Evaluation of the Needle Exchange program

The needle exchange refers to a harm reduction program that was started
to provide sterile needles and syringes to injection drug users. The
program was proposed following the increase in the rate of infection of
diseases such as HIV/Aids, hepatitis C, and hepatitis B among the
injection drug users (Bowen 121-134). The program was named as exchange
programs because it would ensure the exchange of the number of used
needles with an equal number of unused and sterile needles. Different
researchers and health organizations such as the World Health
Organization have continually supported the needle exchange program with
a series of systematic reviews and meta-analysis. The success of the
needle exchange program over the years has resulted from the government
support and the wide range of supportive programs (including the free
HIV and Hepatitis testing and free counseling services) that are
offered, in addition to the sterile needles, and syringe. However, the
needle exchange program has both merits and demerits as considered in
this paper.
The needle exchange program was initiated to counter a variety of
emerging challenges among the injection drug users. Research has shown
that the program has been effective reducing some of the perceived
challenges. First, the program has been effective in reducing and
preventing the spread of infection of a variety of diseases such as
HIV/AIDS, hepatitis B, and hepatitis C among other infectious diseases.
The issue of free sterile needles and syringe for the injection drug
users reduces the rate of infection of IDUs at a significant level
(Uuskula 517). The research showed that the needle exchange program
stabilized the HIV infection among this population by 50% in 2005, 51%
in 2007, and 51% in 2009 in Estonia (Bowen 121-134). However, the
program has only given positive results in the areas where it was
accompanied by civic education to enlighten the community about the
dangers of sharing needles and syringe among the injection drug users.
Secondly, the guiding premise for the design and implementation of the
needle exchange program is risk reduction, but not to encourage drug
use. Risk reduction is the prerequisite step because the program aims at
saving the lives of the injection drug users from addiction. In
addition, the needle exchange program is an effective way of
demonstrating love and care in an effort to get them out of drug
addiction and feel part of the society (Bowen 121-134). This is an act
of social responsibility that has been proven to reduce the substance
addiction among this population. The needle exchange program is a
morality policy that reduces HIV infection and the substance abuse among
the injection drug users (Uuskula 514). However, other research works
have not indicated the reduction in substance abuse among this
population, but they have substantiated the probability of the program
to encourage substance abuse. In addition, injection victims in the
areas where the needle exchange program has been practiced have
increased livelihood and high probability of entering into the drug
treatment program. Currently, there is no study that has proven that the
program result in a change of the community norms in favor of drug use.
Third, the needle exchange program helps the medical dockets in
recruiting the drug addicts into the treatment program. This is achieved
by formalizing the injection habits, which creates an opportunity to
connect the addicts to the health centers. In addition, the needle
exchange programs create an avenue for enlightening the drug addicts
about the risks of disease infection and substance abuse. The health
practitioners and social workers are thus able to create the treatment
awareness among the addicts (Palateer 845-850). The treatment awareness
is also created as the substance addicts visit the health centers to
pick the sterile needles and syringes. The health practitioners and
social workers may take that chance and enlighten the addicts about the
treatment programs offered in the health centers.
Fourth, the needle exchange program may appear expensive to implement
and maintain, but it is economical in the long-run. This is because the
program acts as an effective means of reducing the HIV infection. The
use of sterile needles and syringes protects both the drug addicts and
their partners from HIV infection. This reduces the future burden on the
national budget for the management of HIV and HIV co-infections among
the drug addicts and their relatives (Commonwealth 8-17). The cost of
treating HIV and HIV related infection as continued to increase as a
result of addition of therapies of category 3TC and inhibitors (Gafni
260-262). To this end, the assessment of conservative estimates of
needle exchange program coverage indicates that the cost savings to cost
is raised to 4:1. In addition, the cost effectiveness of the needle
exchange program can be realized in the long run given that the program
averts further transmission. The cost effectiveness as a result of
reduced transmission is determined by discounting the lifetime treatment
cost of HIV. The net benefits of the needle exchange program exceed if
the future earnings of persons who change their behavior as a result of
the implementation of the program.
Despite the benefits that have been shown as a result of the
implementation of the needle exchange program some policy maker’s
researchers and scholars suggest that the program should not be adopted
for various reasons. First, needle exchange program places more emphasis
on the need for harms reduction and neglects the acknowledgment that
substance abuse is illegal and socially unacceptable. The opponents of
the needle exchange program claim that substance abuse is a conscious
decision that should not be allowed to trivialize the community ethics
at the expense of expediency (Cahill 514-526). In addition, the
implementation of the needle exchange programs opens an opportunity for
the medical practitioners and social workers to distribute the
Paraphernalia and illegal drugs. The needle exchange program is subject
to abuse if the implementation process falls out of control. Moreover,
the ineffective implementation of the program may send a negative
message that the policy makers are approving substance abuse. This may
commonly occur among teens and younger adults who are at high risks of
indulging in substance abuse (Bowen 121-134).
Secondly, the needle exchange program impacts the community
negatively in several aspects. First, implementation of the program
results in the increase, in the number of the needles and syringes used.
The majority of the drug users have not environmentally conscious and
discard the needles and the syringe careless. This is environmentally
unfriendly, and the needles may be misused by a small child leading to
infections (Cahill 514-526). In addition, the implementation of the
needle exchange programs in a given community damages the image of that
community. This is because the program creates an impression that the
community upholds the vice of drug use and may discourage people from
residing in such a place. Moreover, the opponents argue that the program
encourages more people to engage themselves in drug use. This increases
the rate of crime, thus deteriorating the security economic conditions
of the affected community (Palateer 845-850). The needle exchange
program operators have showed the tendency of introducing the program
centers without consulting the community. In most cases, the program
centers are set-up in the trading centers. This has resulted in the
dwindling business prospects, in the affected business areas because
customers fear the nearby business enterprises as a result of
overcrowding of the injection drug addicts. The business operators who
raise the complaints are often considered uncompassionate to the plight
of drug addicts or homophobic.
I feel that the needle exchange program is an effective tool that can
help the community in reducing the disease infection in the long run.
This is the program can help the community in accepting the fact there
are people who are drug addicts in the community and then bring them to
the public limelight through social means that will not destroy their
self esteem. This is the first step in reducing the stigma among this
community before introducing them to the treatment programs. I am in
agreement with Bowen (121-134) who suggested that accepting the addicts
of the substance abuse and making them feel part of the society is the
only means of rescuing them from addiction. The policy be implemented in
all areas especially those that are highly affected by the drug abuse.
However, the needle exchange program should not be emphasized over the
need to rescue those who are already addicted and reduce new addicts. To
this end, the needle exchange program policy should be adjusted to
ensure that all the substance addicts are first given free, but the
compulsory counseling program before they are given the free
Paraphernalia. This will create an awareness among them that reduce
disease infection is not enough, but they should make an extra effort to
avoid substance abuse. However, the counseling program should be made
friendly in order to avoid discouraging the addicts and helping them
avoid relapse to needle and syringe sharing habits.
In conclusion, the implementation of the needle exchange program is an
effective means of reducing the disease infection among the injection
drug addicts. Its effectiveness has been proven severally, but it
depends on the approach of implementing. The implementation process that
is accompanied by civic education results in the acceptance of the
program by the society. Civic education helps in creating awareness
about the risk of sharing the needles and syringe among the injection
addicts as well as creating the treatment awareness. However, the
program faces some objection because of lack of proper creation of
awareness among the members of the society.
Works Cited
Bowen, A. “Clean needles and bad blood: Needle exchange as a morality
policy.” Journal of Sociology & Social Welfare 69.2 (2012): 121-134.
Print.
Cahill, S. & Schaefer, N. Syringe exchange programs around the world:
The global context. New York: GMHC, 2009. Print.
Commonwealth. National needle syringe programs strategic framework
2010-2014. London: Office of the Attorney General, 2010. Print.
Gafni, A. Needle exchange programs: an economic evaluation of a local
experience. Hamilton: McMaster University. 2001. 260-262. Print.
Palateer, N., Hickman, M., Hutchinson, S., Rhodes, T. and Goldberg, D.
“Effectiveness of the sterile injecting equipment in preventing HIV
and hepatitis C transmission.” Addiction, 105. 5 (2010): 845-850. US
National Library of Medicine. Web. 23 March. 2013.
Uuskula, A., Jarlais, M., Ruutel, K., Talu, A. & Sobolev, I. Needle
exchange programs and HIV infection among injection drug users. BMC
Public Health, 11 (2011): 517. Breast Cancer Research. Web. 23 March.
2013.
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