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The needle exchange: A single type of prevention or intervention strategy with regards to substance misuse

Title: A individual type of bar or intercession scheme with respects to substance abuse. The needle exchange

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The UK presently has an equivocal and sometimes conflicting set of policies with respects to some issues environing drug usage. In the words of Rice, the UK has:

an uneasy consensus of conflicting forces, sentiments and places that have shaped the whole legislative model and environing issues that govern the manner that we, as a society, trade non merely with controlled drugs, but the jobs that they cause straight and that are associated with their usage. ( Rice et al 1991 )

If one considers the assorted ways in which this “consensus” has evolved over the last few decennaries, one could propose that there is a clear duality between those who feel that the manner forward is through double mechanisms of enforcement and prohibition ( sometimes referred to as the illegalisation motion ) , and those who believe that systems using statute law, injury decrease, authorization and instruction comprise the rational manner frontward. Both parties appear to believe that their mechanism is the lone manner to protect society. ( Holmberg SD 2006 )

Holmberg’s position is further strengthened with an scrutiny of recent events. The illegalisation motion has been demonstrated to be mostly uneffective in states where it has been employed on a big graduated table ( viz. USA ) ( NSDU 2004 ) . The injury decrease motion, considered by some to hold a defeatist philosophy, accepts that drug usage will still happen despite the infliction of the most Draconian steps and hence purposes to cut down the possible degrees of harm associated with drug usage. ( Reinaman & A ; Levine 2004 )

To summarize the push of Fordham’s work, it is frequently the instance that when there is multi-agency engagement in determination devising and authorities by commission, we arrive at a corporate consensus of changing sentiments that get amalgamated into some signifier of legislative model that allows both the opposing cabals to every bit claim both triumph and besides to indicate to lacks in the strategy where they can pull off to renounce duty when it does non work efficaciously. ( Fordham, F et Al. 2007 )

If one considers the specific construct of the needle exchange, so this can be assessed on a assortment of degrees of differing complexness. At the most simplistic degree, it is a mechanism of injury decrease. Bulmenthal paperss the fact that IV drug maltreaters can travel to extraordinary lengths to go on their wont if their equipment is confiscated thereby exposing themselves to illness transmittal hazards by sharing acerate leafs. ( Bluthenthal R N et Al. 2005 ) . The Des Jarlais paper seting frontward the premiss that if they are traveling to prevail in shooting so it should be in the safest mode possible. ( Des Jarlais et Al 1995 )

On a more complex degree there are some that suggest that supplying a needle exchange additions IV drug usage. Such positions are non based on available grounds. The Aggleton paper showing clearly that syringe exchange Centres, with entree to clean and unfertile equipment, neither increases the incidence of drug usage, nor does it increase the frequence of injection of confirmed users ( such factors are provably far more dependent on the local handiness of the drugs ( CDCP 2002 ) ) . More significantly, neither do they increase the figure of new converts to drug injection ( UNAIDS 2003 )

( Aggleton. P 2000 )

Arguably a more of import consideration of a needle exchange is the possible benefit for betterment in the general wellness of the user ( and some would reason in the Public Health ) . The Gostin survey shows that use of a needle exchange implies contact between user and health care services who have the ability to put the user in contact with those services best suited to cut down high hazard activities. ( Gostin et al. 1997 ) . This is besides relevant in consideration of the fact that the bulk of drug maltreaters have at least one associated pathology ( viz. mental unwellness, physical unwellness or other societal pathologies ) . Because they will typically be a extremely nomadic and itinerant population, these persons are easy lost to any type of organized health care follow up or intercession. The needle exchange can move as an chance to step in to seek to help the user trade with their jobs. The simple proviso of acerate leafs represents a lost chance in this regard.

There are two other of import elements associating to the needle exchange. By protecting an addict signifier HIV/AIDS 1 is besides protecting their sexual spouses from exposure. The 2nd ( frequently cited ) component is one of cost. Needle exchanges are relatively inexpensive to run and this must be compared to the societal and fiscal costs of non running them. Aggleton concluded that each syringe exchanged cost 18p. This equates to ?13 per instance of HIV/AIDS prevented. Compared to a life-time of health care costs for a individual HIV/AIDS instance, the nest eggs to society are incalculable. ( Aggleton P 2000 )


Aggleton. P. ( 2000 ) UNAIDS, Report on the Global HIV/AIDS epidemic, June 2000 ; quoted in “ Success in HIV Prevention ” , . UNAIDS Best Practice Collection. Geneva, UNAIDS. 2000

Bluthenthal RN, Kral AH, Erringer EA, et Al. 2005

Drug gears Torahs and injection-related infective disease hazard among drug injectors.

Journal of Drug Issues. 2005 Vol.6

CDCP ( 2002 ) Centers for Disease Control and Prevention: HIV/AIDS Surveillance study 2002: 14

Des Jarlais DC, Hagan H, Friedman SR, et Al. ( 1995 ) Maintain-ing low HIV seroprevalence in populations of shooting drug users. Journal of the American Medical Association. 1995 ; 274: 1226 – 1231.

Fordham, F Jones L, Sumnall, H McVeigh J Bellis M ( 2007 ) The economic sciences of forestalling drug usage An debut to the issues National collaborating Centre for drug Prevention for the National Institute of Health and Clinical Excellence HMSO: London 2007

Gostin L O, Lazzarini Z, Jones T S, et Al. ( 1997 ) Prevention of HIV/AIDS and other blood-borne diseases among injection drug users: a national study on the ordinance of panpipes and acerate leafs. Journal of the American Medical Association. 1997 ; 277: 53 – 62.

Holmberg SD. ( 2006 ) The estimated prevalence and incidence of HIV in 96 big US metropolitan countries. American Journal of Public Health. 2006 ; 86: 642 – 654.

NSDU ( 2004 ) National Survey on Drug Use and Health: 2003 Substance Abuse and Mental Health Service Administration. HMSO: Sept 2004:

Reinarman, C. , Levine H G. ( 2004 ) “ Crack in the Rearview Mirror: Deconstructing Drug War Mythology. ” Social Justice 31 ( 2 ) : 182 – 199

Rice D P, Kelman S, Miller L S. ( 1991 ) Estimates of economic costs of intoxicant and drug maltreatment and mental unwellness, 1985 and 1988. Public Health Reports. 1991 ; 106: 280 – 92.

UNAIDS ( 2003 ) Fact sheet ‘High-income countries’ . WHO Publication 2003

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5.12.2008 Word count 1,113 PDG

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