Evaluating needle exchange

By Tom Nordlie • Published: July 15th, 2010
Category: Health in a Heartbeat

People who use illicit, injectable drugs are at high risk of contracting blood-borne viruses.

These include H-I-V and hepatitis C, both potentially fatal.

Transmission can happen when users share syringes, needles and other drug paraphernalia.

No doubt, this is a public health problem.

But one of the proposed solutions is controversial.

That’s the practice of providing users with new, clean paraphernalia.

Supporters believe it reduces disease transmission.

Others warn the practice encourages continued drug use.

According to a review in the journal Addiction, needle exchange programs do help cut H-I-V infection rates.

Depending on the situation, users obtained paraphernalia from pharmacies, vending machines or outreach workers.

Some programs dealt only with needles and syringes. Others included equipment used to prepare drug solutions for injection.

Researchers said there wasn’t enough evidence to conclude any of these interventions reduced the spread of hepatitis C.

However, needle and syringe exchange programs reduced the rate of H-I-V infections.

These programs also cut self-reported risky behavior by drug users, such as sharing needles.

Which brings up a limitation of these studies: They rely heavily on anecdotal evidence.

Unquestionably, it’s important to gauge how well these programs work. Drug users who end up sick because of unsanitary needles likely receive treatment at taxpayer expense, making it an important issue for policymakers and health-care providers.

Needle-exchange programs may be effective. But additional research is needed to more precisely determine how much they are truly helping.