Intravenous drug users (IDUs) face a vast array of dangers, some that users of other drugs will simply never have to face.
While these sufferers of addiction will, of course, have to deal with the typical fallout that comes with a life driven by the need to use, IDUs are also at a higher risk of multiple additional diseases due to the common practice of sharing needles among the addicted community.
As such, establishing needle exchange programs (NEPs), also known as syringe-exchange programs (SEPs) and needle and syringe programs (NSPs), have become an effective method for mitigating the spread of certain blood-borne diseases such as HIV and hepatitis C.
Not everyone is so quick to jump behind supporting these programs, however. As evidenced by current legislative outlawing of such programs in some states, the scientifically proven benefits of NEPs simply aren’t enough for some lawmakers to stoop to what they see as enabling continued drug use.
Some states, on the other hand, are committed to reducing the transmission of such diseases as much as possible. Las Vegas, Nevada, for example, has become the first city to install syringe exchange vending machines (three in fact) to make the benefits of these programs even more easily accessible.
Syringe Vending Machines: Our Nation’s First
The Trac-B needle exchange program of Las Vegas has become the first to add a whole new level of efficiency to NEPs by incorporating specialized vending machines that provide clean needles to IDUs.
While some people might scoff at the idea of such a flippant and widely available delivery device for materials that can be used to effectively change a person’s life forever, the truth is these vending machines aren’t much different than a traditional NEP.
In the first place, the machines do not operate with money. Instead, the materials inside are released only through the use of a card and a unique ID number. The card and number are given only to individuals that participate in the Trac-B Exchange program. As such, the machine can only be operated by members. Additionally, these vending machines are located only in designated needle exchange centers, not out on the street.
Beyond the physical boundaries that the system provides, each individual is limited to only two kits a week and is highly discouraged from sharing the materials with others.
Proponents of the program are excited about the prospect of reducing the spread of blood-borne diseases such as HIV and hepatitis C. Chelsi Cheatom, manager of the Trac-B Exchange program, said about the program:
This is a harm reduction approach… People are already engaging in these behaviors, and anytime someone’s engaging in a behavior that could cause them some potential health side effects, we want to encourage them to reduce their risk of harm.
The Opioid Epidemic
Programs like Trac-B Exchange are becoming more common with each passing year. One of the main reasons for this rise in needle exchange programs is the growing problem of opioid abuse and addiction, a trend the Center for Disease Control (CDC), World Health Organization (WHO), and the U.S. Department of Health & Human Services (HHS) have all called a national epidemic.
And when you look at the statistics, it’s no wonder; the number of opioid-related overdoses has quadrupled since 1999, more than half a million people were killed by drug overdoses from 2000 to 2015, and a whopping 91 U.S. citizens die every single day due to an opioid overdose. What’s more, these shocking statistics are continually on the rise.
The danger doesn’t just come from the high probability of addiction to these powerful substances or the complexity of treatment plans that make relapse so probable. The spread of blood-borne pathogens like hepatitis C and HIV are also much more likely among drug users due to the sharing of needles as well.
The Benefits of Needle Exchange Programs
As the numbers of opioid addicted citizens continue to rise, the implementation of NEPs like Trac-B Exchange are meant to act as a countermeasure against the spreading of blood-borne diseases that go hand in hand with increased intravenous drug use.
Studies have shown that NEPs are incredibly effective at quelling the increase in diseases exchanged through blood to blood contact. In fact, the CDC states that the one-time use of sterile syringes is the single most effective way of limiting HIV transmission that occurs with injection drug use. What’s more, the spread of HIV via needle sharing has been reduced in the United States by an astounding 33% thanks to NEPs according to the ACLU.
The benefits don’t stop with reduced rates of transmission either. Studies have shown that NEPs are particularly effective at disseminating critical information about disease transmission as well as tactics to help reduce risk behaviors. The Nation Institutes of Health, for instance, released a report that found engagement in needle exchange programs can result in “a reduction in risk behaviors as high as 80 percent in injecting drug users.”
Part of the reason for such a dramatic decrease in risk behaviors is the fact that many NEPs offer a variety of other services in tandem with the actual needle exchange. Trac-B Exchange, for instance, also offers medical consulting, screening for HIV, STDs, and hepatitis C, as well as wound care and education courses on blood-borne pathogens and safe injection practices.
Many of these programs also offer a wealth of information and resources regarding addiction recovery treatment and rehabilitation programs. In fact, access to this kind of information on a regular basis without fear of being prosecuted has led researchers to find that participants in NEPs are five times more likely to enroll in a treatment plan than individuals who’ve never used a needle exchange.
The Legality of NEPs Today
Experts across the country agree that NEPs are incredibly effective at mitigating the spread of extremely harmful pathogens and getting IDUs to enroll willingly into a treatment program.
As the Harm Reduction Coalition’s Deputy Director of Planning and Policy, Daniel Raymond, put it, “The debate over whether syringe exchanges are beneficial has long been settled… The issue now is more, what method is appropriate for my community?”
But despite the overwhelming evidence supporting NEPs, the legislature is still a bit on the fence about the subject. Up until recently, federal law has prohibited government programs from funding these highly beneficial programs. In fact, it wasn’t until an unprecedented HIV outbreak in rural Indiana (which saw 23 new cases a week) was this law overturned.
However, even though federal funding of such programs is now legal, legislation on the state level still blocks many such programs from being founded. As a result, more than a dozen states still banned NEPs entirely in 2014.
So, the question is, what’s the issue here? NEPs are proven effective at preventing the spread of disease, help promote treatment, and have been shown to have no effect on the frequency of drug use.
The problem, it seems, is in continuing to treat substance addiction as a matter of choice rather than the disease that it is. Rather providing access to scientifically proven programs that could help hundreds of thousands of addiction sufferers, many politicians argue that overcoming addiction all comes down to willpower alone. And as research shows, these types of treatment programs are ineffective and rely on outdated information.
Syringe Vending Machines: Part of the Solution
Ultimately, syringe vending machines provide better access to life-saving equipment that not only curbs the spread of infectious diseases like HIV and hepatitis C, but also helps to educate users on crucial safety practices as well as extensive treatment options they may have not had access to otherwise.
As such, syringe vending machines represent a step in the right direction: away from thinking of addiction as a moral failure and towards treating it as the disease it really is.
American Civil Liberties Union (n.d.). Needle Exchange Programs Promote Public Safety: Fact Sheet on Needle Exchange Programs. Retrieved from https://www.aclu.org/fact-sheet/needle-exchange-programs-promote-public-safety
Cornish, Audie (2016, Jan.). Congress Ends Ban on Federal Funding for Needle Exchange Programs. Retrieved from http://www.npr.org/2016/01/08/462412631/congress-ends-ban-on-federal-funding-for-needle-exchange-programs
Center for Disease Control (2016, Dec.). Opioid Overdose: Understanding the Epidemic. Retrieved from https://www.cdc.gov/drugoverdose/epidemic/
O’Hara, Mary Emily (2017, April). Heroin Crisis: Nevada Becomes First State to Install Syringe Vending Machines. Retrieved from http://www.nbcnews.com/health/health-news/heroin-crisis-nevada-becomes-first-state-install-syringe-vending-machines-n746111
U.S. Department of Health and Human Services (1998, April). Research Shows Needle Exchange Programs Reduce HIV Infections Without Increasing Drug Use. Retrieved from https://archive.hhs.gov/news/press/1998pres/980420a.html
Weingberg, Caroline (2016, March). Needle Exchanges Work Wonders Where They’re Actually Legal. Retrieved from http://www.vocativ.com/294846/needle-exchange/
Weinmeyer, Richard, JD, MA, MPhil (2016, March). Needle Exchange Pragrams’ Status in US Politics. Retrieved from http://journalofethics.ama-assn.org/2016/03/hlaw1-1603.html
World Health Organization (2017). Needle and Syringe Programmes. Retrieved from http://www.who.int/hiv/topics/idu/needles/en/
World Health Organization (2004). Evidence for Action on HIV/AIDS and Injecting Drug Use. Policy Brief: Provision of Sterile Injecting Equipment to Reduce HIV Transmission. Retrieved from http://apps.who.int/iris/bitstream/10665/68711/1/WHO_HIV_2004.03.pdf