The opposition to needle exchange

For statements opposing needle exchange, see:

	Reverend Michael Orsi, member of the New Jersey Governor's Advisory Council on AIDS, "Needle exchange undermines society."
	Christine Todd Whitman, former governor of New Jersey
	George W. Bush Administration
	Robert L. Maginnis, Family Research Council

Answers to key questions:

	Do needle exchange programs "send a message" that drug use is OK?
	Do needle exchange programs say "just say maybe" to children?
	Should needle exchange programs be allowed to open, if adequate drug treatment is not available?
	Do needle exchange programs cause drug overdoses and the other kinds of harm associated with injecting drug use?
	Do the studies of needle exchanges in Montreal and Vancouver prove that needle exchange programs do not work?

  Do needle exchange programs "send a message" that drug use is OK?
The question is, is this an empirical statement that can be proved or disproved, or is it a statement of belief which no amount of scientific evidence can refute?

The scientific evidence is clear.  It has been evaluated by the most distinguished research bodies in the United States and our leading medical associations, including the American Medical Association.  They have all concluded that needle exchange programs are effective in slowing the spread of HIV and do not increase drug use. ⁽¹⁾

So we are left with a question: can needle exchange programs be said send a message that drug use is OK, when there is no scientific evidence that anyone hears that message?  

  Do needle exchange programs "just say maybe" to children?
In a state with the third highest injection-related AIDS rate in the United States, former Governor Christine Todd Whitman of New Jersey repeatedly felt pressed to explain her opposition to needle exchange programs.  She casts her opposition in terms of her concern for children.

Government cannot, on the one hand, say that drug use is bad and illegal; and on the other, provide the tools for this destructive behavior in the name of health.  Kids will not accept that.  It is like saying “Just say maybe.” ⁽²⁾

Again, our best scientists say that no such message is being sent; injecting drug use does not increase when needle exchange programs are instituted.⁽¹⁾  So children, like other members of our society, are not getting a message that causes them harm.

But there is a real and uncontested consequence to the absence of needle exchange programs: the spread of drug-related HIV.  In health departments across the country, statisticians count the ill and the dead from injection-related HIV/AIDS.

What kind of message are we sending when we let people get infected with HIV/AIDS, a painful and often deadly disease, when we could have prevented it?⁽³⁾

What message are we sending to children orphaned by HIV/AIDS – that their parents' lives are not worth saving?⁽⁴⁾

We have any number of ways to send the message that injecting drug use is a bad idea, everything from ads in the media to prison sentences.  Why do we have to let people get sick and perhaps die in the name of “sending a message” which our best science tells us no one hears?  

  Should needle exchange programs be allowed to open, if adequate drug treatment is not available?
A member of the Newark City Council  recently said:

If we do not have the ability in our communities to provide the beds for detox and all of the types of support that people need, I question how effective needle exchange will be.⁽⁶⁾

There is no question that needle exchange programs are more effective at HIV prevention if drug treatment is available to those who request help.  Clearly, a person who has been helped to stop injecting drugs is at much less risk for HIV infection than a person who continues to inject drugs.  

But drug treatment is expensive and in limited supply to those without funds.  To prevent the establishment of needle exchange programs until drug treatment is universally available is to condemn many people who inject drugs now to serious illness and perhaps death from AIDS. 

At any point in time, there are people who are unwilling to enter drug treatment.  But at a later time, a number of those now reluctant will be eager for drug treatment.  Even some with limited resources will eventually succeed in getting drug treatment.

People without HIV who enter drug treatment have their whole lifetimes ahead of them.  People with HIV who enter drug treatment face serious illness and often premature death.

  Do needle exchange programs cause drug overdoses and the other kinds of harm associated with injecting drug use?
Many different kinds of harm come from injecting drug use. But they are not caused by needle exchange programs.  Needle exchange programs have only one major consequence – they slow the spread of HIV.  

Footnotes

(1) For information on the scientific research regarding needle exchange, click here.

(2) Christine Todd Whitman. 1998. "Needle exchange sends mixed message." Trenton Times (Trenton, NJ), May 19, p. A10.

(3) For a consideration of some of the ethical and religious issues surrounding needle exchange, click here.

(4) For a first person account by a daughter of a man who died from AIDS, click here.

(5) Jesse Drucker. 1999. "Project aims to cut the spread of HIV." Star-Ledger (Newark, NJ), August 8, p. 41. 

For a list of other materials used on this website, see References.