Needle-Exchange Programs

AuthorTopic: Needle-Exchange Programs
Bob's Big Date
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Needle-exchange programs are set up through hospitals, which exchange dirty needles for free clean ones. The cost is low (needles are relatively inexpensive), and the statistics are good: so far, in areas where these programs have received generous funding, AIDS and other blood-borne diseases have dramatically dropped in prevalence.

In many countries in the world today, in addition to many individual urbanized areas, the biggest risk factor to contract a blood-borne disease seems to be either a relationship with or being oneself a needle-drug user.
(This includes China and Russia, where AIDS seems to be spreading primarily through sex with drug users.)

US policy has leaned towards the official 'gag rule' that it has had on abortion within the last Presidential term: no mentioning of the benefits of clean needles, and absolutely no gov't support for clean-needles programs.

What do you think?

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Posts: 2367 | Registered: Friday, June 27 2003 07:00
By Committee
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...that this is kind of the same conflict as abortion or sex education.

The problem with being a realist is that others don't think you have a heart. This isn't true, however - some realists see the world and cry all the time.

I would posit though that the idealists are the ones without a heart - through their denial of realities such as that, no matter what, people will use drugs or will have sex before marriage, possibly with multiple partners, they are condemning these people to suffering through the spread of disease, unwanted pregnancies, and the need for abortions. All of these things are ultimately bad for society, but denying their existence doesn't make them go away. It's the ideological equivalent of trying to treat a cancer that's been diagnosed through preventative means, rather than curative. Sure, prevention may be a good means of staving off cancer, but it's useless when one already has it.

[ Friday, March 25, 2005 12:23: Message edited by: andrew miller ]
Posts: 2242 | Registered: Saturday, April 10 2004 07:00
Law Bringer
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quote:
Originally written by Bad-Ass Mother Custer:

What do you think?
Same as you probably, since you started the topic.

This "gag" is a moronic approach, akin to closing one's eyes to make a problem go away. Teen pregnancies and drug abuse happen, and by pretending they don't and refusing to accept any program that acknowledges their existence, the problem is worsened. What's new?

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Posts: 8752 | Registered: Wednesday, May 14 2003 07:00
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The practicalities of a needle exchange program in an undeveloped country are not real.

For example in some regions of China some 700,000 people became infected with AIDS because they donated blood. The needles used to donate the blood were dirty.

http://212.67.202.147/~ivnet05/article.php3?id_article=490

The cost of clean needles in hospitals in third world countries is almost prohibitive. 2.5% of AIDS cases in Africa are caused by unclean needles in health care. Hospitals could not afford clean needles.

A new medical needle in a third world country is a large expense. A half a days wages in many cases. Giving them away would not work.

Providing hospitals everywhere with a worldwide supply of clean needles would be a more realistic way of looking at this.

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Posts: 1084 | Registered: Thursday, November 7 2002 08:00
Law Bringer
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Third World countries may not be able to carry out needle exchange programs, but that's no excuse for the United States. If people are going to use drugs, and they are, there should be no added and unnecessary risk of disease.

—Alorael, who supports drug legalization for much the same reason. Drug eradication has proven largely impossible. Legal drug control makes a much better, more feasible, and probably even cheaper option.
Posts: 14579 | Registered: Saturday, December 1 2001 08:00
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quote:
Toasty Warm said

Providing hospitals everywhere with a worldwide supply of clean needles would be a more realistic way of looking at this.


Here's my thing, Toast. I don't disagree with you idea, and it might be a good one, but living in one of those third world countries I've seen enough of our reality to perceive, as biased as you want, how unrealistic that is.

First of all: In order for that to happen, or any such program it has to work, completely outside of the government that it is helping.

Maybe not all third world countries (I hate that term but if I say why I'm gonna detour forever) are like this one, but in my very limited experience if you let the government take care of that project it will:

Mismanage it completely and use every single opportunity to steal as much money as possible. It happens.

If you have an independent party distributing the needles, if that party is responsible for it and answers to an international entity, it might just work.

On the other hand there's the possibility that the independent party will be seduced by the dark side, go native, and become just as hopelessly corrupt as if it were another government agency.

I like the idea of introducing clean needles. I love it. Not only in hospitals. Maybe they could also be distributed to drug users (although I don't know how that would be done since drug using is illegal in many places, but there might be a way). And, they could also offer support and help to drug users as well.

(Quick query to Australian members of this forum: I heard once, and I may be remembering this wrong, that in Australia some hospitals have a room for drug users, and next to this room there is a rehab center? It's been a while since I heard it and I don't remember it specifically. Is there anything remotely like this over there?)

[ Friday, March 25, 2005 13:21: Message edited by: behind stingy cactus ]

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That is not what the topic is, though. This is about users of IV drugs in urban areas who have an extremely high risk of AIDS infection through shared needles. A no-questions-asked needle exchange program could only be beneficial. It will slow the rate of AIDS spreading and is not condoning drug use, despite what some people may say.

In New Jersey, there is a law banning needle exchange programs, which is just idiotic.

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Posts: 9436 | Registered: Wednesday, September 19 2001 07:00
Bob's Big Date
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Drakey has it spot-on. The needle-exchange programs exchange sterile needles for used ones, no questions asked, at major distribution centers (usu. hospitals). There are various U.N. programs aimed at establishing such exchanges in areas in which the local authorities might be helpless (such as, say, China, or an African nation), but the U.S. has done a lot to suppress them.

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Once again you run into a problem. You may like a program and want it to work. I may not have a problem with it, but Russia and China for example are very socially conservative and would never accept an unmodified needle exchange program.

I think the only way you could get this done in a place like this would be with a drug rehabilitation program tied to the program.

The other option would be to tie it in to community aids education programs designed to help stop the spread of AIDS. I would not have a problem if they provided both condoms and needles as part of the program.

In the United States needle exchange programs face fierce opposition. President Bush is trying to shut down methadone clinics designed to reduce drug dependency. The conservative agenda is that a drug user must quit cold turkey without medical intervention (religious intervention is ok). Funding for methadone clinics has been sharply reduced.

Tying a needle exchange program to a rehabilitation center would make the most sense to me.

To put it bluntly I am completely opposed to heroin and the other hard drugs. Drugs are being designed to be more and more potent and addictive.
The key here is "designed".

I think a lot of people overestimate the power of the United States because they live here. We are constantly fed the idea we are in control of many things which we aren't in control of.

[ Friday, March 25, 2005 14:25: Message edited by: Toasty Warm ]

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Triad Mage
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Well, methadone is highly addictive itself - it's just replacing one drug for another. There is promise in bupe, a new drug that can help someone quit a heroin addiction virtually cold turkey.

With needle exchange programs, a worldwide revolution would be nice, but it is not necessary to stop needle exchange programs because the whole world will not embrace them. We should try to save the areas it is possible to save (in the sense that dying from AIDS and spreading it is worse than drug abuse).

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Posts: 9436 | Registered: Wednesday, September 19 2001 07:00
...b10010b...
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quote:
(Quick query to Australian members of this forum: I heard once, and I may be remembering this wrong, that in Australia some hospitals have a room for drug users, and next to this room there is a rehab center? It's been a while since I heard it and I don't remember it specifically. Is there anything remotely like this over there?)
Not quite. There was a proposal a while back for "safe injecting rooms" where IV drug users could inject in a supervised environment, with rehabilitation programs available. They weren't going to be in hospitals, though. The proposal never came to anything, at least in Victoria; not sure about other states.

One problem with needle exchange programs is that in practice they don't always exchange needles; addicts just drop their needle anywhere and pick up a new one from the needle exchange without handing the old one in, and then sometimes people step on the old needles. Considering that the risk of contracting a blood-borne disease from a needlestick injury is pretty remote (less than 0.1% for HIV; higher for hepatitis B, but there's a vaccine for that anyway), I'd say it's an acceptable tradeoff.

[ Friday, March 25, 2005 14:30: Message edited by: Thuryl ]

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(Edit: Thanks for the info, Thuryl)

(I think I misunderstood part of the topic)

I'm sorry about the mess (I know I write weirdly sometimes) :)

A needle exchange program is good. I like the fact that it is no questions asked.

I've known several doctors here from several different hospitals. Hospitals are having difficult times obtaining equipment and a variety of material they need. This material includes everything from sanitary towels, to plaques for X-rays, to syringes, etc. I won't bother you with the procedure, but it is annoying, and many times they just go by as they can. (The private hospitals and clinics do slightly better)

(I know the topic is not hospital oriented, but bear with me for a sec)

My problem is that an exchange program here is not feasible. What I see that could very likely happen is the government announcing a Mission, or program, to do this since it cares so much for its people and never doing a thing about it.

Another problem I have is this: Imagine the U.N, for instance, comes here. The government embraces their help. The U.N gives an agency in the government a number of needles, say 1 million. The goal is that the Agency will exchange this new syringes with used ones. Well, I can assure you that that won't work.

The fact that, as mentioned above, hospitals have a tough time getting supplies is a perfect opportunity to sell them syringes under the table. Also, someone can make money selling these needles (obatined either free or very cheaply through the U.N or whatever organization) in the street, instead of exchanging it.

The U.N will lose its shipment, the needles will never be exchanged, deseases will continue to be spread through the use of contaminated needles and those who worked in the Agency will have made a nice sum of money.

I thought, and think, that there is a chance this may (maybe) work here if the U.N acts as an independent body. That it carries the needle exchange itself, with only whatever minimum help it needs from the government. As I don't see this government accepting that unless it can use it as a way to express how magnanimous it is, etc.

I know Venezuela is not China or Russia or any other third world country. Maybe in those countries this can work. I don't know the level of corruption there, or the interest those countries may have in ensuring that their citizen can have a more healthy life, specially the kind of people that this program may end up helping the most.

Anyway, hope this has cleared any problems with my previous post and that I'm more on target now. Sorry for any inconveniences.

[ Friday, March 25, 2005 14:57: Message edited by: behind stingy cactus ]

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"I suffer from spiritual malaise," said Cugel meaningfully. "which manifest itself in outburst of vicious rage. I implore you to depart, lest, in an uncontrollable spasm, I cut you in three pieces with my sword, or worse, I invoke magic."
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Bob's Big Date
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quote:
Originally written by Toasty Warm:

Once again you run into a problem. You may like a program and want it to work. I may not have a problem with it, but Russia and China for example are very socially conservative and would never accept an unmodified needle exchange program.
Actually, you'd be surprised - our only strong ally on rejecting this one is Japan. Even Iran, of all places, has given support to the current plan.

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