Ending of a Needle Exchange Program Shows How Government is Addicted to Failure

In 2015 Scott County, Indiana made headlines for all the wrong reasons. With a population of fewer than 10,000 people, the county was the center of an HIV outbreak of more than 230 cases. Most of those infected were individuals who engaged in intravenous drug use.

Recognizing the public health emergency, officials acted and implemented a needle exchange program. The program, as the name implies, allows for people who inject drugs to acquire clean syringes and safely dispose of used ones. The logic of such a program is straightforward. When individuals inject drugs without access to clean syringes, they are more likely to reuse them. Needles dull with every use, and can even break off under a person’s skin. Reusing syringes also increases infection risk. When clean supplies aren’t readily available, those who use intravenous drugs are also more likely to share needles. This dramatically increases infection risks—including the risk of contracting HIV or Hepatitis C. Providing clean syringes and a safe means of disposal decreases the likelihood that people will reuse or share needles.

But these programs have other benefits as well. In addition to reducing infection risk, needle service programs can also serve to get drug users into recovery. They can be an important step toward addiction recovery.

So what did officials do? They canceled the program, of course.

When discussing the decision to end the program, Scott County Commissioner President Mike Jones said, “I know people that are alcoholics, and I don’t buy him a bottle of whiskey, and ... I have a hard time handing a needle to somebody that I know they’re going to hurt themselves with.”

While we can appreciate not wishing to enable drug use, Mr. Jones’s analogy doesn’t fly. Taking a swig of Jack Daniels after your friend doesn’t lead to you contracting cirrhosis of the liver. Sharing bottles of alcohol doesn’t create conditions conducive to an HIV outbreak.

His assertion that these programs are harmful isn’t supported by the data. While Jones claimed that overdose rates are increasing in his community, Scott County already had the highest rate of premature deaths in Indiana prior to the implementation of the syringe exchange program. Any suggestion of causation as it relates to the needle exchange program would need some serious evidence—evidence he doesn’t have.

The fact is, needle exchanges do not have the deleterious effects some policymakers claim. According to the Institute of Medicine, syringe programs do not increase the frequency of use among existing intravenous drug users, nor do they encourage initiation among those who do not use. The CDC reports that multiple studies fail to find a link between these programs and increased crime rates.

So why the aversion to these programs?

While there is no singular answer, looking at the last fifty years of drug policy presents a logical starting point. Fifty years ago this month president Nixon declared that drug use was “public enemy number one” and began the war on drugs. Nixon’s successors continued and expanded these policies. With this hard-nosed approach to drugs, many policymakers—and members of the public—have come to view anyone and everyone involved in the illicit drug trade as nothing more than degenerates. As such, policymakers see a program like syringe exchanges and can conveniently ignore the decades of data.

I will predict that Scott County, Indiana will see an increase in infections related to intravenous drug use once their syringe program shuts down. People who would not have become ill will develop lifelong health conditions. Some of them will die.

And these individuals will be yet additional casualties of the “war” on drugs.