In March 2019, Governor Brad Little signed legislation allowing needle exchanges in Idaho. This step aimed at addressing the ongoing drug crisis in Idaho is not without controversy. While supporters say that needle exchanges, harm reduction measures, and other addiction resources save lives, opponents say these programs enable and encourage illegal drug use.
What to Know About Needle Exchange Programs in Idaho
Needle exchange programs establish sites where users of intravenous drugs like heroin, cocaine, and methamphetamine can obtain sterile needles for free, with no questions and no interference from law enforcement. Any used needles brought in will also be safely and properly disposed of. The Idaho program has three main public health goals:
To stem the opportunity for disease transmission that can happen when people struggling with addiction use contaminated syringes
To expand the opportunity for referrals to drug treatment programs
Safe disposal of used needles, thereby preventing accidental infections within the community
It is essential to understand that needle exchange programs are not implemented to stop drug abuse. They are put in place as a means of reducing the public harms resulting from a drug epidemic that has been called the worst public health crisis in American history.
Why Are Needle Exchanges in Idaho Needed?
Of all the ways to consume drugs, intravenous injection carries the most risks. Among people who inject drugs for less than five years, up to 40% admit to sharing needles. By bypassing the body’s natural filters, IV drug users are at greater risk for infection from bacteria or viruses such as HIV, AIDS, or hepatitis B and C.
Facts About HIV Among People Who Inject Drugs
- In 2015, the Centers for Disease Control and Prevention found that 9% of new HIV infections are directly attributable to IV drug use. This is significant because people who inject drugs only make up between 1% and 3% of the population.
- Among Idaho males, over 11% of new HIV cases involve IV drug use. And among Idaho females, the rate is over 12%.
- Even washing a needle with bleach does not kill the HIV virus—it can survive within the blood found in a used needle for up to 42 days.
- 56% of HIV-positive people who inject drugs are homeless.
Facts About Hepatitis C Among People Who Inject Drugs
- In 2010, there were 850 confirmed new hepatitis C infections. By 2015, that number had jumped to 2,436. The single largest contributing factor was intravenous opioid abuse.
- Up to 90% of HIV-positive people who inject drugs also have hepatitis C.
- There were nearly 20,000 hepatitis C deaths in 2015.
- 33% of people who inject drugs between 18 and 30 are infected with hepatitis C.
- Among older and former people who inject drugs, the rate of hepatitis C infection is estimated to be between 70% and 90%.
The Hazards Go Beyond HIV and Hepatitis
Although HIV, AIDS, and hepatitis all of the disease are most often thought of in connection with IV drug use, several other serious health conditions go largely unmentioned:
- Staph infections
- Necrotizing fasciitis
- Septic thrombophlebitis
- Bacterial endocarditis
This last condition, endocarditis, is a potentially fatal bacterial infection of the heart. Although it is typically the result of a heart defect, it can also be caused by using unsanitary needles. Bacteria from the needle directly enters the bloodstream and quickly reaches the heart. IV drug users with endocarditis are ten times more likely to die or require a second surgery than other patients.
The Controversy Surrounding Needle Exchanges
Even though the goals of needle exchanges and other harm reduction programs are lofty, they are still a very controversial response to the drug crisis. The biggest complaint is that their goal is not to stop drug use or to treat HIV, AIDS, hepatitis, or any other medical condition. The philosophy of harm reduction programs is that illicit drug abuse is an unfortunate reality, so the best response is to find ways to limit the personal and public harms it causes.
The Cons of Needle Exchange
Criticisms of exchange programs include potentially:
- Enabling continued IV drug abuse
- Normalizing or even increasing IV drug use
- Encouraging even more drug use within the community
- “Centralizing” drug use and criminal behavior in the neighborhoods where the needle exchanges are located
Plus, it’s not a viable solution for rural areas. 29% of Idaho’s population lives in rural areas.
The Pros of Needle Exchange
But supporters say many positives come with needle exchange programs, like:
- Fewer contaminated needles within the community
- A decrease in new infections
- Reduced criminal and drug-related behaviors
- Reduced high-risk sexual behaviors
- Expanded outreach to marginal populations
- Better access to education about substance abuse
- Increased availability of diagnostic and testing services
- Access to drug rehab referral services
The Bottom Line About Needle Exchanges in Idaho
Even though it is not a perfect solution, having new needle exchanges in Idaho is at least a positive step in the right direction. Needle exchange programs reduce crime, protect public health, ensure the safety of emergency personnel, and save lives that might otherwise be lost to disease or overdose. These are efforts that should be recognized and supported.
At a bare minimum, needle exchanges help keep IV drug users alive longer until they are ready to get help. And when they are ready, they can be quickly referred to an appropriate drug rehab program. This should be the ultimate goal of any harm reduction program.
Northpoint Recovery applauds any evidence-based efforts at reducing the deaths caused by drug abuse and addiction. For more information about what you can do if you or someone you care about is abusing intravenous drugs or any other substance, call 208.486.0130 or contact us online today.