What do you think of the needle exchange program?

needle litter is preferable to galloping contagion.

I fully support them. Should be required in every state.

Additionally, from what I have read in the past, these programs are quite effective.

I’m conflicted.

There are good and bad points. Of course the health aspects (disease and infection prevention) are good things, But in some communities, the exchange program has been used to target and identify a marginalized portion of the population (homeless drug users) for persecution.
It’s really a double-edged sword.

I’m not going to answer whether it’s a “useful” program or not. As the saying goes about weather, “It’s an ill wind that blows nobody any good,” so a program would have to be very destructive indeed to be of no use to anyone.

However, I don’t think it’s a good expenditure of taxpayer money, or perhaps it could just be administered in a slightly less “free and easy” way. That is, giving IV drug users “a supply of clean needles” certainly makes it convenient for the user (and for the person handing out the needles), but why not a needle-for-needle exchange? That way, the drug user at least has some incentive – however slender – to hold onto his used needle for exchange, rather than simply tossing it after use… because he has more where that came from.

Hell, while they’re at it they might as well supply “clean” and pure drugs of known quality and potency, to help to eliminate the likelihood of overdosing. Maybe even a public health nurse to administer the shot in the first place. And clean mattresses in a nicely decorated furnished room for them to crash on, etc.

I’m in favor of making drugs legal, which would tend to make them cheaper and reduce the need for users to hide the usage in the first place, possibly to even hold employment so that they could be somewhat productive (since not all drug users, just like not all alcoholics, are shambling, stumbling zombies) and be regular members of the community with all of the rights and privileges that accrue. I’m not in favor of catering to drug users and bending over backwards to accommodate them, though. And certainly not at taxpayer expense.

It does reduce the spread of infectious disease and probably costs a lot less that the medical costs of one AIDS patient.
But I’d like so see the user take some responsibility for their own actions. I’d change the programs to force a little personal responsibility on the user.
For example: they can get a clean needle if and only if they return one. That would reduce the occurrence of used needles on the street.
I’d also like to see a nominal charge for the service – even if it is only $1. The fee would go to $5 if the user does not turn in an old needle.

I would also like to see a data base of users so the effectiveness of the program could be tracked.

@LuckyGuy Can you imagine how a database of users would be exploited? That part is not a good idea.

No more databases!

I am in favor of them.

I am also in favor of safe (supervised) injection sites, where drug users can go to inject with medically trained supervisors on site. At safe injection sites, trained staffs provide clean needles, administer naloxone when there are overdoses and offer long-term treatment options. People bring their own drugs — most often heroin.

It cuts down on the number of overdose deaths, and has been successful at getting people off drugs altogether.

I think the exchange programs are a good idea. They do rely a lot on trust, which can be a rare commodity in this population.

The daughter of a friend of mine was a committed volunteer while she lived in this area. She would go and sit under a certain overpass once a week with a supply of clean needles. Nobody had to show anything or sign up for anything. They would just come and turn in used needles for new ones. I thought this was excellent, but it did depend on someone who was brave, kind, wise, and reliable, and that doesn’t describe a lot of people.

@Jeruba: That’s the ideal situation, of course. I had a friend who worked at a clinic that was publicly funded, and some of the staff asked for names.

I’m all for the needle exchange programs.

At minimum, anyone should be able to buy needles without a prescription. Some states seem to require a script (maybe that has changed?) which I think is ridiculous. Needles are quite cheap even when you have to pay, but they need to be easily accessible.

One place I lived had containers for needle discard in the bathroom at the mall. It was either TN or NC, I don’t remember. Middle class malls both of them. I thought that was interesting.

I would rather not have exchanges. But it’s kind of like the lesser of two evils. It definitely serves a purpose.

Sadly, there are many places that I drug users pollute with needles…

Free needles, free drugs, a nurse to administer the shots, free rooms and cots. At what point does this become state sponsored drug addiction? It certainly sounds like a good way to keep the electorate under control.

@Jaxk: “Free needles, free drugs, a nurse to administer the shots, free rooms and cots. At what point does this become state sponsored drug addiction?”

Since addiction is a health issue, I suspect many of us that support methods to reduce disease transmission among the addicted (free needle exchanges) also support free drug addiction rehab programs as well.

Is this something you would support – either as an alternative to needle exchange programs or a complementary approach?

@Jaxk The alternative wasn’t doing too well in Ohio, that’s why they have restarted needle exchaneg programs in Cincinnati and other Ohio cities.

@thisismyusername – I don’t have a problem helping to kick the addiction. I firmly believe that to kick an addiction, any addiction, you must want to stop. I don’t support programs that make it easier or more pleasant to remain addicted.

@Jaxk: “I don’t support programs that make it easier or more pleasant to remain addicted.”

These programs are designed to improve public health. And from what I understand, there has never been a heroin addict who decided to quit because it was no longer pleasant and s/he only had access to dirty needles. I’m not sure that this is how it works. Is this your concern?

Heroin users don’t shoot up because they have free needles or clean, safe spaces to shoot up at.

@Darth_Algar Glad someone said it. Thanks.

@Jaxk It’s probably cheaper to give free needles than to put them through rehab ten times.

^Or treat them for any number of blood born pathogens. Hep C, or HIV would be particularly expensive to treat. I’m guessing most heroin addicts don’t have insurance.

@JLeslie – It costs more to put a bank robber in prison than the average take from the heist. Maybe we should give out stacks of cash to anyone that wants to rob a bank. The idea is to stop the bad behavior not facilitate it.

@Jaxk: ”@JLeslie – It costs more to put a bank robber in prison than the average take from the heist. Maybe we should give out stacks of cash to anyone that wants to rob a bank. The idea is to stop the bad behavior not facilitate it.”

You do believe that heroin addicts decide to quit because it is no longer pleasant and they only have access to dirty needles?

As @Darth_Algar points out, “Heroin users don’t shoot up because they have free needles or clean, safe spaces to shoot up at.”.

So what is your opposition to needle exchange programs?

@Jaxk: “The idea is to stop the bad behavior not facilitate it.”

Also, your bank robber analogy doesn’t work.

Heroin use is not “bad behavior” – it’s unhealthy behavior. And it’s quite addictive, so it’s really a health issue – not a behavior issue. Not sure how addiction relates to bank robbing at all.

@thisismyusername – If you believe that drug addiction is acceptable behavior then handout the needles for them. Personally I don’t so don’t expect me to support it. I’ve spent a lifetime trying to stay away from that crap and I’m not ready to follow you down that rabbit hole.

@Jaxk: “If you believe that drug addiction is acceptable behavior,,,”

Drug addiction is as much “behavior” as cancer or diabetes. If you don’t like the illness, treat it.

@thisismyusername No, it’s voluntarily picking up a disease when you use imo. People with cancer don’t get a choice. Terrible analogy.

@KNOWITALL: ”@thisismyusername No, it’s voluntarily picking up a disease when you use imo. People with cancer don’t get a choice. Terrible analogy.”

I don’t think it is.

For starters, many forms of cancer and diabetes are diet-related (or smoking). But the point is that it does little to blame the victim of the illness. As a society, we should be invested in treating illness. We would’t withhold cancer treatment from people who smoked or diabetes treatment from overweight people.

Additionally, many heroin users started by abusing prescription opioids. They experience chronic pain, get treated with addictive drugs, lose health insurance or other means of income and realize that they are addicted to these drugs. Heroin is cheaper.

So, if the intention is to punish the addicted due to past decisions rather than treat them, why would it just apply to addicts? And what benefit is there to not treating them? It hurts non-addicts to do so, by introducing and encouraging infectious diseases into the non-drug using population.

@thisismyusername My doctor says diabetes, cholesterol and many others are simply genetics and not always in our control, and we all know about the cancer gene and how nonsmokers get cancer, so I don’t equate them equally with drug addictions.

So someone who is addicted to pain pills and moves to heroin because they got fired from their doctor or would not comply with rules, is making a conscious choice to move down that path, illegally by the way. Choice is the thing we disagree about, I believe it is a choice, you believe it isn’t, so I assign personal responsiblity, you do not.

@KNOWITALL: “I assign personal responsiblity, you do not.”

Even if you chalk up cancer and diabetes to things out of peoples’ control (which is not necessarily the case), you still find it ok to punish those that have made bad decisions. Why is this? It’s not only cruel – it harms you. It’s to your benefit to live in a society with healthy people. It’s to your benefit to live in a society where people aren’t suffering.

So, maybe you can explain how “personal responsibility” leads to supporting making things worse for those that are suffering and yourself.

@thisismyusername – I think you’re beginning to believe your own bullshit. How is giving addicts free needles ‘Treatment’? If I wanted to follow your cancer example, it would be like providing free cigarettes to cancer patients. Hell they’re already dealing with cancer why make them deal with addiction as well.

Of course you’ve already said that there’s nothing wrong with addiction, it is acceptable behavior.

@Jaxk: ” I think you’re beginning to believe your own bullshit. How is giving addicts free needles ‘Treatment’?”

Because like I said above, “Since addiction is a health issue, I suspect many of us that support methods to reduce disease transmission among the addicted (free needle exchanges) also support free drug addiction rehab programs as well.”

Both of these are necessary.

@Jaxk: “If I wanted to follow your cancer example, it would be like providing free cigarettes to cancer patients.”

Of course, because the method of smoking causes transmission of disease, right? Oh, wait.

You do understand that the whole purpose of needle exchanges is to reduce disease, right?

@Jaxk: “Of course you’ve already said that there’s nothing wrong with addiction, it is acceptable behavior.”

It literally is not behavior. Do I need to state the obvious, again? Ok…

I am opposed to: cancer, diabetes, addiction, depression, heart disease, etc. These are health problems. And I fully support their treatment.

@KNOWITALL “My doctor says diabetes, cholesterol and many others are simply genetics and not always in our control”

If your doctor discounts the cause-and-effect relationship between diet, behavior and these diseases then it’s probably time to find a new doctor. For your own well being.

@thisismyusername I lived with a few addicts, it’s a choice and I don’t feel sorry for them.

@Darth_Algar I’m good, he’s highly educated and been in practice a long time. He knows that sometimes our best still won’t change the outcome. And I have none of those btw.

Doctors always are highly educated. And I once had a doctor who had been in practice in the community for decades. I left him when he started claiming that I should take fish oil supplements for my abnormal heart rhythm.

@Jaxk It’s the government responsibility to protect greater society, and I think the needle exchange does that better than the rehab. Or, I’d rather say it doesn’t have to be one or the other, we can do both.

You compared it to robbing a bank, that is a pure money equation really, but the needle situation is money and health risks. Not only do we not want hep C and HIV being shared, but eventually those people get sick and society pays for their medical treatment. We could put addicts in jail. That’s what we do to bank robbers. I don’t think anyone wants to start jailing all addicts.

Here’s a scenario: some teenage boy decides to shoot up, starts getting addicted, uses an HIV needle, has sex with 5 girls during the school year, and 3 of them become infected. I’d rather pay for the needle exchange.

I agree with your point that giving them needles is like saying the drug habit is ok, and we don’t want to reinforce any sort of acceptance of the behavior, but it’s in a way the lesson of two evils. If the addict does stop using, we want them to be as healthy as possible, and we want them to not have hurt anyone else’s health.

This conversation is starting to sound like some people are saying that a needle exchange program encourages addiction. Do you also believe that sex education in schools is a bad thing?

The spread of disease, the onset of infection, these are expensive (since that seems to be the concern of some) things for the taxpayer, ultimately more expensive than any needle exchange program.