Why Do Needle Exchanges Keep Getting Shut Down Despite Evidence of Their Effectiveness?

If you believe in a god, you probably also believe He works in mysterious ways. Along those same lines, it’s looking increasingly like human compassion can take many various forms throughout the world. Some of them are surprising — and maybe even a little concerning — at first glance.

But being surprised by a new idea doesn’t mean it’s not a good one, which is why the world needs to have an adult conversation about needle exchanges. Even though a mounting body of evidence indicates needle exchanges can literally save lives, conservative-minded governments throughout the developed and developing worlds are instead putting their foot down, effectively stifling conversation on the topic before it really began.

Let’s start at the beginning and explore what this idea actually entails and why it could turn into a humanitarian victory for everybody involved if we’d only give it a chance.

What Are Needle Exchanges?

At their simplest, needle exchanges are staffed locations in local communities where struggling drug addicts can exchange their drug paraphernalia for clean needles and syringes.

However outlandish it seems, the idea has straightforward and compassionate intentions — as we all work to elevate the conversations about drug abuse stigma, there has to be some interim relief for drug users who cannot kick the habit permanently. We also cannot, in good conscience, allow these individuals to pursue their habit using dirty or secondhand needles.

This is an imperfect measure to help curb some of the worst of the collateral damage associated with drug abuse and addiction. But it is a measure with a strong track record of success. And just as importantly, it could be a stepping stone to a more complete replacement of America’s failed drug “wars” and other antisocial policies in favor of something that works.

How Do We Know Needle Exchanges Work?

The idea would not have come this far unless there was compelling evidence to support it. Although civic leaders, including judges, in American communities frequently force the closure of clean needle exchanges, our own CDC actually hosts information about needle exchanges online, noting that they greatly reduce the number of needles that get discarded in public.

They also help cut down on the spread of hepatitis C, HIV and other infectious and potentially deadly diseases. They do not seem to contribute to additional future drug use. They have also been found successful in connecting people with counseling and other forms of professional addiction or medical treatment.

Academic researchers documented and published all of these successes, and many of their findings are available online. The Centers for Disease Control and Prevention and the World Health Organization have both endorsed their findings. Moreover, clean needle exchanges are a vital part of our response to the ongoing opioid overdose epidemic, which has claimed the lives of over 300,000 Americans since 2000.

Who’s Fighting This?

California was the latest state to turn needle exchanges into a news story. In Orange County, a state judge named Joel Wohlfeil ordered that a program called Orange County Needle Exchange Program, or OCNEP, halt its operations. The program would have opened four syringe exchange locations in the county.

Reacting to the judge’s decision, Alex Smith, a resident of California, revealed that some of the benefits of needle exchanges are far less tangible than others. For many human beings whose lives have taken an unfortunate but unasked-for downturn, establishments such as the four proposed by OCNEP represent nothing less than hope. And if not hope, then at least deliverance from an especially poisonous bigotry.

When Smith went to a CVS in search of clean syringes, still deep in the grip of addiction but also suffering collateral medical complications like bacterial infections and MRSA, and open sores across her body, she described the reception she received like this:

“They took one look at me at CVS, and they turned me away. I felt so humiliated, disgusted. I didn’t know what to do … I heard there was a mobile needle exchange in town. So I went … and there was a girl there. The first thing she did was smile at me and ask me how I was. I don’t know why that had such an impact on me. But it was the first time someone had treated me with dignity and humanity in a very, very long time.”

What you see here, among other things, is the startling contrast between a “social” response to human suffering — and one that serves capital first. What we see too is the beginning of a new kind of optimism for communities that have been neglected and underserved in every possible definition of the terms.

The objections to expanding the availability of needle exchanges are, at the end of the day, understandable. But they’re also entirely off-base. Conservative-minded city officials usually seek the closure of needle exchanges because they’re worried about making “needle litter” worse. And who wouldn’t be? But as we noted briefly above, and which seems to have been confirmed by additional academic research, communities with clean needle programs usually see vastly less needle litter than communities without.

America Lags in the Deployment of Needle Exchanges

According to reporting in The New York Times, there were 333 needle exchanges in operation in the U.S. in 2013. Australia has one-tenth the number of citizens, and the country has more than 3,000.

If you’re wondering what happened to Alex Smith, she works at a company that assists the intellectually disabled. She’s been sober for five years and wants to pursue graduate school.

Would we, now, somehow collectively be better off if she was still on the streets somewhere — or worse? Of course, we would not. The community would be diminished by losing a potential life. It’s a life that, now, shares a measure of the hope she received with another group of people whom society tries hard to forget about.