Drug Watch
International
Position Statement
NEEDLE HANDOUTS TO ADDICTS
Providing
needles to addicts for injection of illegal drugs should cease.
No funds should be spent on needle exchange programs unless it can be
scientifically proven that such programs are safe and effective. Studies based
on scientific protocols show no evidence that needle exchange programs (NEPs)
decrease HIV infection rates, and these studies fail to prove that NEPs do not
encourage drug use. The practice
actually facilitates and enables illegal drug use, which puts the drug user at
continual risk of exposure and results in unpredictable behavior, crime,
violence, rising medical costs, drug impaired newborns, and other societal
problems.
Background:
Needle
exchange programs began in 1984 in Amsterdam, the Netherlands, started by a
drug-user advocacy group called the Junkie Union. Subsequent programs were
started in 1988 in Tacoma, Washington and San Francisco, California; and in 1990
in New Haven, Connecticut and New
York City. Currently, many illegal programs are operating in the U.S.1
In Switzerland, liberal drug policies and the drug tolerant atmosphere
they created, brought about the open drug scenes, where large numbers of needles
are distributed to addicts, and caused a dramatic increase in drug addiction,
crime, and violence.2
Rationale:
Needles
provided for the injection of illegal drugs encourage and perpetuate drug use
and unsafe sex that spreads AIDS and other sexually transmitted diseases (STDs).
The most effective approach to address the causal role of drugs with
regard to AIDS is to prevent or intervene in the drug using behavior that leads
to AIDS.3 Scientific studies show that drug use impacts the immune
system and speeds the growth of the HIV virus which causes AIDS.4
Reducing drug use would also decrease the incidence of risky sexual
behavior while under the influence of drugs, a major factor in the spread of HIV
infection, hepatitis and other STDs.5
Aggressive
outreach/education efforts have resulted in decreased seroconversion rates of
HIV/AIDS without providing needles to the population.6
Treatment programs have resulted in markedly reduced rates of HIV/AIDS.7
The HIV prevalence rate in addicts stabilized in NYC in 1983, well before
needle programs began.8 The
Greater Los Angeles area has a lower prevalence of AIDS-infected drug users than
any major metropolitan area in the nation due to the non-existence of government
sanctioned needle exchange programs, coupled with aggressive prevention efforts
and low cost treatment.9 Funds
currently being used for NEPs would be better spent if directed toward expansion
and improvement of drug abuse treatment.10
There
is no valid scientific evidence that providing needles has resulted in any
additional lowering of HIV/AIDS rates, according to the U.S. Center for Disease
Control report.11 Furthermore, as shown in a recent Montreal study,12
seroconversion rates, i.e. the percentage of persons who contract the AIDS
virus, are many times higher in needle exchange participants than in addicts
offered outreach alone.13
Current
studies of needle exchange programs are flawed and inconclusive.
Many use insufficient sample size, do not conduct objective tests, do not
use valid comparisons, and use program staff, rather than independent
evaluators, to conduct client interviews.14 A common failing of these
studies is that they fail to control for the many variables involved.15
In
Switzerland, first a limited number of needles were made available, then the
supply was increased as the number of addicts increased.
Later heroin was provided to addicts.
The large open drug scenes, which have since been closed, became a magnet
for foreign addicts. Currently, needles are distributed at multiple, smaller
sites.16 In the past,
narcotic laws were very effective in getting addicts to enter treatment, since
addicts were given the choice of treatment or prison.
The threat of prison serves as an incentive to stay in treatment and off
drugs.17
The
problems associated with liberal drug policies, the distribution of needles to
addicts, and the resultant rise in addiction, crime, and violence, which have
occurred in Switzerland, are now being replicated in the United States through
NEPs. Police are instructed not to
enforce the anti-drug paraphernalia laws when persons possess a Pilot Needle
Exchange Program Card.18 Persons
who previously would have been ordered into treatment by the criminal justice
system are given the means (needles, syringes, "cookers," and the NEP
card) to continue their addiction. Only
a small minority (16%) of addicts in NEPs enter treatment.19
Residents in the neighborhoods where needles are distributed complain
that giving addicts needles to inject illegal drugs interferes with community
goals of clearing drug users and dealers from their neighborhoods.
Addicts inject drugs in broad daylight, and residents report an increase
of crime and violence.20
Providing
needles to inject illegal drugs is in violation of U.S. Federal law.
Federal funds may not be used for such programs, since they have not been
shown to decrease the spread of AIDS without increasing drug use.21
Anti-drug paraphernalia laws, which are circumvented by NEPs, were passed
to decrease drug use and have proved to be effective.
An
active pro-drug lobby promotes needle exchange programs and the unscientific
"studies" alleging the effectiveness of NEPs in reducing HIV/AIDS
rates. The needle exchange issue is
a priority for drug-legalization groups, who lobby for permissive drug policies
and programs promoting so-called "safer" use of illicit drugs.22
The
most compassionate and humanitarian approach for the addict, the drug user, and
society is prevention, intervention and treatment. Needle handouts to addicts
facilitate and increase drug use, enslaving the user and promoting promiscuous
sexual behavior that spreads AIDS.
COPYRIGHT:
Permission is granted to reproduce this article,
provided credit is given to Drug Watch International.
References:
Needle Handouts
1.
"The Public Health Impact of Needle Exchange Programs in the U.S.
and Abroad," School of Public
2.
Haller, Franziska, PhD. M.A., VPM, Switzerland, "Stop Needle
Exchange Programs," October
1994, Committees of Correspondence, Danvers, MA.
3.
Lapey, Janet M.D., "Why Needle Programs Do More Harm Than
Good,"
4.
Sobel, Kelly H., "Studies Show Morphine, Cocaine, and Heroin Speed
5.
Edlin BR et al, New England Journal of Medicine 331: 1422- 427,1994.
6.
Weibel W et al, Presented at the Ninth International Conference on AIDS,
Abstract WSC 152,
7.
Siddiqui NS et al, Journal of Psychoactive Drugs 25:245-250,1993.
8.
DesJarlais, DC et al, Journal of the American Medical Association 271: 121-127,1994.
9.
Tennant, Forest, M.D. Dr. PH, "Breaking the Cylce: Intravenous Drug
Users Do Not Have To Be
10.
Brown, Lawrence S. Jr. M. D. and Kleber, Herbert, M. D., Columbia
University, Members Institute of
Medicine Committee, Letter to New York Times, re: IOM Report: "Preventing
HIV Transmission: The Role of Sterile Needles and Bleach," September
29,1995.
11.
"The Public Health Impact of Needle Exchange Programs in the U.S.
and Abroad," op cit.
12.
Bruneau J et al, Presented at the 6th International Conference on the
Reduction of Drug Related
13.
Weibel W et al, op cit.
14.
"Needle Exchange Programs: Are They Effective?" Office of
National Drug Control Policy, Bulletin No. 7. July 1992.
15.
Lapey, Janet. M.D. "Flaws in the Studies of Needle Distribution
Programs,"
16.
Haller, Franciska, PhD. M.A., VPM, Zurich, Switzerland, 1995.
17.
Aeschbach, Ernst, M.D., et al Argumentum
Against Drug Legalization,
18.
Boston Police Special Order 94-3, March 7, 1994.
19.
Final Report: First Year of the Pilot Needle Exchange Program in
Massachusetts.
20.
Sosman, Nancy, Member New York Community Board Three,
21.
U.S. Public Law 102-304, Section 514.
22.
“Legalization Group Backs Needle Exchange," Drug Policy Report,
Arlington, VA, 1995.
Additional
References
Breault, William, "Crime Tools: Needle exchange
creates safe zones for addicts,"
Brookoff, Daniel, MD, PhD., Letter to Governor Weld in
opposition to needle handouts to addicts,
Buchholz-Kaiser, Annemarie, Dr., Haller, Franziska, Dr.,
"Swiss Drug Policy: The Present Situation,"
Caltrider, William R., "The Public Policy Impact of
Needle Exchange Programs" December, 1993.
"Close Needle Exchange, community board urges,"
The Villager, November 29, 1995.
"Councilor opposes needle exchanges: Nadeau says
best defense against drug use is educational
"Court backs needle swap convictions," Salem
Massachusetts Evening News, July 16, 1993.
Curtis, James L., M.D., "Needle exchange programs
are not the best idea ," Psychiatry and Substance Abuse Services, Harlem Hospital Center, New York.
Ehrenfeld, Rachel, PhD., "Switzerland's Bad
Trip," The Wall Street Journal, October 18, 1995.
Feder, Don, "The real message of needle exchange is
'Say Yes to Drugs'," The
Boston Herald,
"HIV Prevention Tied to Quashing Other STD's,"
Internal Medicine News, September 15, 1995
"Hypo-Handouts: Skepticism on needle-exchange
proposal," Worcester Telegram
& Gazette,
"Indigent Abusers Are Costly to Doctors and
Hospital," Narcotics Demand Reduction Digest, Vol. 6 No. 2, February 1994.
John Watters, "Needle
Exchange Pioneer Dies of Apparent Drug Overdose," The Boston Herald,
November 24, 1995.
Kleber, Herbert, M. D. and Brown, Lawrence S. Jr., M.D.,
Letter to the Editor re: Institute of Medicine
Lowe, Carla, "Taxpayers must fund treatment, not
needles for injecting drug users," Executive Summary
Nahas, Gabriel G., MD, "The Drug Addict and
AIDS," Columbia University College of Physicians
and
Surgeons, New York, NY.
"Needles Bill Opposed by Governor Merrill," The
Union Leader, Manchester, N.H., March 16, 1993.
"Needle Exchange Is An Approval of Drug Use In the
Most Destructive Way," November
1992, Committees of
Correspondence, Inc. Danvers, MA
"Needle Exchange: Necessary Public Health Strategy
or Invitation to Drug Abuse? " Institute
on Black
Chemical Abuse, Minneapolis, MN, Summer, 1994.
Official Position Statements of the Medical Society of
State of New York: Opposing Providing Sterile
Opinion of Attorney General Daniel E. Lundgren, State of
California, Needle Exchange Programs:
Violation of State Law, No. 94-1104, June 7, 1995.
"Pacific Legal Foundation Sues To Strike Down
Sacramento County's Needle Exchange Program,
February 22, 1995 Sacramento CA.
Rangel, Charles, U.S. Representative, "Providing
Needles is a Dangerous Idea," USA
Today, November 3, 1990.
Rosenthal, Mitchell S., M.D., "Assessing Needle
Exchange Programs," August 15, 1991,
"Senate kills needle bills designed for drug
users," Union Leader, Manchester,
New Hampshire,
Sosman, Nancy, "Legalizing Syringes Won't Curb Drug
Abuse," New York Times, September 6, 1995.
"Will Maryland Become a
Needle Park?," Governor's Executive Advisory Council Examining
Dangerous Substance Abuse, Volume 3 No.1,
August-September 1993.
Wilson, Pete, Governor of the State of California.
Veto of Needle & Syringe Exchange Pilot Project Bills:
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