty needles. The concept is that, if addicts get
clean needles, it will cut the spread of the AIDS virus HIV because
addicts will not share dirty needles. These ideas, while well
intentioned, will only cause more public health problems and divert
resources from better methods of preventing the spread of AIDS. The
science is uncertain. Supporters of needle exchange frequently gloss
over gaping holes in the data -- holes that leave significant doubt
about whether needle exchange decreases HIV transmission. It would be
imprudent to take a key policy step on the basis of yet uncertain and
insufficient evidence.

Treatment should be our priority. Treatment has a documented record of
reducing drug use as well as HIV transmission. Our fundamental
obligation is to provide treatment for those addicted to drugs. Needle
exchange should not be funded at the expense of treatment.

HIV is transmitted primarily through high-risk sexual contact, even
among intravenous drug users. Contrary to prior assumptions, a
recently released 10-year study found that the biggest predictor of
HIV infection for both male and female intravenous drug users is
high-risk sexual behavior, not sharing needles. High-risk homosexual
activity was the most significant factor in HIV transmission for men
and high-risk heterosexual activity the most significant for women.
The study noted that, in the past, we assumed that HIV-positive
intravenous drug users had been infected through dirty needle-sharing.
This study proves that this assumption is very suspect. Indeed, the
use of needle exchange programs to address a problem caused primarily
by high-risk sexual behavior would seem to be highly misguided.

Needle exchange programs do nothing to ameliorate the impact of drug
use on disadvantaged neighborhoods. Needle exchange programs are
normally located in impoverished neighborhoods. These programs attract
addicts from surrounding areas and concentrate the negative
consequences of drug use in these neighborhoods, including criminal

HIV, regardless of how it is contracted, is not the primary cause of
death for intravenous drug users. A study conducted at the University
of Pennsylvania followed 415 IV drug users in Philadelphia over four
years. Twenty eight died during the study. Only five died from causes
associated with HIV. Most died of overdose, homicide, suicide, heart
or liver disease, or kidney failure.

Supporting needle exchange programs will send the wrong message to our

Provision of needles to addicts may encourage drug use. The message
sent by such government action would be inconsistent with the goals of
our national youth-oriented anti-drug campaign.

Most citizens oppose needle exchange programs in their communities,
and are concerned about the prospect of dirty needles being discarded
in public places. These fears are not without merit. Needle exchange
programs distribute millions of needles every year, and there is
little or no accountability for needles once they have been
distributed. A survey showed that, in 1998, more than 19,397,527
needles were handed out, and at best 62 percent were exchanged,
leaving 7 million to 8 million needles unaccounted for. Carelessly
discarded needles create a well-documented public hazard.

Needle exchange programs will only make a bad problem worse. We should
focus instead on drug treatment and reducing high-risk sexual behavior.


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