Needle Exchanges: Avoiding Hep C or Assisting Addicts?

Three million people are living with hepatitis C in the U.S., which has been a serious health threat for years. In light of recent outbreaks of hepatitis C around the country, many states are turning to a controversial practice to curb the transmission of deadly disease— needle exchange programs. Needle exchange programs, which allow intravenous drugs users to exchange their used needles for new sterile needles, have been proven to prevent the transmission of blood-borne infections in clinical trials and have been in use across Europe since the 1990s.

The controversy over needle exchange programs stems from the fact that many lawmakers feel that providing clean needles for drug users is condoning or even encouraging the use and abuse of illegal drugs. Understandably, it’s a difficult decision to make. The benefits of preventing the sharing of needles— namely, preventing more cases of HIV and hepatitis C, which can go on to be spread sexually as well as through exposure to tainted blood— must be weighed against the negative consequences of drug use. The War on Drugs launched by President Richard Nixon in 1971 has resulted in the incarceration of millions of Americans, many of whom are already positive for STDs like chlamydia and HIV. Once in prison, STDs spread and flourish.

Advocates for needle exchange programs argue that in addition to decreasing the number of people suffering from HIV and hepatitis C, providing clean needles for drug users also prevents costly medical care for heroin and other intravenous drug users who are in poor health but don’t seek medical attention until their condition warrants a trip to the emergency room. The clean needles lessen some of the negative health conditions and serve as a way to encourage treatment for illnesses and addiction. The American Medical Association, the Centers for Disease Control and Prevention (CDC), and the Institute of Medicine have all expressed support for needle exchanges.

The federal government banned funding for needle exchange programs, leaving the decision to implement the programs to individual states and cities. Over 100 cities implemented their own needle exchanges, supported by local tax dollars. In light of studies proving the efficacy of clean needle programs in preventing the spread of HIV, President Obama lifted the ban on federal funding in 2009. This year, Indiana’s Governor Mike Pence declared a state of emergency after an outbreak of HIV, which frequently occurs as a co-infection in people who suffer from hepatitis C. The state of Kentucky, which has the highest rate of new hepatitis C infections in the U.S., recently passed a new law allowing counties to start their own needle exchange programs to lower the chances of the spread of hepatitis C.


States with Needle Exchange Programs:

  • Alaska
  • Arizona
  • California
  • Colorado
  • Connecticut
  • District of Columbia (DC)
  • Delaware
  • Florida
  • Georgia
  • Hawaii
  • Illinois
  • Indiana
  • Louisiana
  • Massachusetts
  • Maryland
  • Maine
  • Michigan
  • Minnesota
  • Missouri
  • Montana
  • North Carolina
  • New Jersey
  • New Mexico
  • Nevada
  • New York
  • Ohio
  • Oregon
  • Pennsylvania
  • Rhode Island
  • Tennessee
  • Utah
  • Vermont
  • Washington
  • Wisconsin

To find a needle exchange program near you, click here.


Visit our Definitive Guide to Hepatitis C and Hepatitis C Testing for more information about hepatitis C.

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Medically Reviewed by on September 26, 2018 - Written by STDcheck Editorial Team.

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Author: Kristena Ducre

Kristena is a sex-positive LGBTQ ally and general fan of sexy things. As a writer, she is passionate about empowering people's sex lives with accurate and straightforward information. Sex can be a ton of fun, but sexual health is not a laughing matter. In the bedroom, as in life, knowledge is power.