Needle Exchange Programs in the Urban Core promote good health practices and are important mechanisms for predictably protecting the well being of the mainstream community while saving those who are the most incapable of making good decisions about their health.

Why does the USA Federal government punish those who most need a clean needle?

The American Journal of Public Health argues in favor of government sponsored needle exchanges:

New Haven, Conn. — For injection drug users, the most productive and cost-effective approach to managing the spread of HIV is expanding syringe exchange and drug treatment, as well as promoting antiretroviral treatment for those already infected with HIV, according to a new study by researchers at Yale School of Medicine.

The Kaiser Family Foundation provides this analysis of drug use in the city center:

* The use of sterile injection equipment would reduce the risk of the spread of HIV, hepatitis, and other diseases, even among users who fail to reduce the frequency of injection.

* Needle and syringe exchange programs would be one way to bring injection drug users into drug treatment programs.

* Needle exchange would be a bridge to general clinical care, including early intervention services for HIV infection.

* Contact with a needle exchange program would be an opportunity to impart advice about adopting safer sexual practices.

Needle and syringe exchanges are not the only possible means of distribution. Pharmacies in some countries sell needles and syringes to drug users, in some cases giving a discount for equipment returned. They have the advantage of being open for long hours and, at least in urban areas, enjoy relative anonymity. A needle exchange program in Tacoma, Wash., operates out of a clinic pharmacy.

We need a federally funded Needle Exchange program in the USA to protect the general welfare and to provide for the needs of the drug-disabled.

Needle exchange programs, which increase the availability of sterile syringes, are an important means of reducing the transmission of HIV infection and other blood-borne diseases such as hepatitis B and C among injection drug users and their often unsuspecting sexual partners and children – the most rapidly growing population of people with HIV. Most needle exchange programs operate on a one-for-one basis, so they also reduce the presence of infected needles in playgrounds, streets, and trash receptacles, thus protecting children, sanitation workers, and others from accidental needle sticks.

The use of federal funds to support needle exchange programs has been prohibited by Congress since 1988. The original intent was that the ban on federal support would remain in effect until the U.S. Secretary of Health and Human Services determined that such programs were effective in preventing the spread of HIV and did not encourage the use of illegal drugs. In the years since the funding ban was put instituted, an impressive number of researchers and medical organizations have carefully examined the issue and concluded that needle exchange programs are effective, necessary, and did not increase injection drug use.

In December 2007, the federal ban on exchanging needles by using city money to pay for the program was finally lifted:

WASHINGTON — President Bush signed legislation on Wednesday lifting a ban that for nearly a decade has prevented city officials here from using local tax money for needle exchange programs.

Officials of the District of Columbia Health Department said that with the ban lifted, they would allocate $1 million for such programs in 2008.

Since 1999, the nation’s capital, which reports having the highest rate of AIDS infection of any major city in the country, has been the only city barred by federal law from using municipal money for needle exchanges. A recent report by the city showed that intravenous drug users’ sharing of needles was second only to unprotected sex as a leading cause of H.I.V. transmission.

Needle Exchange programs do not promote drug use.

Needle Exchange programs in the streets and back alleys reduce cross-transmission of infectious diseases:

NEW YORK – Seeking bold action to stem the HIV/AIDS epidemic among black Americans, the NAACP, the National Urban League and other groups Thursday urged Congress to repeal a 20-year-old ban on federal funding for needle exchange programs.

More than 200 such programs have been established locally and regionally across the country, with the aim of slowing the rate of HIV infection among drug addicts who might otherwise use contaminated needles.

Advocacy groups say the ban on federal funding leaves many of these programs in a shaky financial position while deterring many local and state officials from supporting needle exchange.

“We are talking about saving lives,” said Allan Clear, executive director of the Harm Reduction Coalition, which coordinated the lift-the-ban campaign to coincide with National Black HIV/AIDS Awareness Day.

Blacks are disproportionately affected by HIV/AIDS — though comprising only 13 percent of the U.S. population, they accounted for roughly half of new HIV cases in 2005, according to federal figures. Injection drug use is now blamed for causing roughly a third of new HIV cases in the United States — and it accounts for a higher proportion of cases among blacks than among whites.

Can we come together in the best interests of the greater health of a nation and exchange a dirty needle for a clean one without making a moral judgment or a values-based qualification of needs and necessity?

Or are we always doomed to become the smallest of us in declaring bad behavior as forever in need of punishment instead of reformation?


  1. Give them all the needles and drugs they want, David. The barter is they have to leave the rest of us be. They can’t steal from us. Or beat people up for money. Take care of all their basic needs and let them die. That’s what they want anyway right? They are trying to change their life with the pathways to death. Let them do it.

  2. That’s a scary thought, Anne! I agree people should be allowed to choose their lives and their paths to death — but if they are doing mind-altering things and they’re roaming free… I have a feeling lawlessness and a failure to honor the “barter” would result and that would make us all more miserable in our skins.

  3. To me the illegalization of drugs seems curious. Tobacco = legal. Alcohol = legal. Heroin = illegal. Why? I wonder to what extent fewer people would use drugs if they were legal – it’s less of a thrill to do something that you’re allowed to do, I think.

    If we’re going to tax and sell some mood-altering things — why not sell them all or ban them all? We tried banning booze and that didn’t work out.
    So now we ban the drugs people really want because the Feds can’t figure out a way to tax it and for big business to make money off of it. What a crazy game we play with our health.

  5. How much money is spent by the government because certain drugs are illegal? How much spent for arresting people who want to smoke a joint now and again? How much would be made, on the other hand, if all the drugs were legal and taxed? How many fewer people would be murdered or robbed if it cost $10 for quantity xyz of cocaine and not $100 due to it being illegal?
    So many questions.

  6. Great points, Gordon, but once the label “illegal” has been attached to a substance or drug — it becomes harder later to say, “Okay, go ahead, and here’s a tax to pay for using it.”
    Booze is hard to control. Prisoners make it in their jail cells!
    Cocaine and tobacco are very specific and hard-to-grow-anywhere sorts of “commerce.”
    Why do I feel if we natively had in the USA the poppy fields Afghanistan holds… we would all be high all the day long and taxed for the experience and paying higher prices for the Big Medicine “pure and safe” version of the drug?

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