New Research Should Stop NJ Needle Exchanges
Len Deo, President of the NJFPC and former member of Governor's Advisory Council on AIDS 1998-2002, with Toni Meyer, Sr. Research Analyst, NJ Family Policy Council

PRINTED: Bergen Record - 9-06
On September 14th, just four days prior to the NJ Senate Health Committee, passing bill S-494 in support of handing out free needles for drug addicts, the Institute of Medicine released a study acknowledging that there is very limited conclusive data to support such programs. While the Institute continues its longstanding support of needle exchange programs intended to reduce disease risk among injection drug users, the study commissioned by the Bill and Melinda Gates Foundation and UNAIDS, makes some key acknowledgements that should cause our state legislators to refrain from pouring taxpayer dollars into such a controversial and risky venture.

The most major admission in the Institute of Medicine’s assessment of needle exchange, hits at the heart of pro-needle supporters’ rationale which speculates that giving addicts access to clean needles will prevent the transmission of HIV. The Institute states: “E vidence regarding the effect on HIV incidence is limited and inconclusive.¹ This acknowledgement is huge, considering nearly every major newspaper in NJ, their columnists and even Gov. Corzine continue to blindly repeat false blanket statements like ”all research shows that clean-needle programs lower the incidence of HIV transmission and AIDS”. The NJ Family Policy Council has released several papers over the past few years explaining that only a seroconversion study (study utilizing a sample of injection drug users who agree to use a specified NEP, test their blood to determine negative HIV status then after set periods of time testing their blood again at predetermined levels to determine whether or not they have contracted HIV) would provide valid statistical data to make such an assertion one way or the other. In such cohort studies using viral incidence or prevalence as markers of transmission, no evidence has been demonstrated that NEPs effectively reduce or prevent the transmission of HIV².

The new Institute of Medicine study further states that there is even "Less impact on transmission and acquisition of hepatitis C virus (HCV) than on HIV³." These conclusions are verified by studies like the large Vancouver Injection Drug User Study begun in 1996. By 2003, the prevalence of HIV had reached 35% and the prevalence of HCV had reached 92%, near saturation despite the large needle exchange that serves its participants⁴.

Then there are the “unintended” consequences of NEPs, like new drug users, more frequent injection among established users, expanded networks of high-risk users, more discarded needles in the community and increased crime trends. The Institute of Medicine concludes there is limited data suggesting that no increases occur in these categories. Specifically, they explain that further research is likely to change the estimates regarding discarded syringes in the community, and injection frequency, and they state that the evidence showing no increase in new users, expanded drug networks and crime is weak and that further research is very likely to change the estimates.

Concerning new drug users, frequency of use, and discarded needles, recent newspaper reports from Scotland, the UK, and Ontario Canada reveal that the number of needles accessed by IDUs continues to grow as does the numbers of discarded needles in the community. More than half-a-million needles and syringes were handed out to Glasgow Scotland’s drug addicts last year, which were expected to be “exchanged” at these needle exchange schemes, yet alarmingly more than 200,000 were never returned⁵. At the same time, no mention is made of the impact on HIV or hepatitis which the NEP is supposed to prevent. With regard to NEPs impact on crime, ask the police in Vancouver, who on July 19 th made it their official policy to not arrest people for using drugs but to instead focus on those who sell and make them. They have abandoned the overwhelming enforcement task of arresting users outside the NEP, and are focusing solely on the dealers. Is this what we want for New Jersey?

A decision by our legislators to not allow drug addicts access to free clean needles in NJ at taxpayer expense would be a sign of wise and thoughtful independence from the rest of the states. Drug treatment and prevention efforts – not needle exchanges – are by far the best solutions for both the addict and society.

¹ Advising the Nation, Improving Health, Institute of Medicine, September 14, 2006, Slide 27.

² Fred J. Payne, MD, MPH (former medical epidemiologist for CDC, Sr. Epidemiologist NIAID, NIH, Director of HIV Case Mgtmt. Prog., current Med. Adv. Children’s AIDS Fund), “An Evidence-Based Review of Needle Exchange Programs,” HIV/AIDS Perspectives,The Children’s AIDS Fund, July 2001, modified May 10, 2006, http://www.childrensaidsfund.org/showarticle.asp?id=246.

³ Advising the Nation, Improving Health, Institute of Medicine, September 14, 2006, Slide 27.

⁴ Fred J. Payne, MD, The Impact of Needle Exchange on Child Health, Drug Watch International, March 2006, Vol. XI, No. 1.

⁵ Advising the Nation, Improving Health, Institute of Medicine, September 14, 2006, Slide 28, and Conclusion 3-7.

⁶Shock as 1/2M needles given to city addicts; 200,000 never returned to exchange centres ,June 13, 2006, Evening Times (Glasgow, Scotland, United Kingdom), Section: News; p.7, Brian Currie, Political Editor.

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