Legalize needle-exchanges for addicts in Texas?

[jochhejaam]

Yeah, I'm sure hundreds of thousands are just waiting for those free needles so they can ride the white horse.

Turning to drugs isn't a rational decision that you think out. People turn to drugs because they despair. They need chemical anesthesia to get through a DAY in their life, and I don't think they are considering if the needles are dirty or clean, just if they have heroin in them.

Detective Exstatic, I state, with a high degree of confidence, that you are the only one that took my post at face value.

[Wild Cobra]

So, since Bexar County doesn't have a needle exchange, it is ok for the homeless addicts from there to be sent to someplace that does have a government funded needle exchange program like -- oh, I don't know -- say, Multnomah County?

http://www.mchealth.org/cd/hivhcv/needlex.shtml

Thanks for the idea! Be sure to welcome them at the airport!

Exactly. Our homeless population has exploded by programs like this and others already. We also have a place call "Dignity Village." We are a sanctuary city for many undesirable habits. I've had enough of it. I wouldn't place to much stock in the articles accuracy, especially if you know about the chronic lies and deceptions perpetrated by the county I live in.

When another place opens up, I'm more than happy to try to pawn off some of ours elsewhere!

Believe me, these lowlifes here living off the tax dollar are a real big problem. You don't want to encourage more of the same activity anywhere!

[ChumpDumper]

Are there studies showing an increase in overall IV drug use when a needle exchange program is established?

[jochhejaam]

I have a problem with buying someone a needle to shoot up with, but that pales in comparison to how I feel about addicts passing along HIV because they don't have sterile syringes.





Maybe you can get the free needles if you can prove that you are living in abject poverty.
<careful ex>

[Wild Cobra]

Are there studies showing an increase in overall IV drug use when a needle exchange program is established?

I don't know. It would defy common sense to think otherwise.

Can you explain how free needles vs. hard to acquire ones would decrease the number of cases?

I would suggest that the lower rates are not factual. AIDS is spread easily by only a limited number of means. I think it can be assumed with confidence that if people are both gay and intravenous drug users, and drugs being found in blood tests, that they would claim the needle is how they got AIDS rather than admitting they were gay! When you have needle programs, they can no longer make such a claim now, can they? At least not by the same numbers...

[ChumpDumper]

I don't know. It would defy common sense to think otherwise.

Why?

Can you explain how free needles vs. hard to acquire ones would decrease the facts?

Decrease the facts?

I would suggest that they are not facts. AIDS is spread easily by only a limited number of means. I think it can be assumed with confidence that if people are both gay and intravenous drug users, and drugs being found in blood tests, that they would claim the needle is how they got AIDS rather than admitting they were gay! When you have needle programs, they can no longer make such a claim now, can they? At least not by the same numbers...

What the are you talking about?

You were better off stopping at "I don't know." That mere ignorance was better than the stupidity that followed.

[Wild Cobra]

Decrease the facts?

I made an error in my typing. I went back and edited my work.

You were better off stopping at "I don't know." That mere ignorance was better than the stupidity that followed.

Theory is not stupidity. I did not say it with enough conviction to call it such. Besides, people who have poor care for themselves will likely increase the risk of AIDS and or Hepa is by the other living standards they have let decline. Do we really want to make it easier for people to live in such settings? I say we should emphasize increasing a persons dignity rather than making it easy for them to live undignified existences.

[ChumpDumper]

I made an error in my typing. I went back and edited my work.

The argument for needle exchange programs don't necessarily include decreasing overall IV drug use, but at least an anecdotal argument could be made that treatment options could be made available to those who take part in the program. It's more about slowing the spread of disease.

Theory is not stupidity. I did not say it with enough conviction to call it such. Besides, people who have poor care for themselves will likely increase the risk of AIDS and or Hepa is by the other living standards they have let decline. Do we really want to make it easier for people to live in such settings? I say we should emphasize increasing a persons dignity rather than making it easy for them to live undignified existences.

I still have no idea what this tangent is all about. Maybe you need a time out.

[xrayzebra]

Maybe we can get SA210 to check in and give us her opinion. She
works with the homeless quite a lot. I haven't seen her in her since
her favorite Presidential candidate withdrew, but her opinion would
be welcome.

[RandomGuy]

I voted no but, I am in favor of decriminalizing the use of narcotics. Addicts can pay for their own needles.

And, RG, I voted no because I don't think the government should be in the business of supporting addicts in their bad behaviors.

(shrugs)

I don't think the government should be in the business of supporting addicts in their bad behaviors either.

BUT

This isn't "supporting" them.
They WILL do the drugs whether or not you give them clean needles, yes or no?

[RandomGuy]

I voted no. 1) Why should addicts of illegal drugs get comped on their needle supply when diabetics have to pay for theirs to some extent?

2) How is that fair?

It isn't quite fair.

BUT

This isn't about fair or not.

This is about preventing disease.

Do you want to pay for, say $100, worth of needles per year, or a $50,000 medical treatment when they get so sick they need to be hospitalized?

or worse yet, spread Hepa is to you?

Would that be fair?

[RandomGuy]

If they don't have their own insurance, or cannot pay for the treatments themselves, let them die. Why do people try to thwart Darwin?

immoral
Adjective
1. morally wrong; corrupt

wicked, bad, wrong, abandoned, evil, corrupt, vicious, obscene, indecent, vile, degenerate, dishonest, sinful, unethical, depraved, impure, unprincipled, nefarious, dissolute, iniquitous also see amoral

Because, unlike most animals, humans are capable of morality, and living for something beyond their own selfish interests.

You might not have any morals, but the rest of us do.

When you make something free, it encourages more.

Indeed. That's the point isn't it? In this case we are making clean needles free, not the drugs themselves, you idiot.

I'll tell you what. I'm sick of the addicts in downtown Portland begging on every block corner. If that passes, I'll every now and them take one to the Airport, and buy a one-way ticket to county seat of Bexar County if they like the free benefits offered there. Want to see a population of homeless increase there? There are plenty of people like me who do just that from time to time. Pay an indigent to go elsewhere.

Short-sighted, economically costly, and stupid.

Make the symptom go elsewhere instead of dealing with the underlying problems. Because sticking your fingers in your ears and going "la la la" always worked when you were a kid, right?

Are we as a nation incapable of dealing with grown up problems, with grown up solutions?

I think we are better than that.

[RandomGuy]

Are there studies showing an increase in overall IV drug use when a needle exchange program is established?

I don't know. It would defy common sense to think otherwise.

Can you explain how free needles vs. hard to acquire ones would decrease the number of cases?

I would suggest that the lower rates are not factual. AIDS is spread easily by only a limited number of means. I think it can be assumed with confidence that if people are both gay and intravenous drug users, and drugs being found in blood tests, that they would claim the needle is how they got AIDS rather than admitting they were gay! When you have needle programs, they can no longer make such a claim now, can they? At least not by the same numbers...

This isn't just AIDS, brain trust. This is a host of blood-borne diseases.

I would suggest that the lower rates are not factual.

You can suggest that your penis is 12" long too, but proving either statement is another thing.

There are plenty of reasonable studies in peer reviewed medical journals. You can "suggest" that they are not factual as much as you want, but the actual science doesn't back you up on that.

You talk about "common sense" backing up the thesis that giving clean needles to addicts doesn't slow the spread of blood-borne diseases, but how about this common sense question:

Yes or no, if an addict uses a clean needle, and does not share it, would that tend to decrease the possibility of disease transmission?

[RandomGuy]

Link to something that shows the results of lots of other studies

Syringe/Needle Exchange Programs

"Syringe exchange programs (SEPs) provide sterile syringes in exchange for used syringes to reduce transmission of human immunodeficiency virus (HIV) and other bloodborne infections associated with reuse of contaminated syringes by injection-drug users (IDUs). . . . SEPs can help prevent bloodborne pathogen transmission by increasing access to sterile syringes among IDUs and enabling safe disposal of used syringes. Often, programs also provide other public health services, such as HIV testing, risk-reduction education, and referrals for substance-abuse treatment."

Source: "Update: Syringe Exchange Programs -- United States, 2002," Morbidity and Mortality Weekly Report, July 15, 2005, Vol. 54, No. 27 (Atlanta, GA: US Centers for Disease Control), p. 673.

"While it is not feasible to do a randomized controlled trial of the effectiveness of needle or syringe exchange programs (NEPs/SEPs) in reducing HIV incidence, the majority of studies have shown that NEPs/SEPs are strongly associated with reductions in the spread of HIV when used as a component of comprehensive approach to HIV prevention. NEPs/SEPs increase the availability of sterile syringes and other injection equipment, and for exchange participants, this decreases the fraction of needles in circulation that are contaminated. This lower fraction of contaminated needles reduces the risk of injection with a contaminated needle and lowers the risk of HIV transmission.
"In addition to decreasing HIV infected needles in circulation through the physical exchange of syringes, most NEPs/SEPs are part of a comprehensive HIV prevention effort that may include education on risk reduction, and referral to drug addiction treatment, job or other social services, and these interventions may be responsible for a significant part of the overall effectiveness of NEPs/SEPs. NEPs/SEPs also provide an opportunity to reach out to populations that are often difficult to engage in treatment."

Source: Volkow, Nora, Director, US National Ins ute on Drug Abuse, correspondence with Allan Clear, Aug. 4, 2004, as accessed online at http://hepcproject.typepad.com/hep_c...derzerhou.html, on May 11, 2005.

"After reviewing all of the research to date, the senior scientists of the Department and I have unanimously agreed that there is conclusive scientific evidence that syringe exchange programs, as part of a comprehensive HIV prevention strategy, are an effective public health intervention that reduces the transmission of HIV and does not encourage the use of illegal drugs."

Source: US Surgeon General Dr. David Satcher, Department of Health and Human Services, Evidence-Based Findings on the Efficacy of Syringe Exchange Programs: An Analysis from the Assistant Secretary for Health and Surgeon General of the Scientific Research Completed Since April 1998 (Washington, DC: Dept. of Health and Human Services, 2000), as accessed at http://www.harmreduction.org/researc...urgreview.html, on May 11, 2005.

According to Dr. Harold Varmus, then-Director of the National Ins utes of Health, "An exhaustive review of the science in this area indicates that needle exchange programs can be an effective component in the global effort to end the epidemic of HIV disease."

Source: Varmus, Harold, MD, Director of the National Ins utes of Health, Press release from Department of Health and Human Services, (April 20, 1998).

"For injecting drug users who cannot gain access to treatment or are not ready to consider it, multi-component HIV prevention programs that include sterile needle and syringe access reduce drug-related HIV risk behavior, including self-reported sharing of needles and syringes, unsafe injecting and disposal practices, and frequency of injection. Sterile needle and syringe access may include needle and syringe exchange (NSE) or the legal, accessible, and economical sale of needles and syringes through pharmacies, voucher schemes, and physician prescription programs. Other components of multi-component HIV prevention programs may include outreach, education in risk reduction, HIV voluntary counseling and testing, condom distribution, distribution of bleach and education on needle disinfection, and referrals to substance abuse treatment and other health and social services."

Source: Committee on the Prevention of HIV Infection among Injecting Drug Users in High-Risk Countries, Ins ute of Medicine, National Academy of Sciences, "Preventing HIV Infection among Injecting Drug Users in High Risk Countries: An Assessment of the Evidence" (Washington, DC: National Academy Press, 2006), p. 142.

A literature review in 2004 by the European Union's drug monitoring agency, the European Monitoring Centre on Drugs and Drug Addiction, found that "Major reviews (summarised in Vlahov and Junge, 1998; Bastos and Strathdee, 2000; Ferrini, 2000) suggest that NSPs (Needle and Syringe Programs) may reduce rates of seroconversion to HIV and hepa is by one third or more, without negative side effects on the number of IDUs (Vlahov and Junge, 1998). A landmark study from Hurley et al. combined HIV seroprevalence data from 81 cities with (n=52) or without (n=29) NSPs (Hurley et al., 1997). They showed that the average annual seroprevalence was 11% lower in cities with an NSP than in cities without an NSP, providing important evidence on the effectiveness of NSPs in reducing the spread of HIV."

Source: de Wit, Ardine and Jasper Bos, "Cost-Effectiveness of Needle and Syringe Programmes: A Review of the Literature," in Hepa is C and Injecting Drug Use: Impact, Costs and Policy Options, Johannes Jager, Wien Limburg, Mirjam Kretzschmar, Maarten Postma, Lucas Wiessing (eds.), European Monitoring Centre on Drugs and Drug Addiction, 2004.

"Access to sterile needles and syringes is an important, even vital, component of a comprehensive HIV prevention program for IDUs. The data on needle exchange in the United States are consistent with the conclusion that these programs do not encourage drug use and that needle exchanges can be effective in reducing HIV incidence. Other data show that NEPs help people stop drug use through referral to drug treatment programs. The studies outside of the United States are important for reminding us that unintended consequences can occur. While changes in needle prescription and possession laws and regulations have shown promise, the identification of organizational components that improve or hinder effectiveness of needle exchange and pharmacy-based access are needed."

Source: Vlahov, David, PhD, and Benjamin Junge, MHSc, "The Role of Needle Exchange Programs in HIV Prevention," Public Health Reports, Volume 113, Supplement 1, June 1998, pp. 75-80.

"Pediatricians should advocate for unen bered access to sterile syringes and improved knowledge about decontamination of injection equipment. Physicians should be knowledgeable about their states' statutes regarding possession of syringes and needles and available mechanisms for procurement. These programs should be encouraged, expanded, and linked to drug treatment and other HIV-1 risk-reduction education. It is important that these programs be conducted within the context of continuing research to do ent effectiveness and clarify factors that seem linked to desired outcomes."

Source: "Policy Statement: Reducing the Risk of HIV Infection Associated With Illicit Drug Use," Committee on Pediatric AIDS, Pediatrics, Vol. 117, No. 2, Feb. 2006 (Chicago, IL: American Academy of Pediatrics), p. 569.

"We found that in cities with NEPs HIV seroprevalence among injecting drug users decreased on average, whereas in cities without NEPs HIV seroprevalence increased. A plausible explanation for this difference is that the NEPs led to a reduction in HIV incidence among injecting drug users.
"NEPs have the potential to decrease directly HIV transmission by lowering the rate of needle sharing and the prevalence of HIV in needles available for reuse, as well as indirectly through activities such as bleach distribution, referrals to drug treatment centres, provision of condoms, and education about risk behaviour. Although these mechanisms have strong theoretical support, the published evidence for NEP effectiveness is limited. Previous studies of the effect of NEPs on HIV incidence used observational designs or statistical models. ... Our study is distinguished from previous work by its worldwide scope and its design, which compares changes in HIV seroprevalence in cities with and without NEPs, rather than changes within a single city."

Source: Hurley, Susan F., Damien J. Jolley, John M. Kaldor, "Effectiveness of Needle-Exchange Programmes for Prevention of HIV Infection," The Lancet, 1997; 349: 1797-1800, June 21, 1997.

Donna Shalala, Secretary of Health and Human Services in the Clinton Administration, stated: "A meticulous scientific review has now proven that needle exchange programs can reduce the transmission of HIV and save lives without losing ground in the battle against illegal drugs."

Source: Shalala, D.E., Secretary, Department of Health and Human Services, Press release from Department of Health and Human Services (April 20, 1998).

Between 1991 and 1997, the U.S. Government funded seven reports on clean needle programs for persons who inject drugs. The reports are unanimous in their conclusions that clean needle programs reduce HIV transmission, and none find that clean needle programs cause rates of drug use to increase.

Sources: National Commission on AIDS, The Twin Epidemics of Substance Abuse and HIV (Washington DC: National Commission on AIDS, 1991); General Accounting Office, Needle Exchange Programs: Research Suggests Promise as an AIDS Prevention Strategy (Washington DC: US Government Printing Office, 1993); Lurie, P. & Reingold, A.L., et al., The Public Health Impact of Needle Exchange Programs in the United States and Abroad (San Francisco, CA: University of California, 1993); Satcher, David, MD, (Note to Jo Ivey Bouffard), The Clinton Administration's Internal Reviews of Research on Needle Exchange Programs (Atlanta, GA: Centers for Disease Control, December 10, 1993); National Research Council and Ins ute of Medicine, Normand, J., Vlahov, D. & Moses, L. (eds.), Preventing HIV Transmission: The Role of Sterile Needles and Bleach (Washington DC: National Academy Press, 1995); Office of Technology Assessment of the U.S. Congress, The Effectiveness of AIDS Prevention Efforts (Springfield, VA: National Technology Information Service, 1995); National Ins utes of Health Consensus Panel, Interventions to Prevent HIV Risk Behaviors (Kensington, MD: National Ins utes of Health Consensus Program Information Center, February 1997).

Research published in the Journal of Urban Health estimated that in 1998, there were 1,364,874 injection drug users in the US.

Source: Friedman, Samuel R., Barbara Tempalski, Hannah Cooper, Theresa Perlis, Marie Keem, Risa Friedman & Peter L. Flom, "Estimating Numbers of Injecting Drug Users in Metropolitan Areas for Structural Analyses of Community Vulnerability and for Assessing Relative Degrees of Service Provision for Injecting Drug Users," Journal of Urban Health (New York, NY: NY Academy of Medicine, 2004), Vol. 81, No. 3, p. 380.

"Estimates of the annual number of syringes required to meet the single-use standard run in the range of 1 billion. The most recent estimate of the number of syringes distributed by needle exchange programs in the United States (1997) was 17.5 million."

Source: Burris, Scott, JD, Lurie, Peter, MD, et al., "Physician Prescribing of Sterile Injection Equipment to Prevent HIV Infection: Time for Action", Annals of Internal Medicine (Philadelphia, PA: American College of Physicians, August 1, 2000), Vol. 133, No. 3, from the web at http://www.annals.org/issues/v133n3/...010-00015.html, citing Lurie P, Jones TS, Foley J. A sterile syringe for every drug user injection: how many injections take place annually, and how might pharmacists contribute to syringe distribution? J Acquir Immune Defic Syndr Hum Retrovirol 1998;18(Suppl 1):S45-51, and Update: syringe exchange programs -- United States, 1997. MMWR Morb Mortal Wkly Rep. 1998;47:652-55.

In 1997, Dr. Ernest Drucker wrote in The Lancet that if current U.S. policies limiting clean needle programs were not changed, an additional 5,150 to 11,329 preventable HIV infections could occur by the year 2000. In 1999 alone, the CDC reported there were at least 2,946 new injection-related HIV infections.

Source: Lurie, P. & Drucker, E., "An Opportunity Lost: HIV Infections Associated with Lack of a National Needle- Exchange Programme in the U.S.A.", Lancet, 349: 604-08 (1997); Centers for Disease Control, HIV/AIDS Surveillance Report (1999 Year-End Edition, December 1999), Vol. 11, No. 2, Table 6, p. 15, available online at http://www.cdc.gov/hiv/stats/hasr1102/table3.htm.

The estimated lifetime cost of treating an HIV positive person is $195,188.

Source: Holtgrave, DR, Pinkerton, SD. "Updates of Cost of Illness and Quality of Life Estimates for Use in Economic Evaluations of HIV Prevention Programs." Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, Vol. 16, pp. 54-62 (1997).

"Eastern Europe, the Commonwealth of Independent States, and significant parts of Asia are experiencing explosive growth in new HIV infections, driven largely by injecting drug use (UNAIDS, 2006). While the primary route of transmission in most of these areas is sharing of contaminated injecting equipment, sexual and perinatal transmission among IDUs and their partners also plays an important and growing role. In many highly affected countries, rapid growth in the number of IDUs infected with HIV has already created a public health crisis. Countries where the level of HIV infection is still relatively low have the chance -- if they act now -- to slow the spread of HIV."

Source: Committee on the Prevention of HIV Infection among Injecting Drug Users in High-Risk Countries, "Preventing HIV Infection among Injecting Drug Users in High Risk Countries: An Assessment of the Evidence" (Washington, DC: National Academy Press, 2006), p. 141.

In 2005 the US Centers for Disease Control published the results of a survey conducted by staff from Beth Israel Medical Center and the North American Syringe Exchange Network (NASEN) of 148 Syringe Exchange Program (SEP) directors around the country (of whom 126 completed the survey). According to the report: "These 126 SEPs reported operating in 102 cities in 31 states and the District of Columbia (DC). More than two-thirds (86) of SEPs were in seven states: California (25), Washington (15), New Mexico (14), New York (12), Wisconsin (eight), Massachusetts (six), and Oregon (six). "SEP size was classified by the number of syringes exchanged (Table 1); 119 SEPs reported exchanging a total of 24,878,033 syringes; seven SEPs did not track the number of syringes exchanged. The 11 largest programs exchanged 49% of all syringes."

Source: "Update: Syringe Exchange Programs -- United States, 2002," Morbidity and Mortality Weekly Report, July 15, 2005, Vol. 54, No. 27 (Atlanta, GA: US Centers for Disease Control), p. 673.

"The findings indicate that in 2002, for the first time in 8 years, the number of SEPs, the number of localities with SEPs, and public funding for SEPs decreased nationwide; however, the number of syringes exchanged and total budgets across all programs continued to increase."

Source: "Update: Syringe Exchange Programs -- United States, 2002," Morbidity and Mortality Weekly Report, July 15, 2005, Vol. 54, No. 27 (Atlanta, GA: US Centers for Disease Control), p. 673.

"SEPs provided other services in addition to syringe exchange. One hundred ten (87%) SEPs provided male condoms, 96 (76%) female condoms, 111 (88%) alcohol pads, and 86 (68%) bleach; 97 (77%) provided referrals for substance-abuse treatment; 91 (72%) offered voluntary on-site counseling and testing for HIV, 54 (43%) for hepa is C, and 37 (29%) for hepa is B; 42 (33%) provided vaccination for hepa is A and 45 (36%) for hepa is B; 39 (31%) offered sexually transmitted disease (STD) screening; 29 (23%) provided on-site medical care; and 28 (22%) provided tuberculosis screening. Most programs provided risk-reduction and risk-elimination education to IDUs. One hundred fifteen (91%) programs provided education on hepa is A, B, and C; 114 (90%) on HIV/AIDS prevention; 111 (88%) on safer injection practices; 104 (83%) on abscess prevention and care; 100 (79%) on vein care; 110 (87%) on STD prevention; 110 (87%) on male condom use; and 94 (75%) on female condom use."

Source: "Update: Syringe Exchange Programs -- United States, 2002," Morbidity and Mortality Weekly Report, July 15, 2005, Vol. 54, No. 27 (Atlanta, GA: US Centers for Disease Control), pp. 673-4.

"During 2002, a total of 126 SEPs maintained an average of six exchange sites each (median: 3.0; range: 1-47). SEPs served clients for an average of 26 hours/week (median: 18 hours/ week; range: 1-202 hours/week). Buildings (e.g., storefronts, clinics, or health centers) were the most commonly reported sites; 68 total SEPs (54%) operated 156 sites/week for 1,334 hours/week). Forty-five (36%) programs served clients through health vans or car stops (203 sites/week for 616.5 hours/week), and 25 (20%) operated other types of fixed sites, such as at tables on streets, in private homes, or at shooting galleries (i.e., locations where persons inject drugs) (141 sites/week for 413.5 hours/week). Fifteen (12%) programs used mobile workers on foot or bicycle (81 sites/week for 202.0 hours/ week). Of the 126 total SEPs in 2002, 69 (55%) had multiple types of exchange sites, 36 (29%) were entirely building-based, 14 (11%) were vehicle-based, five (4%) used other fixed sites, and two (2%) used mobile sites only. Delivery of syringes and other risk-reduction supplies to residences or meeting spots was reported by 62 (49%) SEPs. Secondary exchange (i.e., exchange of syringes on behalf of other persons) was allowed by 103 (82%) programs."

Source: "Update: Syringe Exchange Programs -- United States, 2002," Morbidity and Mortality Weekly Report, July 15, 2005, Vol. 54, No. 27 (Atlanta, GA: US Centers for Disease Control), p. 674.

According to the National Ins utes of Health, "individuals in areas with needle exchange programs have an increased likelihood of entering drug treatment programs."

Source: National Ins utes of Health Consensus Panel, Interventions to Prevent HIV Risk Behaviors (Kensington, MD: NIH Consensus Program Information Center, February 1997), p. 6.

Needle exchange programs can "prevent significant numbers of [HIV] infections among clients of the programs, their drug and sex partners and their offspring. In almost all cases, the cost per HIV infection averted is far below the $119,000 lifetime cost of treating an HIV infected person."

Source: Lurie, P. & Reingold, A.L., et al., The Public Health Impact of Needle Exchange Programs in the United States and Abroad (San Francisco, CA: University of California, 1993), Vol. 1, Executive Summary, pp. iii-v.

"The purchase of syringes through pharmacies may be a major source of contact with the health service for some injectors, and the potential to exploit this contact point as a conduit to other services clearly exists. Work to motivate and support pharmacists to develop the services they offer to drug users could form an important part of extending the role of pharmacies, but to date only France, Portugal and the United Kingdom appear to be making significant investments in this direction."

Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 79.

"Although most US states have legal restrictions on the sale and possession of syringes, pharmaceutical practice guidelines often allow pharmacists discretion in syringe sales decisions; this may lead to wide variation in syringe sales by individual pharmacists and to discrimination based on gender, age, race, ethnicity, or socioeconomic status. Individual-level factors associated with pharmacists' relative willingness to sell syringes include familiarity with customers; concerns about deception, disease transmission, improperly discarded syringes, and staff and customer safety; business concerns, including fear of theft and harassment of other customers by IDU patrons; and fear of increased drug use because of easier syringe access."

Source: Diebert, Ryan J., MPH, Goldbaum, Gary, MD, MPH, Parker, Theodore R., MPH, Hagan, Holly, PhD, Marks, Robert, MEd, Hanrahan, Michael, BA, and Thiede, Hanne, DVM, MPH, "Increased Access to Unrestricted Pharmacy Sales of Syringe in Seattle-King County, Washington: Structural and Individual-Level Changes, 1996 Versus 2003," American Journal of Public Health, Vol. 96, No. 8, Aug. 2006, p. 1347.

"Studies on behalf of the US government conducted by the National Commission on AIDS, the University of California and the Centers for Disease Control and Prevention, the National Academy of Science, and the Office of Technology Assessment all concluded that syringe prescription and drug paraphernalia laws should be overturned or modified to allow IDUs to purchase, possess, and exchange sterile syringes."

Source: Diebert, Ryan J., MPH, Goldbaum, Gary, MD, MPH, Parker, Theodore R., MPH, Hagan, Holly, PhD, Marks, Robert, MEd, Hanrahan, Michael, BA, and Thiede, Hanne, DVM, MPH, "Increased Access to Unrestricted Pharmacy Sales of Syringe in Seattle-King County, Washington: Structural and Individual-Level Changes, 1996 Versus 2003," American Journal of Public Health, Vol. 96, No. 8, Aug. 2006, p. 1352.

According to a study in 1996, "Drug paraphernalia laws in 47 U.S. states make it illegal for injection drug users (IDUs) to possess syringes." The study concludes, "decriminalizing syringes and needles would likely result in reductions in the behaviors that expose IDUs to blood borne viruses."

Source: Bluthenthal, Ricky N., Kral, Alex H., Erringer, Elizabeth A., and Edlin, Brian R., "Drug paraphernalia laws and injection-related infectious disease risk among drug injectors", Journal of Drug Issues, 1999;29(1):1-16. Abstract available on the web at http://www.nasen.org/NASEN_II/research1.htm.

"The data in this report offer no support for the idea that anti-OTC laws prevent illicit drug injection. However, the data do show associations between anti-OTC laws and HIV prevalence and incidence. In an ongoing epidemic of a fatal infectious disease, prudent public health policy suggests removing prescription requirements rather than awaiting definitive proof of causation. Such action has been taken by Connecticut, by Maine, and, recently, by New York. After Connecticut legalized OTC sales of syringes and the personal possession of syringes, syringe sharing by drug injectors decreased. Moreover, no evidence showed increased in drug use, drug-related arrests, or needlestick injuries to police officers."

Source: Friedman, Samuel R. PhD, Theresa Perlis, PhD, and Don C. Des Jarlais, PhD, "Laws Prohibiting Over-the-Counter Syringe Sales to Injection Drug Users: Relations to Population Density, HIV Prevalence, and HIV Incidence," American Journal of Public Health (Washington, DC: American Public Health Association, May 2001), Vol. 91, No. 5, p. 793.

"Anti-OTC laws are not associated with lower population proportions of IDUs. Laws restricting syringe access are statistically associated with HIV transmission and should be repealed."

Source: Friedman, Samuel R. PhD, Theresa Perlis, PhD, and Don C. Des Jarlais, PhD, "Laws Prohibiting Over-the-Counter Syringe Sales to Injection Drug Users: Relations to Population Density, HIV Prevalence, and HIV Incidence," American Journal of Public Health (Washington, DC: American Public Health Association, May 2001), Vol. 91, No. 5, p. 793.

"In multivariate analyses, we found that police contact was associated independently with residing in the area with no legal possession of syringes; among SEP users, those with access to SEPs without limits had lower syringe re-use but not lower syringe sharing; and that among non-SEP users, no significant differences in injection risk were observed among IDUs with and without pharmacy access to syringes. "Conclusion We found that greater legal access to syringes, if accompanied by limits on the number of syringes that can be exchanged, purchased and possessed, may not have the intended impacts on injection-related infectious disease risk among IDUs."

Source: Bluthenthal, Ricky N., Mohammed Rehan Malik, Lauretta E. Grau, Merrill Singer, Patricia Marshall & Robert Heimer for the Diffusion of Benefit through Syringe Exchange Study Team, "Sterile Syringe Access Conditions and Variations in HIV Risk Among Drug Injectors in Three Cities," Addiction Journal, Vol. 99, Issue 9, p. 1136, Sept. 2004, abstract online at http://www.blackwell-synergy.com/lin...4.00694.x/abs/ last accessed Jan. 6, 2005.

The US Office of National Drug Control Policy in 2005 was caught by the Washington Post misrepresenting the results of research on syringe exchange programs. According to the Post in its editorial, "Deadly Ignorance":
"An official who requested anonymity directed us to a number of researchers who have allegedly cast doubt on the pro-exchange consensus. One of them is Steffanie A. Strathdee of the University of California at San Diego; when we contacted her, she responded that her research "supports the expansion of needle exchange programs, not the opposite." Another researcher cited by the administration is Martin T. Schechter of the University of British Columbia; he wrote us that "Our research here in Vancouver has been repeatedly used to cast doubt on needle exchange programs. I believe this is a clear misinterpretation of the facts." Yet a third researcher cited by the administration is Julie Bruneau at the University of Montreal; she told us that "in the vast majority of cases needle exchange programs drive HIV incidence lower." We asked Dr. Bruneau whether she favored needle exchanges in countries such as Russia or Thailand. "Yes, sure," she responded."
The Post further noted:
"The Bush administration attempted to bolster its case by providing us with three scientific articles. One, which has yet to be published in a peer-reviewed journal, was produced by an author unknown to leading experts in this field who is affiliated with a group called the Children's AIDS Fund. This group is more renowned for its ties to the Bush administration than for its public health rigor: As the Post's David Brown has reported, it recently received an administration grant despite the fact that an expert panel had deemed its application "not suitable for funding." The two other articles supplied by the administration had been published in the American Journal of Public Health. Although each raised questions about the certainty with which needle-exchange advocates state their case, neither opposed such programs."

Source: "Deadly Ignorance," The Washington Post, Feb. 27, 2005, from the web at http://www.mapinc.org/newscsdp/v05/n327/a08.html, last accessed March 18, 2005.

Drug Czar Barry McCaffrey misinterpreted results of two Canadian needle exchange studies when he suggested in testimony to Congress that the studies showed needle exchange efforts have failed to reduce the spread of HIV and may have worsened the problem. In a clarification published in The New York Times, the authors of the studies corrected him, pointing out that among other factors, in Canada syringes can be purchased legally while they could only be purchased with prescriptions in the United States. Therefore, unlike in the USA studies, the populations in the Canadian studies were less likely to include the more affluent and better functioning addicts who could purchase their own needles and who were less likely to engage in the riskiest activities. Thus, it was not surprising that participants in the study had higher rates of HIV than those who did not - they were in different risk categories.

Source: Bruneau, J. & Schechter, M.T., "Opinion: The Politics of Needles and AIDS," The New York Times (April 9, 1998); Federal Information Systems Corporation Federal News Service, "Hearing of the National Security, International Affairs and Criminal Justice Subcommittee of the House Government Reform and Oversight Committee subject: Office of National Drug Control Policy chaired by: Representative Dennis Hastert (R-IL) Barry R. Mccaffrey, Director, Office of National Drug Control Policy." (March 26, 1998)

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Knock yourself out there WC.

[Wild Cobra]

Wow RG.... All that work. You need free needles or something?

I don't care how many studies you find. If I made the effort, I'm sure I can find studies that support my opinion.

Here is the bottom line for me. We should not take tax dollars to help people who make a choice to engage in dangerous activities. If you want to start a charity to do a free needle program, then have at it. But stay out of my wallet.

We have too many programs that rob the working class of their hard earned money. We have working people who do not live as well as people on the government take. That simply isn't right. I am against all government programs that give to people who can help themselves, except for short term help. The exception to this is those who cannot support themselves because of some disability.

All the social programs out there rob support to the people who legitimately need it!

Again, if you believe in such programs to help others, do it as a charity. Don't expect the government to do it. If you with to live as a socialist, then please move to a socialist country and leave this great nation alone.

[RandomGuy]

I don't care how many studies you find. If I made the effort, I'm sure I can find studies that support my opinion [that needle exchange programs don't decrease the rate of disease transmission among IV drug users].

No. You can't.

I call bull . Find a study. Any study.

I ing dare your dumb ass to find one single, solitary, scientific study from a peer-reviewed medical journal that backs up your bull .

s or GTFO.

[RandomGuy]

Wow RG.... All that work. You need free needles or something?

I don't care how many studies you find. If I made the effort, I'm sure I can find studies that support my opinion.

Here is the bottom line for me. We should not take tax dollars to help people who make a choice to engage in dangerous activities. If you want to start a charity to do a free needle program, then have at it. But stay out of my wallet.

We have too many programs that rob the working class of their hard earned money. We have working people who do not live as well as people on the government take. That simply isn't right. I am against all government programs that give to people who can help themselves, except for short term help. The exception to this is those who cannot support themselves because of some disability.

All the social programs out there rob support to the people who legitimately need it!

Again, if you believe in such programs to help others, do it as a charity. Don't expect the government to do it. If you with to live as a socialist, then please move to a socialist country and leave this great nation alone.

After Connecticut legalized OTC sales of syringes and the personal possession of syringes, syringe sharing by drug injectors decreased. Moreover, no evidence showed increased in drug use, drug-related arrests, or needlestick injuries to police officers."

I don't mind opinions and public policy based on data and reasonable assumptions.

BUT

What pisses me off to no end is morons like you who spew a bunch of feel-good rhetoric at the expense of solutions that provably work.

At least, when you say you are willing to watch fellow human beings die for lack of health insurance, you don't try to pretend you are a moral person. I have never seen anybody revel in outright evil though. Honest, but evil. Scary.

[Wild Cobra]

I don't mind opinions and public policy based on data and reasonable assumptions.

BUT

What pisses me off to no end is morons like you who spew a bunch of feel-good rhetoric at the expense of solutions that provably work.

Provable work? We have had a war on drugs for how long? Has it made any difference? Now this?

Why is it not a reasonable assumption that new users will be more easily attracted to shoot up if the fear of catching some disease is nearly eliminated? Why is it not reasonable to think someone might actually dry out if they cannot find a needle?

Why must we protect people from themselves in a free society?

Even if such a program works, which I doubt works beyond reducing transmission of diseases, I am not for robbing the public treasure to help someone destroy themselves.

QUOTE]After Connecticut legalized OTC sales of syringes and the personal possession of syringes, syringe sharing by drug injectors decreased. Moreover, no evidence showed increased in drug use, drug-related arrests, or needlestick injuries to police officers."[/QUOTE]

This is fine. Make it legal o sell them. Selling it OTC (over the counter) is not taking tax dollars. You will never convince me it reduces usage. Are you saying it violates the laws of supply and demand?

At least, when you say you are willing to watch fellow human beings die for lack of health insurance, you don't try to pretend you are a moral person. I have never seen anybody revel in outright evil though. Honest, but evil. Scary.

Is it moral to steal from others to help others? If you want to take the moral high ground here, then dammit. Do it with your money. Form a charity of like minded individuals. Not other tax payers money who want to maintain a limited government. I'm tired of ing socialists like yourself. I pick and choose causes for my money. Lord knows, I cannot help everyone. When my tax burden increases, that is less money I can contribute to charities and causes I agree with.

I don't care how many studies you find. If I made the effort, I'm sure I can find studies that support my opinion [that needle exchange programs don't decrease the rate of disease transmission among IV drug users].

No. You can't.

I call bull . Find a study. Any study.

You're the ing liar. I never said it doesn't reduce the rate of transmission. I said it entices more users. I agree it reduced infection rates. Where did I say otherwise?

off if your going to put words in my mouth. I responded to "increase in overall IV drug use"

Are you an idiot or a liar? People only seeing your response to me with misquoted words see something not true. That was my concern on the thread with ozone. You are guilty of what I said the article was. Apparently it is a normal way of life, lying that way, that you don't see the blatant propaganda within that article.

New Name = RandomPropagandist!

I ing dare your dumb ass to find one single, solitary, scientific study from a peer-reviewed medical journal that backs up your bull .

s or GTFO.

Are you telling me I wont find any worth while story supporting that something free doesn't encourage it to expand?

Are you really that dumb?

Again. I'm not wasting my time. I have a life outside this internet. Apparently you don't.

[jochhejaam]

In 2002 Surgeon General David Satcher issued a report to Congress that concluded:

“After reviewing all of the research to date, the senior scientists of the Department and I have unanimously agreed that there is conclusive scientific evidence that syringe exchange programs . . . are an effective public health intervention that reduces the transmission of HIV and does not encourage the use of illegal drugs.”


Additional organizations that support needle-exchange programs as effective tools for protecting the public health of communities include:

American Academy of Pediatrics
American Bar Association
American Foundation for AIDS Research
American Medical Association
American Public Health Association
Association of State and Territorial Health Officials
National Alliance of State and Territorial AIDS Directors
New York Academy of Medicine

http://eliminateaids.blogspot.com/20...on-needle.html

[ChumpDumper]

I said it entices more users.

Prove it.



Should be really easy given all programs, including the one in your county. Give them a call.

As for your overly simplistic tax rant -- if needle programs cut down on the HIV and other infections, that will save money for the federal government and health care providers and insurers and premium payers.

That's a good thing.

[RandomGuy]

Are you telling me I wont find any worth while story supporting that something free doesn't encourage it to expand?

Repeat after me:

Needles are not drugs

needles are not drugs

needles are not drugs


Giving needles to people will not cause them to use more illegal drugs.

If your theory was correct, then increasing the supply of needles would cause more illegal drug use.

Connecticut increased the supply of available needles by allowing them to be legally sold over the counter, and experienced no increase in narcotics usage.

THEREFORE:

It can be logically concluded that the supply/demand curves for illegal drugs are not dependant on the supply/demand curves for needles.

[RandomGuy]

As for your overly simplistic tax rant -- if needle programs cut down on the HIV and other infections, that will save money for the federal government and health care providers and insurers and premium payers.

That's a good thing.

(sighs)

But it wouldn't make him feel smug and superior, which is rather obviously a more important metric than say, data and causality.

People like him rail against social services to poor kids in order to save $10000 per year for 5 years, and then throw money hand over fist at $50,000 a year for 50+ years on trials and prisons for those kids after they reach adulthood.

Myopic and sad.

[RandomGuy]

You're the ing liar. I never said it doesn't reduce the rate of transmission. I said it entices more users. I agree it reduced infection rates. Where did I say otherwise?

Can you explain how free needles vs. hard to acquire ones would decrease the number of cases?

I would suggest that the lower rates are not factual. AIDS is spread easily by only a limited number of means. I think it can be assumed with confidence that if people are both gay and intravenous drug users, and drugs being found in blood tests, that they would claim the needle is how they got AIDS rather than admitting they were gay!When you have needle programs, they can no longer make such a claim now, can they? At least not by the same numbers...

To be fair, you were responding to a quesiton about overall drug usage.

For whatever reason you then went off and talk about "cases" which normally is linked to "AIDS cases". This is implicit when you start trying to bull your way through data you don't like in the second paragraph.

Maybe I am wrong about what you really meant. If so: I take it all back. Well, except for the part where I said you were evil for wishing people without health insurance dead. That part was pretty unambiguously evil.

[RandomGuy]

Again. I'm not wasting my time. I have a life outside this internet. Apparently you don't.

Translation:

"I don't like it when someone smarter than I am spanks my proverbial pee-pee, and being smarter than most other people is important to me. So, I will simply try to negate/reduce that loss to my ego by implying that getting spanked in that manner isn't really that important."

Meh. Whatever. Just stop pretending your opinions are based on anything other than making you feel better about yourself at the expense of others.

[Wild Cobra]

RG, I'll tell you what. Let's say the needle program works without increasing the number of drug users. Still, what gets me about all this is more tax dollars being spent. I go back to if this is something youi support, do it with your own money. To use county, state, or federal money is flat out wrong. There are other issues that need money to, and more deserving. Where do we stop before we tax this society into oblivion?