Needle exchange programs have been cited by health advocates as a necessary way to curb the spread of HIV and other pathogens. They argue that stigmas surrounding the programs are unfair and compel people to take unrealistic positions about combatting some of the problems associated with the opioid epidemic.
Caitlin Mahon, a spokeswoman for AVERT, an advocacy organization dedicated to curbing the transmission of AIDS, said needle exchange programs minimize the likelihood of getting HIV and Hepatitis, among other diseases.
“When a clean needle and works is used for every new injection, and needles are not shared, then the risk of infection HIV, Hepatitis and other blood-borne illnesses is zero,” Mahon said. “However, the drivers of drug use are complicated and often linked to poor mental wellbeing and a lack of social safety nets.
“Providing clean needles isn’t about ‘encouraging’ or ‘condoning’ drug use; it’s simply an effective and proven way to reduce the spread of HIV and hepatitis among people who use drugs and their networks.”
Needle exchange programs are a point of controversy for state and federal lawmakers because while some see it as a method to reduce the spread of diseases, others see them as encouragement to continue using heroin.
AVERT recommends needle programs dispensing 200 sterile needles per person, per year in every country. In the United States, the most recent estimates from 2010 found that only 23 syringes were distributed per person who injects drugs per year.
The opioid crisis is one of the top priorities for Pennsylvania Gov. Tom Wolf's administration, according to his spokesman J.J. Abbott. Wolf provided funding to implement 45 treatment centers throughout the state and expanded access to treatment for nearly 75,000 people. Currently, he is looking into the matter of needle exchange programs.
“The State’s Controlled Substance, Drugs, Device, and Cosmetics act prohibits carrying syringes intended for the use of drugs, however, the administration is currently exploring legislative and or regulatory changes to enable communities to implement syringe service programs, similar to programs in Philadelphia and Pittsburgh, which can help reduce the spread of disease,” Abbott said.
State Rep. Bryan Barbin, a Democrat representing parts of both Somerset and Cambria counties, said he has mixed thoughts on needle exchange programs. He said the drug abuse plaguing the region has multiple aspects to it, each posing different challenges.
“How do we spend money to reduce drug use? That's the biggest thing. If a person gets addicted, there is another cost too. You can use needles and you can get AIDS,” Barbin said. “We have to look at it because addiction causes large healthcare expenses. It's one of the parts, but it's not the primary part. The primary thing we should look at is which of the therapies are making the problem worse and which are making them better.
But the issue is larger than the preventing the transmission of disease. People need to get help so that they're not using any needles to shoot up heroin.
“That is done with detox and things like long-term blockers,” Barbin said. “We have to get them off of the drug. Because if we let them stay on the drug, we'll continue to have problems even with clean needles.”
On the federal level, local congressman Bill Shuster, R-Hollidaysburg, opposes using taxpayer money for needle exchange programs, though he supports funding for counseling and treatment.
“Instead of focusing federal funding on needle exchange programs, Congressman Shuster believes the focus should be on how we stop this crisis in our region and across the country for good,” his spokesman Casey Contres said.
Kate Rosario, spokeswoman for U.S. Rep. Keith Rothfus, R-Sewickley, said he also supports treatment options.
“Congressman Rothfus believes we need to encourage those who are in addiction to be seeking treatment programs,” Rosario said. “We also need to ensure that when they seek treatment, treatments centers are available and have adequate resources to help them. Whether it is heroin, fentanyl, carfentanil, these are lethal poisons, and with limited resources, Congressman Rothfus believes that we should be directing available funds to prevention and therapy programs.
Larissa Dneaster, a recovering addict from Central City, is ambivalent about whether she supports or opposes needle exchange programs.
“I think it's a good thing to keep disease from spreading,” Dneaster said. “But I feel like it also tells the addict that it's ok to use and use the needles. I see it as a good thing and as a bad thing. For health reasons, it's a good thing. But the addict is then thinking it's OK.
“I have mixed feelings about it. I was at Somerset playground, and I saw needles on the ground. Maybe if there was needle exchange program, maybe it wouldn't happen. So I don't know.”
Dr. Daniel Geary, medical director of the Integrated Acute Care Team at Somerset Hospital, said people need to realize that needle exchange programs are a realistic approach to combatting this aspect of the heroin epidemic.
“We need to make sure we remove the negative stigma surrounding the crisis to make sure that patients are getting the care that they need,” Geary said.
Mahon agrees with that. She thinks the “tough on drugs” mentality has made people inflexible on taking steps that could be beneficial to the larger public.
“Stigma and discrimination, the War on Drugs, a lack of political will and funding and a lack of provision of harm reduction in prisons are the main barriers to increasing access to NSP and other harm reduction interventions,” Mahon said. “Many of these stem from a perceived ‘morals’ or ‘values-based’ argument against providing support for people who inject drugs — despite the evidence of its effectiveness.”