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There are at least 221 needle exchange programs located nationwide. Of those programs, about 91 percent of them were independent facilities that obtained legal authorization to operate as needle exchanges; as well, almost 40 percent of them employ personnel from local health authorities. Annually, it’s estimated that at least 36 million syringes are provided through needle exchange programs nationwide with most of these being given out at the larger programs located in urban centers. As well, this means that there have been millions of used syringes disposed of in a safer and more proper way rather than improperly.
Although our history with substance abuse extends back at least several thousand years, it’s been over the course of the past century that it’s grown to become a major scourge to the human race. There are certain substances — alcohol, marijuana, and opiates, for example — that have been in widespread use for a long time, but recent years have seen these are numerous new substances reach epidemic-level proportions. All mind-altering substances remain a major problem, but it’s heroin and intravenous opiates that are one of the biggest concerns today. In fact, the heroin addiction is why there are needle exchanges being offered in the hope of mitigating the extent to which heroin use has penetrated our communities, from the largest of cities to the smallest towns.
What is a needle exchange? Well, it’s actually a lot like it sounds. However, before we have a discussion about needle exchanges, we’re going to review the state of the heroin problem and one of the several strategies currently being employed to address this issue. That strategy is referred to as harm reduction. We are also going to clarify the specific purpose of a needle exchange, answer the question of whether there are needle exchanges available in the U.S., and identify any other harm reduction options similar to needle exchanges that are available. The purpose of this discussion is to bring awareness to needle exchanges, informing individuals about the strategy behind this controversial service and comparing needle exchanges to other services that serve similar purposes.
The current heroin problem actually began with the release of a single pharmaceutical drug: OxyContin. Although oxycodone had been available before the 1990s, OxyContin was both extremely powerful and marketed very aggressively by Purdue Pharma, the pharmaceutical company that produces OxyContin. As more and more of the drug was being prescribed, more and more people began abusing the drug and becoming physiologically dependent on it. To make matters worse, other companies were releasing their own opiate painkillers in the hope of capitalizing on the growing popularity of OxyContin. By the 2000s, there was a painkiller epidemic occurring nationwide; individuals were traveling as far as Florida from across the country to see multiple doctors and get duplicate prescriptions, selling some on the street and making it incredibly easy for substance abusers to obtain opiates illicitly.
Hoping to combat the painkiller epidemic, some laws were changed that made it harder for people to obtain duplicate prescriptions. Many manufacturers began to make their drugs tamper-resistant, which meant it was incredibly difficult for individuals to abuse them. Seemingly overnight, people who had become addicted to painkillers were finding themselves increasingly unable to find painkillers, leading them to turn to a drug that happened to be more readily available, less expensive, and more powerful: heroin.
Since then, rates of heroin abuse have skyrocketed. Currently, heroin accounts for nearly one in five admissions to addiction treatment centers in the U.S. The Center for Disease Control and Prevention has referred to the state of heroin addiction as an actual epidemic. Somehow, the drug is being imported into large cities in the U.S. from Mexico; in particular, cities like Miami, Baltimore, New York City, and in virtually all major cities along the U.S.-Mexico border. And it seems that despite the increased vigilance of law enforcement and public officials, heroin addiction continued to rise over the past several years.
The most obvious strategy to mitigate the heroin problem would be to make addiction treatments more effective and more widely available. However, it’s not that treatments aren’t available; instead, there are many addicts who simply aren’t seeking treatment. According to statistics, only one in ten addicts is currently receiving any level of treatment, which has resulting in the need to resort to alternative means of mitigating the heroin problem and some of the negative effects that result from heroin use. In particular, this has led to a number of harm reduction initiatives.
The most straightforward way to explain harm reduction with regard to heroin use is that it refers to methods used to curb the negative effects associated with heroin use. To understand some of the harm reduction methods currently employed for heroin addicts, you must know some of the key effects that can occur to those who use heroin. One of the main problems is blood-borne illnesses and diseases, which are caused by heroin addicts who use the drug intravenously sharing their hypodermic needles with other drug users. And since heroin is such a powerful opiate with a high potential for overdose, another form of harm reduction would be to switch heroin addicts to a substance that would keep withdrawal symptoms at bay while protecting them from withdrawal and the numerous other side effects of heroin use. However, at present we’re going to discuss one form of harm reduction in particular.
Historically, needle exchange programs were a very European concept. Much like with heroin assisted programs — programs in which heroin addicts would inject heroin in a supervised clinical environment with or without the assistance of a nurse — needle exchange programs are typically facilities where heroin addicts and other intravenous drug users can go to dispose of their used syringes and pick up clean, unused syringes for free. In most cases, needle exchange programs are a free service available to anyone who has a need for clean syringes. More often than not, these facilities are located in larger, more populous cities where there’s likely to be a more substantial communities of intravenous drug users.
In most cases, needle exchange programs are considered a social service and a public health service comparable to free health clinics where individuals on limited or no income can get vaccinations and birth control. However, rather than vaccines, needle exchange programs provide hypodermic needles and other needed paraphernalia to intravenous heroin users. Unlike heroin assisted programs, however, needle exchange programs don’t typically allow heroin users to inject themselves with the drug on-site. Instead, they’re provided with the tools they need to inject the drug and must do so off the premises. Once they have used the hypodermic syringe and other apparatuses, they can return to the needle exchange to dispose of the used utensils while picking up clean, unused utensils, ad infinitum. As well, needle exchange programs typically offer to help addicts find the recovery resources they need to overcome their addicts if they would like to begin receiving treatment.
As we mentioned above, a needle exchange program is designed to be a form of harm reduction. Rather than preventing people from abusing heroin or providing them with addiction treatment, needle exchange programs are a place where intravenous drug users can go to get clean, unused syringes and paraphernalia (often collectively called “gear” by intravenous drug users). The purpose of a needle exchange is to protect intravenous drug users from using or reusing dirty syringes and to discourage them from sharing their syringes from others.
The tendency for heroin addicts and certain other drug users to share hypodermic syringes is one of the main ways that bloodborne illnesses such as hepatitis, HIV, and AIDS is spread from person to person. In fact, the sharing of hypodermic needles can causes these bloodborne illnesses to spread through entire communities of drug users extremely rapidly. However, needle exchange programs help to stop the spreading of these diseases by ensuring that individuals only use heroin with clean gear and so that they’re not sharing their syringes with others.
There are other benefits for heroin addicts to use needle exchange programs beyond just getting clean syringes. They are provided useful advice by the nurses and staff members, such as, for instance, how to use heroin while minimizing the amount of harm that’s done to the body, how to minimize one’s chances of overdose, what to do in an overdose situation, and they even provide access to other helpful things like condoms.
Needle exchange programs have proven to be very controversial like any other type of harm reduction service. Those who are against needle exchange programs believe that this service encourages continued heroin use by providing addicts with an essential tool that allows them to continue using heroin. In other words, these individuals believe that needle exchange programs prolong and exacerbate heroin addiction rather than having any type of benefit. However, there have been numerous studies on needle exchange programs that have proven just how effective they can be. In particular, needle exchange programs have significantly slow the spreading of HIV, AIDS, hepatitis, and similar incurable diseases in communities in which there are needle exchange programs available.
Although treatment and recovery is always preferable, the idea behind a needle exchange program is that the heroin addict is going to use heroin whether or not his or her syringes are clean; therefore, we might as well provide them with clean, unused syringes so that they at least won’t have to worry about spreading or contracting deadly bloodborne diseases.