Condoning programs like needle exchanges sends a terrible message that treatment, interdiction and prevention do not work. A needle exchange demonstrates an acceptance of a criminal and deadly habit. It also signals that we will spend money to help sustain drug addiction, but not provide the life-saving drug treatment needed to turn lives around. Giving away sterile syringes — without compelling the addict into treatment — is the path of least resistance that does nothing to remedy the ravages of drug addiction.
No society that cares about its people should be providing the instruments with which to inject poison. Every dollar spent on syringes could be better spent on providing treatment. Keeping drug users free of AIDS is a noble, but narrow goal. The best hope of keeping them alive is to get them off drugs and into treatment. I am especially grateful to Katherine Wells, who provided substantial data work and excellent research assistance.
I am also grateful to Lisa Roberts for providing data and for many useful conversations about the interworkings of the Portsmouth syringe exchange program. The views expressed herein are those of the author and do not necessarily reflect the views of the National Bureau of Economic Research.
Download Citation Data. Share Twitter LinkedIn Email. These incidences have a negative effect on communities, often decreasing property values, harming local businesses, and discouraging growth of the community. Many believe that those who choose to abuse drugs must take full responsibility for the associated risks. Although NEPs offer screenings and treatment, actual referrals and follow ups appear low, so the thought is that clients are scared off by the additional services offered.
Many NEPs have also been introduced without the support of their community. But, in communities that have already been damaged by drug use and crime, how much harm could an NEP really do?
That too is in flux. In jurisdictions across the country, officials are choosing the former. During the conversations in West Virginia, Pollini said, legislators conflated drug use with syringe programs. In reality, syringe programs are a reaction to injection drug use, not the other way around. Even Scott County, the poster child for using syringe services to halt its infamous outbreak, voted to end the needle exchange this year on the grounds that it enables drug use.
When Cooke, who was brought up in an Evangelical church, first began treating patients who used drugs in Scott County, his instinct was "put up my hand, say no and basically kick people out of my practice," he said. In the beginning, he did. But over time, his outlook changed. He got to know patients as people and not just strangers who used drugs. He witnessed them die from preventable disease and lack of access to routine medical care. He saw patients take measures of control over their health by using sterile needles instead of sharing them and by getting treatment for HIV.
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