— This is where the concept of damage decrease ends up being crucial
by
Ryan D. Assaf, PhD, MPH
February 11, 2024
Assaf is an epidemiologist and postdoctoral fellow looking into compound usage, drug-related overdose, and damage decrease.
A needle exchange programlikewise referred to as a syringe services program, is a damage decrease method that offers tidy and sterilized injecting devices to those who inject drugs. Initially look, these programs might sound extreme. The truth is, people who are injecting or utilizing drugs are going to do so regardless of whether they have access to tidy injecting devices.
This is where the concept of damage decrease ends up being crucial: these are evidence-based methods for individuals who utilize drugs to avoid or restrict the unfavorable results that might originate from their substance abuse. The concept accepts that individuals utilize drugs which there are extremely genuine effects to substance abuse, however that it is not our function to stop individuals from utilizing drugs.
Needle exchange programs– which are backed by the CDC as a public health technique– exist in numerous states throughout the U.S. and have actually been shown to lower the transmission of viral infections and to function as a bridge to other services, such as medication-assisted treatment. This life-saving method continues to get reaction.
Home Bill 4866which was just recently presented in the West Virginia House of Delegates, would end needle exchange programs in the state. West Virginia leads the country in drug-related overdoses per capita and has actually been battling with HIV break outs over the last a number of years. Prohibiting needle exchange programs in the state will just make these obstacles even worse.
I’ve seen firsthand the effect of these programs: for almost a years I have actually operated at several needle exchange programs throughout California. Every program I have actually operated at likewise supplied lots of other services such as HIV/hepatitis C screening, medical services, psychological and behavioral health services, naloxone circulation for overdose avoidance, social services, and real estate services.
These programs likewise offer vaccine circulation for influenza and liver disease A and B, food kitchens, hot meals, and clothes circulation. Most notably, these services develop an area of trust where people who utilize drugs can look for aid, recommendations, and navigation to compound usage treatment and therapy if and when they are prepared for it. These programs might likewise reach and benefit other populations beyond those who utilize drugs, such as individuals experiencing homelessness.
In the U.S., substance abuse continues to grow: in 2022, amongst individuals ages 12 and older, 5.3 million individuals utilized drug (1.9%), 2.7 million utilized methamphetamine (1%), and 1 million individuals utilized heroin (0.4%). Research study approximates that over 3.5 million individuals injected drugs in the U.S. in 2018, a number that has actually progressively increased over the last 10 years.
Offered these boosts in substance abuse and associated damages such as overdose, it is very important to satisfy individuals where they are and use a selection of non-judgmental methods and resources to restrict the damages they might confront with substance abuse. It is likewise vital to develop trust and deal autonomy so that people can make choices about their substance abuse without feeling stigmatized.
Particularly, the main function of a needle exchange program is to supply safe injection devices to avoid sharing of needles with others, and to avoid reuse of needles by the very same person.
In doing so, needle exchange programs intend to lower the spread of blood-to-blood viral infections such as HIV and liver disease C while likewise decreasing bacterial skin contagious such as Staphylococcus aureusThese infections are quickly avoidable, yet have the prospective to trigger considerable damage when the best resources are not readily available.
A typical misunderstanding about needle exchange programs is that they motivate and boost substance abuseand boost criminal activity and needle litter. Years of research study have unmasked these claims.
Research study reveals that needle exchange programs do not increase substance abuse, nor cause the initiation of substance abuse. Other research study exposed that those taken part in needle exchange services are most likely to get compound usage treatment
Extra research study shows that needle exchange programs do not increase criminal offenseand cities with needle exchange websites are most likely to practice correct needle disposalOver 30 years of information show that needle exchange programs are economical and safe, and assist avoid HIVliver disease C, other infections, and drug-related overdoses.
Substance abuse and descriptions for substance abuse are complicated. There are numerous social and structural reasons that individuals might utilize drugs, consisting of to manage injurydifficulties in life, experiences with homelessness historic injustice, earnings inequalityor since of the environment where an individual lives.
Criminalizing drug usage and the services intended at supporting those who utilize drugs does not make the issue go away. West Virginia– and any other state without access to needle exchange programs or a state that’s thinking about getting rid of them– need to reconsider its policies.
Policymakers, neighborhood supporters, and health care employees alike should think about how the advantages and expenses of having needle exchange programs far surpass the threats if these programs are eliminated.
It is very important for all stakeholders to deal with neighborhood companies, doctor, and those with a lived experience of substance abuse to have programs that finest fulfill the requirements of the neighborhood.
Ryan D. Assaf, PhD, MPH, is a postdoctoral fellow with the Benioff Homelessness and Housing Initiative at the University of California, San Francisco, and a public voices fellow through The OpEd Project.