Needle Exchange Programs: The Necessary Step in Decreasing Blood-borne Infections Among People who Inject Drugs

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Injection drug use is on the rise in the United States, consequently increasing the risk of HIV and Hepatitis C infections among People Who Inject Drugs (PWIDs). 8% of all new HIV infections, and 25% of all AIDS cases in the United States are attributed to injection drug use (1,2).

Needle exchange programs (NEPs) provide injection drug users the opportunity to exchange used needles for new sterile needles. Since the inception of NEPs, trends in declining HIV and HEP C rates among PWIDs have become significant. According to the DC Department of Health, the number of HIV infections among PWIDs has decreased by 80%, after initiating their NEP (3,4). In contrast, Hepatitis C infections more than tripled between 2006-2012 in 4 states that do not provide or support NEPs. 70% of those newly infected reported injection drug abuse (5). Many public health organizations, including the WHO and CDC, have justified the impact of needle exchange in reducing these rates, yet federal funding of needle exchange programs remains forbidden. Due to this gap in federal support, some states have opted to fund their own NEPs, while other states oppose them because they are concerned that these programs will encourage commencement of drug use by non-drug users. However, evidence has shown that the presence of NEPs has little bearing on recruiting new injection drug users, and that the benefits far outweigh the potential negatives (4). While it is evident that locally regulated NEPs are successful, it is critical to have federal support and funding to encourage the sustainability of the existing programs and create programs in jurisdictions without local government support. Therefore, our group feels that NEPs should be federally supported to supplement existing local programs and to bring new programs to areas with little governmental support of the program.

  1. CDC HIV and Injection Drug Use in the United States Fact Sheet:
    http://www.cdc.gov/hiv/riskbehaviors/idu.html
  2. American Civil Liberties Union (ACLU) Needle Exchange Fact Sheet:https://www.aclu.org/needle-exchange-programs-promote-public-safety
  3. WAMU News, Needle Exchanges Have Contributed To Decreasing HIV Rate, Say D.C. Officials
    http://wamu.org/news/13/09/25/needle_exchanges_have_contributed_to_decreasing_hiv_rate_say_dc_officials
  4. DC Department of Health, Needle Exchange Program (NEX)
    http://doh.dc.gov/service/needle-exchange-nex
  5. Wall Street Journal CDC Warns of Rise in Hepatitis C Cases Linked to Injection-Drug Use
    http://www.wsj.com/articles/cdc-warns-of-rise-in-hepatitis-c-cases-linked-to-injection-drug-use-1431018001
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5 Responses to “Needle Exchange Programs: The Necessary Step in Decreasing Blood-borne Infections Among People who Inject Drugs”

  1. kaarimsc Says:

    Thank you so much for your thoughtful post on Needle Exchange Programs (NEPs). I agree with this group that there should be federal funding for NEPs as they have shown to be effective. I have had the privilege of visiting a safe-injection site in Vancouver, B.C. known as “Insite”. This program not only provides sterile drug equipment, but is also staffed by medically trained personnel, including nurses to supervise the use of injection drugs. Although this harm reduction strategy is not likely to be taken up by the states, this strategy has shown to be effective at saving lives and prevent the transmission of HIV and Hep C. Understanding the effectiveness of harm reduction is important for public health professionals and can have a great impact on many lives.

    Andresen MA, Boyd N (2010). A cost-benefit and cost-effectiveness analysis of Vancouver’s supervised injection facility. The International Journal on Drug Policy, 21(1), 70–6. doi:10.1016/j.drugpo.2009.03.004.

  2. sdell2 Says:

    Thank you for your post. I have worked with several NEPs. With the programs I have worked with, in addition to providing clean needles and works equipment, they also provide medical services like wound care and GYN services, HIV testing, and always had a substance abuse councilor on board to refer people to inpatient treatment centers if they wanted. NEPs are so much more then just needle exchange sites and offer many more resources in terms of harm reduction. I agree that the laws restricting federal resources to these programs needs to be overturned.

  3. nikettaw Says:

    I really enjoyed reading your post and thanks for bringing attention to this public health concern. I have not worked directly with NEPs but have watched presentations from non-profits who serve low-income communities with high needle drug usage. I think that this program can possibly attract federal funding by implementing the medical aspects into the services in which they provide. As the previous post has mentioned, a program that will also conduct HIV testing, treatment for wounds and infections, and other services then will possibly qualify for more funding via federal grants or other funding programs.

  4. mhafez1 Says:

    This is a great post, shed light on a very important public health issue, NEPs are protective and deserves attention and funds from government and non-government organizations.

  5. ssaleem4jhmiedu Says:

    This is a great post on needle exchange programs. I would love to see some commentary on things we as individual citizens might do to support their implementation

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