Harm Reduction in a Needle Exchange Context
The sharing of needles and syringes is one of the most effective methods of transmitting HIV and Hepatitis C. Inhibiting the spread of these diseases amongst injecting drug users (IDUs), their sexual partners and children, and from them to the broader community, is seen by most public health specialists in New Zealand to be a crucial strategy in public health.
It has been well documented that once HIV has become established in the IDU population it has the potential to spread rapidly. In some areas, such as Edinburgh and New York, it is estimated that more than 50 percent of IDU have been infected within a period of 2-4 years,. In response to this threat the Department of Health established the New Zealand Needle Exchange Programme (NEP). The programme is based on a philosophy of harm reduction rather than abstention; that is, it is primarily concerned not to minimise injecting drug use as such but rather to minimise the potential harm from HIV and other diseases flowing from such use.
The Rationale for Needle Exchange
This approach aims to reduce the harmful effects on health which result from injecting drug use. It does not condone the use of illegal drugs, but accepts that drug use continues to exist despite its legal prohibition.
Harm reduction is based on the following rationale
Despite drug education and treatment programmes many individuals will choose to inject illicit and licit drugs for varying periods of time.
People must be provided with knowledge and skills necessary to make informed choices about risk behaviours.
The wider, non drug using community faces a greater danger from the wider spread of HIV and hepatitis infections than it does from the effects of drug use itself.
The harm reduction model accepts that in the absence of a vaccine or an effective cure behavioural change is the only device we have to minimise the spread of HIV and other blood-borne diseases.
Needle Exchange offers an excellent opportunity to educate people who inject drugs on an individual basis. Through regular contact the safer injecting/safer sex message can be reinforced.