Vilification of Needle/Syringe Programs (NSP’s) and laws preventing their operation are certainly nothing new. It didn't take long after the introduction of the 'modern' hypodermic needle in the late 1800's for laws limiting their availability to follow. In fact, the year 1911 marked the introduction of the first law in the U.S. that would require injection drug users to obtain a prescription from a physician in order to purchase syringes. That law originated in the state of New York, and by 1915, several other states had enacted similar laws, all with the goal of limiting access to syringes. Unfortunately, misinformation and fear surrounding harm reduction initiatives, including needle exchanges, continued to persist throughout history.
In 1930, The United States Department of the Treasury created the Federal Bureau of Narcotics, headed by the infamous Harry Anslinger until 1962. The impact of this is still felt today as Anslinger's policies and campaigns play a massive part in creating the war on drugs and drug users.
The 1970's brought with them 'drug paraphernalia' laws that allowed for the criminalization of certain items used by drug users including syringes. But not long after, the emergence of AIDs slowly contributed to a change in the way NSPs were viewed. Being transmissible through intravenous drug use, access to sterile syringes was imperative in order to help decrease transmission.
In the 80's, other countries around the world started to take action, and in an effort to help reduce transmission of HIV and other communicable diseases, introduced the first Needle/Syringe Programs of their very own. The Netherlands, United Kingdom, Australia, and Canada, were all beginning to take steps towards harm reduction.
Back in the U.S. however, the year 1988 brought with it both the first Needle/Syringe Program in Tacoma, Washington, as well as an unfortunate new federal ban which was enacted on the U.S. funding of NSPs. The fine print stated that it could in fact be lifted, but only if it were to be proven that these programs do help to reduce the transmission of HIV without increasing drug use.
Oddly enough, "there was also an administrative ban on research to evaluate NEPs from 1988 to 1991; this was the quintessential Catch-22." Without the ability to conduct formal research into whether or not NSPs do in fact reduce the HIV transmission without increasing drug use, the ban on funding wouldn't be going anywhere anytime soon.
In 1998, the evidence required to lift the funding ban (proof that NSPs reduce transmission without increasing drug use) was obtained and presented to the Clinton administration, but the funding ban would remain, even in the face of the evidence.
Paraphernalia laws, drug laws, and the war on drugs itself ensured that misinformation and fear would continue to hold the health and safety of intravenous drug users in a very low regard. Even though the outlook seemed bleak, it wouldn't be enough to stop various needle exchange programs from popping up across the United States of the next 10 years. "Despite the lack of federal funding, by 1999 there were over 160 SEPs in operation in 39 U.S. states, the District of Columbia and Puerto Rico."
As of June 2014, there were a total of 194 needle/syringe programs in the United States known to the North American Syringe Exchange Network (NASEN). That means that only 34 more exchanges have begun operating between 1999 and June 2014. If we pretend for a second that they are spread out evenly between states (which they in fact are not), that would mean only about 4 per state. While that might seem like a decent amount, in reality it is far from enough. It leaves a large portion of intravenous drug users without access to clean supplies, risking their health and wellbeing.
Allowing U.S. funding for NSP's is a crucial step in keeping them safe.
Even today, these unfounded fears and misguided beliefs on harm reduction and needle/syringe exchanges continue to persist. The U.S. funding ban in Indiana was only recently repealed in the wake of an HIV outbreak amongst the states intravenous drug users. Southeastern Indiana was facing 181 new cases of HIV, and completely insufficient access to affordable, sterile needles/syringes. A public health emergency was declared, with the state’s Governor issuing an executive order which finally allowed for the first needle/exchange to open its doors.
Similarly, it took a surge in Hepatitis C cases in Kentucky for that state to give permission for Needle/Syringe Exchange Programs to be implemented. Other states began to take notice of just how serious the consequences can be when you deny access to free clean needles, with at least 34 states now operating exchange programs of their own.
However, many states continue to oppose this essential service, even though the evidence is not on their side. Research has shown a slew of positive effects from reduced risk of Hepatitis B & C, reduction in HIV, and increased rates of entry into detox treatment programs, to reduction in high-risk behaviors such as needle sharing and reduction in the rate of needle reuse. On top of all those benefits, they are cost-effective and provide a crucial gateway into healthcare and treatment services.
We cannot continue to relegate people who inject drugs to the sidelines, only addressing their health and safety concerns, when they balloon into a very public health emergency.
We have seen what happens when we choose that route, and it doesn't help anyone involved. It only places unnecessary health risks on those who use drugs intravenously, and by extension, the community as a whole. When steps are taken to ensure that users are provided with accessible, cost-free, sterile needles/syringes, everyone wins.