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How a Needle Exchange Program Makes an ImpactEssay

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¶ … exchange programs are essential in the limiting of the spread of disease among intravenous drug users. The sharing of needles accounts for a significant percentage of how diseases like HIV / AIDS are spread, and by providing drug users with the ability to exchange their needles for new ones rather than share them, needle exchange programs instill a healthy and positive habit of responsibility that can allow drug users to embark a course towards ultimate sobriety. The main and direct impact of needle exchange programs, however, is their ability to mitigate the risk of blood diseases being spread by providing drug users with access to clean needles. These programs have a high success rate (measured by the rate of return) among drug users; this indicates that they are effective in mitigating risk. This paper discusses the various reasons for why needle exchange programs are a positive and beneficial addition to society and how they help drug users, contrary to the opinion of some who view such programs negatively and skeptically.

Why Needle Exchange Programs are Beneficial

Needle exchange programs (NEPs) are effective ways to mitigate risk associated with intravenous drug usage, such as the transmittance of blood diseases (HIV for instance as well as Hepatitis B and C) from one needle user to another (State of Rhode Island Department of Health, 2015). As the Centers for Disease Control and Prevention (CDC) notes, needle sharing is responsible for 1/4th of all AIDS cases in the U.S. (ACLU, 2016). With just shy of 1 million persons living in the U.S. with HIV / AIDS, a reduction in the number of syringes that are passed among drug users could potentially reduce the number of infection by 250,000. A quarter of a million lives could be potentially saved by simply making needle exchange programs available to drug users. Critics suggest that such programs only serve to reinforce drug usage and do nothing to mitigate the risk (Ajayi, 2003, p. 168). However, the assumption that underlies this criticism is that NEPs are facilitators of a deadly habit rather than facilitators of a strategy of prevention. But as Ksobiech (2004) observes, NEPs actually have a worldwide return rate of 90% (comparable in the U.S.) -- a figure which indicates that 9 out of 10 intravenous drug users who make use of NEPs are returning in a responsible way to exchange out their used syringes for new ones. In other words, the program has a 90% success rate in preventing the sharing of needles and, by extension, the spreading of diseases like HIV / AIDS. This paper will show, therefore, why NEPs are good for society, as they help to mitigate the risk of the spread of infection among intravenous drug users.

To better understand why NEPs are helpful (and why they are not responsible for enabling drug users), it is advantageous to understand the psychology of drug addiction and how a habit is formed and broken. Intravenous drug usage is not and never has been dependent upon needle sharing programs for the availability of syringes. Drug users are able to obtain needles from the environment in which their drug habit is conducted. NEPs did not originate in that culture but offer a way for individuals within that culture to act more responsibly. Moreover, the habit of acting responsibly can act as a lever upon which the drug user can move towards quitting the habit entirely.

Drug use has been shown by researchers to have a biological foundation (Kalivas, Volkow, 2014). Based on their studies, Kalivas and Volkow (2014) argue that "cellular adaptations in prefrontal glutamatergic innervations of the accumbens promote the compulsive character" of drug usage (p. 1403). The stimulating nature of the prefrontal innervations is what drives the drug user towards cultivating the habit. There is no evidence within scholarly research that indicates that it is the availability of syringes that directly leads to the spread of drug usage.

Another criticism of NEPs is that they simply do not work -- that they only make needles more available to intravenous drug users and that the users do not return them later (so as to keep the needles off the streets and from being used again and shared). However, the study by Ksobiech (2004) refutes this notion and provides evidence that NEPs are actually highly successful in deterring needle sharing. Needle exchange programs have thus been shown to be a non-factor in the development of drug use habits and a positive factor in the mitigation of risk associated with the spread of disease via needle sharing.

NEPs can also help drug users overcome their drug habit. By existing within a social context of safety and responsibility, NEPs can provide a path forward for intravenous drug users to grow and reach new stages of positive development with the end goal being to overcome their drug dependency. As drug use has been identified as having roots in "adolescence and young adulthood" when experimentation is more likely to occur, the habit of acting responsibly about drug use can be perceived as a first step towards identifying the attendant risks associated with drug use and taking the necessary steps to mitigate those risks (Chambers, Taylor, Potenza, 2014, p. 1041). The spread of disease is one risk, but another is the destruction that is caused to the body as a result of prolonged drug use. A drug user who takes the steps of acting responsibly by going to NEPs for needles is an individual who is one step closer to attending to the other risks that drug use poses. NEPs, therefore, can act as extensions or mediators between drug users and drug rehab programs by serving as a stepping stone in the process of total rehabilitation (Jurgens, 2002).

Thus, NEPs do more than help prevent the spread of disease. They also help users to cultivate a habit that is more positive and healthful than the drug habit under which they currently labor. By promoting positive thinking and positive habits, NEPs are effective in paving the way, from a cognitive behavioral theory standpoint, towards an acceptable target behavior that is beneficial in the long-run for the drug user. Cognitive behavioral therapy is a method whereby an interventionist helps the individual to identify positive traits, behaviors, habits and goals that the individual should focus on achieving in his or her life. In this respect, NEPs act as an intervention strategy that can facilitate the association between healthy living and the drug user's mindful habits.

NEPs are also typically set up in areas where healthy doctrine is actively promoted via available literature that is free for reading and/or disseminating and via workers and volunteers, nurses and clinicians, who understand the psychology of drug use and know how to help drug users stay positive and not lose hope in the face of the crushing despair that can sometimes be associated with long-term drug use, especially in users who have attempted to quit before and not had any success. A positive atmosphere that an NEP can offer is something that a drug user could use in his or her life to help the user from becoming depressed, losing hope, or slinking off to less desirables surroundings where risky behavior may be practiced.

NEPs are also an expression of the kind of social advocacy that progressive societies and charitable organizations support -- it is an outreach effort that aims at helping handicapped and oppressed individuals to come to a better place in life. Thus, while the immediate aim of an NEP is to help stop the spread of disease among drug users, the fact that the NEP exists at all is an example and sign of a community spirit that projects an image of love and concern for all persons. It is a truly transcendent idea that can encourage persons (not just drug users) to act more responsibly in their lives and to take some small part in trying to help others. The positivity that comes out of the implementation of an NEP is such that it can transform the way that communities think about and view themselves.

Critics might suggest that NEPs just attract drug users and that such people are not welcome in any community -- but this is a sad commentary on the critics themselves; drug users are in every community. They are not just in rundown urban communities; they are especially in the suburban communities on the outskirts of the rural rundown communities. Drugs like heroin have become extremely popular in American suburbs even since the American invasion of Afghanistan which serves as the source of the poppy fields where heroin originates. This drug has found a willing and participating audience in American youth of every class, culture, race, gender and ethnicity. It is inaccurate and prejudicial to imagine that all intravenous drug users are poor, homeless, uneducated and unethical individuals who do not need help or assistance at all. The fact is that many intravenous drug users are cousins, brothers,… [END OF PREVIEW]

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