Needle exchange programs reduce HIV infections dramatically

Hi all, I’m still thinking through issues about the legal position on drugs. Should Australia decriminalise heroin or not? But maybe that’s not the main issue of the day. It seems that discussion about the legal status of drugs sometimes overwhelms discussion about how to help drug users. We can have harm minimisation schemes running along side those same drugs remaining banned. We’ve managed to do so here in Australia: heroin use remains illegal while we still manage to hand out safe, clean needles to those suffering from drug addiction. As the Australian Drug Foundation says:

Illegal drugsThe following drugs are some of the drugs that are illegal in Australia. Federal and state laws provide penalties for possessing, using, making or selling them, or driving under their influence.

  • cannabis, including some synthetic cannabinoids
  • cocaine
  • ecstasy (MDMA)
  • GHB (gamma hydroxybutyrate)
  • heroin
  • LSD (lysergic acid diethylamide)
  • PCP (phencyclidine).

There are also laws that prevent the sale and possession of bongs and other smoking equipment in some states and territories. (For example, Victoria has passed new legislation that will ban the sale of cannabis water pipes (bongs) from January 2012.)

But, as I learned in my Social Sciences Advanced Diploma, harm minimisation programs like needle exchanges and safe drug injecting rooms have a demonstrable, measurable, positive result on public health. Needle exchanges reduce the spread of HIV and safe lives. As Shereen El-Feki showed at this TED talk, HIV has spread like wildfire amongst drug users in countries without needle exchange programs. But Fred Nile confuses needle exchange programs with a soft attitude towards drugs. Maybe he is right, and we should not decriminalise heroin. I am yet to be convinced one way or the other. However, if we accept the statistics above, he is wrong to conflate needle exchanges with a soft attitude to drugs. Rather, it shows a commitment to our war on the spread of HIV! In June 2012 Fred stated:

“I note also that the Sydney Morning Herald has launched a campaign of so-called drug reform seeking to change public opinion strongly opposed to any watering down of laws regarding illegal drugs and supporting continuation of our current war against drugs. Some critics such as Australia21 and the Sydney Morning Herald suggest this war against drugs has not succeeded. They do not acknowledge that the war against drugs is continually sabotaged. The whole campaign of harm minimisation undermines the campaign against illegal drugs. The needle exchange program and the drug injecting room in Kings Cross undermine the war against drugs.

I don’t understand: how does saving the lives of drug users undermine our ‘war against drugs’? FACT: Needle exchanges prevent HIV infection, and drug injecting rooms prevent death by accidental overdose. Police may turn a blind eye to users attending both needle exchanges and drug rooms, while still banning drug use in the wider community. Sure there might be a few grey areas approaching exchanges and injecting rooms. This calls for careful evaluation of policing policy. It does not require either the wholesale adoption of heroin into our society, nor does it demand that we close all injecting rooms and needle exchanges.

I am still to be convinced whether decriminalising heroin itself is a good thing. I need more statistics. Can private heroin use be decriminalised while trading in the stuff remains an offence? What benefits would that bring for users seeking treatment and admitting to their health problem in the first place? Or would there be a large uptake in heroin use with consequences for the health budget in years to come? After all, one statistic I remember all too clearly is that it is the legal drugs like alcohol and tobacco that cost our health budget overwhelmingly more than the illegal drugs. But what is the cost to society in policing to keep those illegal drugs down? Is there a better legal and/or policing strategy? I’m thinking out loud here. But the one thing I remain committed to is needle exchange programs and harm minimisation programs. Fred Nile is, in my opinion, just plain wrong to confuse the two.

PS: I never knew heroin was also known as ‘harry’. That’s a bit unfortunate, given it is my son’s name! Some other names:

Heroin is also known as “smack”, “skag”, “dope”, “H”, “junk”, “hammer”, “slow”, “gear”, “harry”, “big harry”, “horse”, “black tar”, “china white”, “Chinese H”, “white dynamite”, “dragon”, “elephant”, “homebake” or “poison”.

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3 Responses to Needle exchange programs reduce HIV infections dramatically

  1. onesalientoversight says:

    As far as I understand, one idea behind the legalisation of such drugs as heroin and cocaine is that addicts go to their doctors and get a prescription, and then go to the chemist to get the drugs. The drug in question could even be available in pill form, giving the addicts their needed drugs without resorting to injection. The heroin addicts could take their pills before bedtime and the coke addicts could take their pills in the morning.

    What such a policy would do is essentially prevent about 99% of the hard drug trade in Australia. Criminal gangs are only interested in selling illegal drugs because they make a profit out of it. By making the drugs available through a chemist, criminal gangs would have their costs undercut dramatically, forcing them to do something else illegal or even something legal in order to gain money.

    AFAIK, drug users have their own network, which is how new addicts enter the loop. This network provides comfort, information and socialisation for illegal drug users. Allowing prescription hard drugs breaks the need for this network which, in turn, will prevent new people from becoming addicts.

    Furthermore, the drugs themselves would be pure, as they would be manufactured by pharmaceutical companies operating under careful government regulation. The practice of “cutting” hard drugs with agents like chalk or talcum powder would disappear.

    Of course legal heroin and cocaine will not solve all the problems of drug abuse, and there will always be a demand for illegal drugs such as these, even with a legal framework (eg: there are illegal tobacco and alcohol products available currently despite current regulation, and there is certainly a black market for prescription drugs out there that people exploit). In the end, however, I think the positives outweigh the negatives.

  2. Eclipse Now says:

    Hi OSO,
    some very interesting thoughts there: things I should have known or felt deep in my guts from experience in welfare. It seems I’m a bit rusty! Your paragraph about the socialisation of drug use rings true. The D&A component of my course looked at how drug culture radically affects drug use and addiction behaviours. We looked at everything from drug cultures in tea and coffee drinking, through to alcoholism being largely prevented in children who are raised in families and cultures that drink moderately. The surprise was it seems more successful that way than with complete teetotallers.

    It’s similar with heroine use. I remember one D&A counsellor saying some people hate heroin on their first hit, and just remember throwing up in a bad reaction to it rather than some sort of instant bliss. But addiction can still kick in if this is encouraged as some sort of ‘rite of passage’. Young people are looking for acceptance. If that is in the rebellious, hard-corps drug crowd you describe, then they might be willing to go through a rough initiation and then eventually developing dependency over time.

    Are you aware of any studies overseas with the results of other legislative frameworks?
    Cheers, and thanks for your comments!

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