No Reason to Fund Needle Exchanges

Len Deo, President, NJ Family Policy Council & Member of the Governor's Advisory Council
on HIV/AIDS (1998-2002)

When I ask the average New Jerseyan whether our tax dollars should be used to give clean needles to drug addicts in the hope that they will not spread HIV, the vast majority think the idea is preposterous.  Nevertheless, Governor Corzine and the NJ Legislature authorized six pilot needle exchange programs (NEPS) at the end of 2006, allocating 10 million for drug treatment, leaving it up to private entities to fund needles and paraphernalia. Yet, now just months after inception, proponents are asking NJ taxpayers to provide funding for needle programs without any proof the pilot programs are even working.   

In fact, there is still no concrete proof that any needle exchange scheme works to reduce the spread of HIV.  A comprehensive 2006 Institute of Medicine study of NEPS states“Evidence regarding the effect on HIV incidence is limited and inconclusive.”  If proponents seriously believe that giving out free clean needles reduces the spread of HIV and other blood-borne diseases, then they should get private funding to do valid scientific research.  The only test parameter that yields valid statistical data is: utilizing a sample of injection drug users who agree to use a specified NEP, testing 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, and comparing those results to a sample of injection drug users at set intervals in the same area not using the NEP.  In the seven studies of this caliber – no evidence has been demonstrated that NEPs effectively reduce or prevent the transmission of HIV. 

Unknown to the average citizen taxpayer, the studies routinely quoted by NEP proponents never utilize the aforementioned quality of research, including government agencies that espouse political support for NEPs.  Sadly, the NJ pilot programs will also not yield any credible results. In Newark for example, users are questioned about their history of HIV and drug treatment, but no testing is mandatory. After six months they will be questioned as to whether they are still sharing needles, which is self-reported data from an addict.

While the push for NEP funding continues in NJ, consider what is really going on regarding HIV/AIDS and injection drug use in NJ, and in NEPs elsewhere:

1. In NJ since 2003, the proportion of HIV/AIDS cases (and the number of) exposed through IDU is decreasing – without the existence of NEPs – while the proportion and number of cases exposed through sexual contact is increasing, according to the latest Dec. 2007 NJ HIV/AIDS report.  This is all the more reason why we must not fund NEPs which will do nothing to address sexual contact exposure. 
2. Costs of NEPS continue to escalate. In Vancouver since 1996, the number of syringes jumped from 128,000 to one million, users of the NEP have increased from 545 to 2,000, and AIDS Vancouver says it needs $585,000 – more than double its current operating budget – to run an expanded NEP in a new location¹. In Newark alone a 2004 study estimated there are over 23,000 injection drug users (IDUs), yet at the present there are only 200 in Newark’s pilot program.
3. Cities where the NEP is located are badly affected. In Victoria, Canada junkies continue to shoot up, defecate, buy drugs, and collapse on the streets around the NEP, while area businesses try to shut it down.  One business owner says “every afternoon about 4PM it’s like Night of the Living Dead…and it’s horrible until 6AM.”   
4. Needles are not always “exchanged”. San Francisco’s NEP gave out over 2 million needles and only received about 70 percent back. Needles wind up in parks, playgrounds, and even people’s gardens. Golden Gate Park Recreation says on any day they collect about 100-200 discarded syringes.   
5. NEPs are not an effective bridge to treatment, nor are they a substitute for treatment.  NJ does not even have enough treatment facilities to meet the demand of IDUs who say they want treatment.
6. The Institute of Medicine study reveals that NEPs have even "Less impact on transmission and acquisition of hepatitis C virus than on HIV."  In San Francisco since the existence of an NEP, rates of Hepatitis C have reached epidemic levels.   

With the state of New Jersey deep in debt, there is absolutely no reason whatsoever to consider funding controversial, unproven needle exchange programs. Any future allocations would be much better spent meeting the need for more drug treatment to end the cycle of addiction.

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