If you could severely mitigate the spread of the HIV, AIDS, and hepatitis C, would you?
According to the Center for AIDS Prevention Studies, injecting drug use accounts for 36 percent of AIDS cases and 60 percent of hepatitis C infections in the United States.
Despite these well-documented statistics, the U.S. maintains counterproductive policies that increase the spread of disease from intravenous drug use.
There are two approaches governments can take in response to drug use. The first is a criminal justice model that seeks to prohibit the production, distribution and consumption of illegal drugs through criminal penalties.
The second approach is known as the public health model and is based on the principle of harm reduction and seeks to reduce the health risks associated with drug use.
The most prominent public health initiative has been needle exchange programs, also known as syringe exchange programs.
The Centers for Disease Control and Prevention explains that these programs “provide sterile syringes in exchange for used syringes to reduce transmission of [âĦ] blood-borne infections associated with reuse of contaminated syringes by injection-drug users.”
These programs also provide services such as safe disposal of used syringes, HIV testing, risk-reduction education and substance-abuse treatment.
The need for programs is unprecedented. According to the National Survey on Drug Use and Health, 425,000 U.S. residents used needles to inject illegal drugs. The problem is that 71 percent did not properly clean their needle before use, and 13 percent reused a needle someone else had used.
Success of needle exchange programs has been immense. AIDS Action, a Washington D.C. nonprofit, states that after Washington D.C. established a syringe exchange program in 1996, the rate of new AIDS cases among injecting drug users dropped 73 percent. Even more striking, cities worldwide with syringe exchange programs saw HIV infection rates drop by 5.8 percent per year, as compared to a national increase of 5.9 percent per year.
Still, the U.S. remains firmly within the criminal justice model since it continues to prohibit the possession, distribution and consumption of drugs. The country has nevertheless slowly embraced a public health model by supporting needle exchange programs.
Last year, Congress passed a bill lifting a 21-year federal ban on federal funding for needle exchange programs. But it does not guarantee federal funding since needle exchange programs cannot be opened within 1,000 feet of a school, park, library, college, video arcade or any place children might gather.
Access Works!, MinnesotaâÄôs only needle exchange program, closed last year. It was unable to receive funds from private donors and the government due to the economy.
Ever since needle exchange programs were founded in Minnesota, though, they have been successful. From 1992 to 2005 there was more than a 90 percent drop in HIV transmissions from injecting drug use.
Additionally, the lifting of the ban does not abolish otherwise harmful criminal procedures.
For instance, this November two men were cited in the Como neighborhood with possession of injection equipment such as needles and syringes. Although there was no narcotic residue in the equipment, UMPD Deputy Chief Chuck Miner said, “They had enough evidence that it was used for that.”
These types of policies criminalize and marginalize injecting drug users. In order to lessen the spread of AIDS, needle exchange programs must be funded and encouraged despite prevailing stigmatization of injecting drug use.
Julian Switala welcomes comments at [email protected].