Harm Reduction For Heroin Addiction
The growing prevalence of heroin addiction across the country is leading to not only a large amount of deaths due to fatal overdoses, but it is also contributing to an increase in the proliferation of diseases such as HIV and hepatitis C. These serious diseases have a significantly higher rate of incidence in those who struggle with heroin addiction due to the tendency to share needles, which exposes multiple people to these viruses. This is why many health officials across the country have been strongly advocating for the development of needle exchange programs in order to introduce a measure of harm reduction into the IV drug use community.
Obviously, in an ideal world quality substance abuse treatment would be available to everyone struggling with heroin addiction at all times. However the lack of treatment options for many drug addicts create a situation where sometimes good treatment options are unavailable due to long waiting lists or high insurance deductibles. Another issue is the fact that substance abuse treatment for those with heroin addiction is typically a voluntary process, meaning the individual has to have a desire to quit using drugs. There are many drug addicts who lack this motivation to quit. These issues create a situation where there are many people in active heroin addiction who either cannot or will not receive treatment for their addiction.
These active heroin users are one of the largest sources of new HIV and hepatitis C cases. Heroin addicts tend to be more susceptible to these diseases because of the prevalence of IV use of the drug compared to other substances. IV drug use requires the use of a syringe and hypodermic needle in order to inject the drug directly into the vein in order to receive a quicker and more powerful reaction from the drug. In many parts of the country however it can be difficult for those struggling with heroin addiction to have safe and easy access to clean, unused injection equipment which leads to the re-use and sharing of hypodermic needles. This sharing of needles is an extremely dangerous activity which can very easily lead to the spread of serious diseases like HIV and hepatitis C.
Some regions are more impacted than others
While the use of needle exchange programs across the country continues to be a divisive and controversial issue, recent data is pointing to a clear correlation between regions of the U.S. without needle exchanges and a higher rate of new HIV cases. Areas of the country which tend to lean left on the political spectrum are typically more likely to provide those who struggle with heroin addiction access to needle exchange programs, while more conservative areas of the country tend to ban or heavily restrict these programs.
Data Source: U.S. Centers for Disease Control and Prevention
Following these same regional lines, new HIV cases and HIV deaths are both significantly clustered in the most conservative areas of the country. While there are more than likely multiple reasons that this is the case, the restriction of needle exchanges and other harm reduction programs is almost certainly contributing to the problem. Heroin addiction is an issue that is impacting people across the entire country and is not limited to a specific region, however a heroin addict’s access to clean and safe injection equipment is mostly determined by the area of the country that they live in. The southern United States in particular is extremely strict on regulations regarding needle exchanges or the sale of hypodermic needles over the counter, creating a situation where those who struggle with heroin addiction are left to re-use and share needles in order to get high.
This has led to a situation in which the South is home to over half of the new HIV diagnoses and HIV deaths in the entire country. That is most alarming when considered along with the fact that the South only represents a relatively small portion of the overall population of the country.
Looking at heroin addiction through a different lens
As with many other policies in this country which are written and carried out with an intention to stem the problem of drug addiction, the ban on needle exchanges is based on the idea that making drug use harder for addicts will compel them to quit and become normal and contributing members of society. Essentially, the belief is that drug addicts are making a choice to be bad people and they need to be punished or coerced into being “good.” This unfortunately flies in the face of all the modern research in the field of addiction which has shown that it should be treated as a disease.
The disease model of addiction states that those who are afflicted with drug addiction use drugs because of a malfunctioning reward mechanism in the brain which makes them believe that they need the drug in order to survive. While there is still controversy on this issue, however the growing evidence that things like restricting those who struggle with heroin addiction access to clean injection equipment does nothing to deter them from using drugs points to the validity of this disease model.
There have also been multiple studies which show that areas of the country with needle exchange programs have saved the taxpayers significant amounts of money. The cost of needle exchange programs is minuscule compared to the resources that are spent treating those who end up with diseases like HIV and hepatitis C. This is yet another reason why the expansion of needle exchange programs across the country is likely to prove beneficial to all of society and not just IV drug users.
Still, there are many out there who argue vehemently against these programs citing the fact that providing addicts with clean needles is essentially underwriting their drug use and making things like fatal overdoses more likely. It’s difficult to know with absolute certainty if this is true however, and more studies will need to be done in order to obtain more concrete data for analysis.