Needle-exchange programme
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A needle-exchange programme is a controversial social policy, based on the philosophy of harm reduction, whereby people can obtain hypodermic needles and syringes without a prescription for little or no cost. They may require the exchange of a dirty (used) needle for the clean needle, and education on drug abuse and blood-borne diseases may be provided.
The policy is aimed at injection drug users. The idea is to prevent the reuse and sharing of contaminated needles. Needle sharing is a major cause of the spread of certain diseases, notably HIV and hepatitis C. In the United States a third of all new AIDS cases can be traced to needle sharing and almost 50% of long-term addicts have hepatitis C. The provision of a needle exchange therefore provides a social benefit in reducing health costs and also provides a means to dispose of used needles in a safe manner. Countries where these programmes exist include: Canada, New Zealand, United Kingdom and the United States; however in the United States such programs may not receive federal funding.
The provision of needle-exchange programmes is opposed by certain groups on the grounds that it represents a weakening of the "War on drugs" and encourages drug use and associated criminality. European studies have found the provision of needles does not cause a rise in drug use. In the US the use of federal funds for needle-exchange programmes was banned in 1988 and most states criminalise the possession of needles without a prescription, even so far as to arrest people as they leave private needle-exchange centres.
Critics state these programmes endorse injection drug use and do provide encouragement to drug users to become abstinent. However, all existing credible scientific evidence flatly refutes such notions; the exchange programs are very effective and do not promote use. These findings have been endorsed by, among others, former United States Surgeon General Dr. Davis Satcher, former Director of the National Institutes of Health Dr. Harold Varmus, and former Secretary of the Department of Health and Human Services, Donna Shalala.