EXCHANGE PROGRAMS HELP PREVENT AIDS, HEPATITIS C

Public's Health

We face many complex challenges, such as global warming, aging baby
boomers, potential pandemics and the decreasing availability of oil.
Coping with these issues will require intelligence, cooperation and
an ability to challenge some of our established beliefs.

The strategies presently used in the United States to cope with our
drug problems do not give me a lot of hope. A significant number of
us think drug abusers are immoral and undesirable rather than sick
people in need of treatment. Because of these entrenched negative
beliefs, we do not treat abusers in the most effective and
compassionate manner. An example of our ineffective behavior is
withholding clean needles from injecting drug users (IDUs).
Withholding clean needles does not positively impact the drug problem
and instead contributes to needless death, disease transmission and
increased health care costs.

As of 2004, injection drug use causes 20 percent of the 40,000
HIV/AIDS cases and 60 percent of the 26,000 hepatitis C infections
that occur in the United States each year. IDUs become infected and
then spread disease through sharing syringes or risky sexual
behavior. Evidence indicates that if we established syringe exchange
programs (SEPs) across the country, we could significantly decrease
the spread of HIV/AIDS and hepatitis C to drug users and many others,
including family members and children.

Syringe exchange programs distribute clean syringes to drug addicts
who exchange used needles that may be infected with disease. These
exchange programs often provide access to education, treatment,
screening and primary medical services.

Earlier work indicates that syringe exchange programs, as well as
saving lives and preventing the spread of disease, can save
significant dollars. In the 1990s it was estimated SEPs had an
average annual budget of $169,000 while the lifetime cost of
treating one person with AIDS was more than 100,000. If in a year's
time an SEP prevented two cases of AIDS, it would pay for itself.

A study reported in the journal Lancet indicates approximately 7,200
AIDS cases could have

been prevented between the years 1987 and 1995 if SEPs had been
established. This would have saved more than $500 million in health care costs.

Several studies show SEPs do not increase drug use among present-day
users or increase the number of first-time users.

According to Kristen Tobias, the only needle exchange program in Ohio
is at the Free Clinic of Greater Cleveland. Tobias, who administers
this SEP, said the program exchanges clean needles for used ones with
a very wide range of clients, including 75-year-old grandmothers and
Toledo drug users who make the drive to Cleveland.

If needle exchange programs save lives, prevent AIDS and hepatitis C
transmission, save money and do not increase the number of drug
users, logic would indicate, as it has to the other industrialized
countries, that we set up many more needle exchange programs across
the country. We haven't. Hopefully, clearer thinkers are working on
the warming, oil and pandemic problems.