City Politics How clean needle exchange and supervised injection programs work By Eric Boll Posted on October 23, 2019 6 min read 0 0 247 Clean needle exchange supplies. Photo courtesy of Wikimedia Commons Drug rehabilitation and prison reform are topics that have recently been brought up by candidates running for government positions in Athens, such as Independent Ellie Hamrick, and Democrats running in the 2020 presidential election. Many candidates throw around the terms “clean needle exchange program” and “supervised injection sites,” but what do they actually mean, and what evidence is there to support these candidates’ claims? Clean needle exchange: Athens already has a clean needle exchange program (NEP) in place, according to The Athens NEWS. The program, which began in 2017, is primarily focused on reducing the rates of disease and medical conditions frequently associated with unclean needle use, such as HIV and AIDS. This program has exchanged 36,681 needles, averaging about 32 clients a week, according to Community Solutions, an Ohio-based public policy think tank. Athens County also experienced its first decline in the number of new hepatitis C cases since 2008. Clean needle exchange programs are often focused on offering support to drug users, in addition to providing safe needles. Athens’ NEP offers training in naloxone, a medication used to combat opioid overdose. The organization also distributes kits containing the life-saving drugs. The goal for many of these programs is to ensure that drug users avoid becoming infected with HIV, AIDS, hepatitis and other bloodborne illnesses. The clean needle program is intended to help drug users recover and raise awareness for both these illnesses and the negative consequences for public health. Supervised injection sites: Supervised injection sites (SIS) are locations where drug users can use drugs in a safe and sterile environment. There they receive education about safer ways to use their drug of choice and the health services available to them. At no point during their time at the SIS will staff administer drugs to individuals, nor will they provide them with illegal narcotics. The staff at the site is tasked with observing individuals who administer drugs to themselves. Staff will intervene with naloxone should an individual overdose. Currently, the federal government staunchly opposes SIS, and it threatened legal action against anybody who attempts to open one, according to NPR. One of the largest supervised injection sites worldwide is located in Vancouver, Canada. The facility, called Insite, had over 3.6 million injections, and its staff responded to more than 6,000 overdoses between 2003 and 2018. A 2008 study from PLOS ONE, a science journal, found that Insite had prevented between eight and 51 deaths in the area surrounding it, as overdose rates in the immediate vicinity decreased. Both practices history: Portugal is the poster child for many of the programs candidates are proposing. The country was in the midst of a drug crisis that began in the late 1970s, following the collapse of its authoritarian government, which led to an increase in narcotic use among its citizens. An estimated 1% of the population in the country were using heroin in the 1990s, according to Time. That large amount of heroin usage led to Portugal having the highest HIV infection rate in the EU. The Portuguese government decriminalized all drug consumption in 2001 and began to funnel money into drug rehabilitation and safe use programs. That — along with a push to combat the social stigma surrounding drug use — led to a society where drug users feel more capable of seeking help, according to Time. All of these programs created a culture where drug use is seen as more of a medical issue than a criminal one, according to NPR. Portugal’s drug-induced death rate is now five times lower than the European average, and HIV infections that are related to drug use have dropped 95%, NPR reported.