Pubdate: Mon, 12 Mar 2007
Source: Toledo Free Press (OH)
Copyright: 2007 Toledo Free Press
Contact:  http://toledofreepress.com/
Details: http://www.mapinc.org/media/4392
Author: Stephen Roberts
Note: Stephen Roberts is an associate professor in the UT Department 
of Public Health and Homeland Security.
Bookmark: http://www.mapinc.org/find?143 (Hepatitis)
Bookmark: http://www.mapinc.org/find?137 (Needle Exchange)

EXCHANGE PROGRAMS HELP PREVENT AIDS, HEPATITIS C

Public's Health

We face many complex challenges, such as global warming, aging baby 
boomers, potential pandemics and the decreasing availability of oil. 
Coping with these issues will require intelligence, cooperation and 
an ability to challenge some of our established beliefs.

The strategies presently used in the United States to cope with our 
drug problems do not give me a lot of hope. A significant number of 
us think drug abusers are immoral and undesirable rather than sick 
people in need of treatment. Because of these entrenched negative 
beliefs, we do not treat abusers in the most effective and 
compassionate manner. An example of our ineffective behavior is 
withholding clean needles from injecting drug users (IDUs). 
Withholding clean needles does not positively impact the drug problem 
and instead contributes to needless death, disease transmission and 
increased health care costs.

As of 2004, injection drug use causes 20 percent of the 40,000 
HIV/AIDS cases and 60 percent of the 26,000 hepatitis C infections 
that occur in the United States each year. IDUs become infected and 
then spread disease through sharing syringes or risky sexual 
behavior. Evidence indicates that if we established syringe exchange 
programs (SEPs) across the country, we could significantly decrease 
the spread of HIV/AIDS and hepatitis C to drug users and many others, 
including family members and children.

Syringe exchange programs distribute clean syringes to drug addicts 
who exchange used needles that may be infected with disease. These 
exchange programs often provide access to education, treatment, 
screening and primary medical services.

Earlier work indicates that syringe exchange programs, as well as 
saving lives and preventing the spread of disease, can save 
significant dollars. In the 1990s it was estimated SEPs had an 
average annual budget of  $169,000 while the lifetime cost of 
treating one person with AIDS was more than 100,000. If in a year's 
time an SEP prevented two cases of AIDS, it would pay for itself.

A study reported in the journal Lancet indicates approximately 7,200 
AIDS cases could have

been prevented between the years 1987 and 1995 if SEPs had been 
established. This would have saved more than $500 million in health care costs.

Several studies show SEPs do not increase drug use among present-day 
users or increase the number of first-time users.

According to Kristen Tobias, the only needle exchange program in Ohio 
is at the Free Clinic of Greater Cleveland. Tobias, who administers 
this SEP, said the program exchanges clean needles for used ones with 
a very wide range of clients, including 75-year-old grandmothers and 
Toledo drug users who make the drive to Cleveland.

If needle exchange programs save lives, prevent AIDS and hepatitis C 
transmission, save money and do not increase the number of drug 
users, logic would indicate, as it has to the other industrialized 
countries, that we set up many more needle exchange programs across 
the country. We haven't. Hopefully, clearer thinkers are working on 
the warming, oil and pandemic problems.
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MAP posted-by: Beth Wehrman