WHERE TO GO TO SHOOT UP
large cities in the U.S. have needle exchange programs, although they
receive no federal funding and the Bush Administration opposes them. They
tend to be located in the seediest part of the city, and they hand out
clean, sterile needles to anyone that wants one, no questions asked. Why? Because sharing needles spreads AIDS. In the biz we call this sort of thing “harm reduction.”
programs have resulted in lower incidence of HIV infection, and in
spite of concerns to the contrary, they are not associated with
increased drug use. It turns out people do not start using heroin just because there’s a guy on the corner handing out needles.
In Vancouver, B.C., they go even further. A pilot program there offers a safe injection site. Users go in, get sterile equipment, swab their skin with alcohol, and inject themselves under the watchful eyes of nurses. A waiver makes the clients and staff at the site immune from drug law enforcement.
As you might expect, this program is not favored by conservatives. But a new study shows uniformly positive results. Like the needle exchanges here, the program decreases HIV infection. Crime in the neighborhood has not increased. And many people who come in ask for help—not to shoot up but to get into treatment.
here’s the conundrum: the Vancouver safe injection site facilitates
drug use (though not for anyone who doesn’t already use them). It also saves lives. From a strictly public health perspective, there’s no doubt about its value.
Efforts to eliminate drug use through law enforcement have been an abject failure from the very beginning of the “War on Drugs.” I’m
sure many people would say “screw the addicts, let ‘em get AIDS and
die,” but even if you take that morally questionable tact, you can’t
ignore the enormous cost in dollars of every single AIDS case, or the
fact that every HIV-infected junkie potentially puts numerous others at
What do you think? Is a safe injection site a legitimate AIDS prevention tactic?
suggests that addicts buy their own damn syringes, but in fact they are
not available over-the-counter in many places. In some states
people caught with a syringe are arrested for possession of drug
paraphernalia. Consider this:
RESEARCH ON OVER-THE-COUNTER SALE OF SYRINGES
In 1992, Connecticut legalized sale and possession of up to 10 syringes
without a prescription. An evaluation was made of risky injection practices
and HIV infection among drug users both before and after the new law.
· Syringe sharing was reduced by 40%
· Street purchase of syringes dropped by 62%
· Police incidents of needlestick dropped by 66% (drug injectors
no longer felt they needed to conceal syringes from police)
Source: Groseclose SL, Weinstein B, Jones TS, et al. (CDC and Connecticut
State Health Dept) Impact of Increased Legal Access to Needles and Syringes
on Practices of Injecting Drug Users and Police Officers-Connecticut, 1992-1993
Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology
10:82 © Lippincott-Raven Publishers, Philadelphia
· At these success rates, New York State HIV infections could
be reduced by 6 per day.
· If these infections are not prevented, it will cost $109,500,000
in AIDS care (at an estimated lifetime cost of $50,000 per person with AIDS
x 2,190 preventable infections). (This does not include the cost of foster
care for orphaned children)
· The cost of these infections to families, particularly to orphaned
children, is incalculable. The majority of injection-related HIV infections
are among New York’s communities of color, already suffering from poverty,
inadequate access to healthcare and housing.