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Drug Addiction in Canada -- Needle Exchange Program to Reduce Infection
Drug addiction in Canada -- Needle exchange program to reduce HIV infection
According to the WHO, some of the main harm reduction initiatives in the prevention of HIV infections for individuals with substance abuse problems are syringe and needle programs. Over the last two decades, more and more studies have revealed new and better ways of delivering needle and syringe programs. For instance, needle exchange initiatives are executed with the aim of providing drug users with clean syringes and needle for drug injection. Medical experts have warned that hypodermic needles can carry up to twenty blood diseases such as HIV and Hepatitis B and C. One of the biggest issues with injecting is that it can result in blood-to-blood contact between persons sharing the same needles. Such contact increases the likelihood of acquiring or transmitting HIV and other blood-borne infections. Another probable issue is that any contaminant in the equipment can lead to vein or skin infections (Strike & Watson, 2014).This fact is highlighted, by the statistic that almost 50% of Canada's new HIV infections were drug users (CBC, 2004). Florida homes at least 90,000 IDUs, of which 19% afflicted with HIV and more than 23,000 with Hepatitis-C. The health costs expenses for HIV is at least $600,000and for Hep-C, a minimum of $300,000 in a lifetime. It is an understood fact that Street addicts lack a health insurance (Schackman et al., 2006). Furthermore, it has been found that drug users inject themselves up to a thousand times per year exposing themselves to such diseases. This clearly shows that there is a problem and that programs in this particular area of prevention will go a long way in helping reduce infection rates (CBC, 2004).
The country's first needle exchange initiative started in 1989. Since then, many more organizations have been formed to run needle exchange programs in the country. As of 2004, Ontario has the largest network of needle exchange programs (CBC, 2004).
A needle distribution program is an HIV and Hepatitis B prevention intervention used in many cities around the globe. One of the main ways through which HIV spreads is through the sharing of needles by drug users. Needle exchange programs provide new and clean needles to reduce the likelihood of drug users sharing needles and syringes when injecting themselves. Such programs have proved highly effective in reducing HIV infection rates among drug users. Studies have shown that offering clean needles and syringes to injection drug users significantly reduces the number of infections due to shared equipment. While needle exchange programs do not eliminate the sharing of needle completely, or other risk behaviors, they still play an important role in the reduction of HIV infection and the spread of other blood-borne infections among drug users (UHRI, n.d.). This paper analyses policy concerns for implementing NEP amongst the Injecting Drug Users (IDUs).
The connection between drug use and crime is unpredictable and exceedingly politicized. In spite of the fact that the way of the causes and the bearing of causality are not known, it is consistent with overwhelming substantiation that substance use is connected with a criminal way of life, which incorporates such attributes as aimlessness, self-assimilation and a powerlessness to identify with other individuals. As an aftereffect, it is a noteworthy reason for sympathy toward governments who are attempting to keep their residents safe (Riley, 1998).
Indeed, in many countries and states in the U.S., legislations prohibit people from carrying sterile needles. Therefore, enforcement authorities are empowered to identify and detain needle exchange consumers, which would act as a deterrent to the Needle exchange program. As such, some means of balance and consideration between the two conflicting positions needs contemplation if NEP are to succeed. Sills substantiates it in his study, stating that NEP and anti-drug policies are in direct opposition (Sills, 1994, p.149).
According to Peter Selwyn, researchers around the world agree that NEP programs are effective in helping reduce incidents of HIV and Hepatitis C. In the U.S. the policy makers and sociologists, however require very high standards of scientific authentication before adopting such programs for clinical interventions or preventative measures. The tendency in the U.S. is to view drug abuse as more of a legal issue than a social health concern. The outcome is that resulting social dynamics evoke a response of legal sanctions and punitive discretion instead of corrective and preventive actions (Selwyn, 1994).
However, in the Canadian context, there has been a much-improved treatment to the issue of prevention of spread of HIV and Hepatitis induced through drug abuse. Canadian approaches identified with psychoactive substances have increased following the sanctioning in 1908 of the Opium Act precluding the non-restorative utilization of sedatives. Endeavors to avert, treat, and control substance utilize and mishandle are currently coordinated at an assortment of illicit and licit substances including cannabis, cocaine, heroin, methamphetamines, rapture, tobacco, liquor, inhalants, and solution and over-the-counter drugs. Canada's Drug Strategy (CDS) is a key activity composed by the Federal government which addresses the harmful socio-economic impacts (well-being, social, security and financial) of substance abuse on people, families, and groups. The CDS comprises of divergent institutions, including elected offices, common and regional governments, non-legislative associations, proficient affiliations, and global organizations (Collin, 2006).
Why it is a policy concern
Infusion drug use has been a known danger for procurement of HIV and Hepatitis B and C for over two decades now. Therefore, needle trade programs have been created worldwide with an end goal to decline transmission rates. The concern for policy makers, in addition to the Socio-economic and legal angles and predisposition is that of financial support, too. The issue of provision of funds for such programs requires federal support as local, provincial governments may not be able to sustain the costs involved. However, there has been a lack of federal funding by way of subsidizing the costs for sterilized needles for NEPs on grounds of ethical and moral concerns as well as the state of economy. Thus, such programs had to depend largely on private, individual donations and large organizations (for example, in Lancaster). With growing academic, scientific, and political shifts in the matter of social health, the congress has decided to avail federal funds to such preventive programs. In addition, as economy stabilizes federal funds may be available. Convinced of the viability, Congress as of late lifted the prohibition on government subsidizing (O'Gurek & Kirchner, 2010).
Factors important to a provincial government
HIV prevalence rates vary significantly among injection drug users, ranging from as low as 3% in Regina to as high as 24% in Edmonton. The national prevalence rate (overall average) among injection drug users is 13% (Public Health Agency of Canada, 2006). According to a 2011 Canada public health study, approximately 16% of all new HIV infections occur among injection drug users (Public Health Agency of Canada, 2012). This study also includes 435 new HIV infections attributed to drug use, 80 which are attributed to either drug use or MSM (men having sex with men); for participants who reported engaging in both risk behaviors prior to the study. Among women, up to 23% of new infections are attributed to injection drug use.
The provincial government should be able to substantiate its endeavor and need for NEP for federal funds by demonstrating the positive effects of the program. It can document changes in injecting behaviors cross-sectionally or by studying IDU cohorts over extended periods, thus establishing a baseline HIV and Hepatitis B prevalence. Based on this data, the improvements accrued by NEP may be used to authenticate the validity of the measure. Given the inclination in the U.S. on scientific rigor and result-oriented studies and programs, such deliberation and excescize may prove useful continued support from the federal government (Hankins & Gendron, 1994).
To ensure that needle distribution programs succeed it is important for the following measures need consideration;
Provision of a variety of syringe and needle types (with regards to brand, size and gauge) and educate clients about their proper use;
Offer prepackaged safer injection kits complete with syringes/needles, alcohol swabs, sterile water for injection, filters, cookers and ascorbic acid when required, lubricants and condom.
Make it easier for injection drug users to access the new needles and injection kits.
Increase funding to methadone programs to reduce the likelihood of heroin users to revert to street drugs.
Encourage rehabilitation by allowing heroin users more chances to return to treatment programs if they stray; currently programs do not accept individuals back even after a single slip.
Decriminalizing drug use and starting to treat it as a public health issue; this will help more individuals to feel comfortable to come forth for help.
Cities ought to draft and adopt comprehensive anti-drug use initiatives similar to the one commissioned by Vancouver in 2000, which recommended a 4-pronged approach to fighting drug use that included: prevention; harm reduction; enforcement and treatment. This initiative led to the opening of the city's first… [END OF PREVIEW]
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