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When I Used Heroin, I Didn’t Know Needle-Syringe Programmes Existed

Needle-syringe programmes (NSPs) save lives and reduce the spread of HIV and Hepatitis C, as they allow people to obtain sterile needles, get harm reduction advice, and access treatment.

When I used heroin and fentanyl, finding sterile needles was the last thing on my mind. I would reuse my needles until they broke, and share needles with people around me. Getting my hit was more important to me than avoiding the risk of obtaining a blood-borne disease, such as HIV. I wasn’t even aware that NSPs existed. To make matters worse, there was such a stigma surrounding intravenous drug use that I never even encountered conversations around safer injecting practices.

The situation here in the US is better now. There is more awareness about, and access to, NSPs – but there is still a long way to go.

The main goal of NSPs is to reduce the transmission of HIV, and other blood borne pathogens that are contracted from shared and reused needles, among people who use drugs. The Centre for Disease Control and Prevention (CDC) estimates that around 10 per cent of "new HIV diagnoses in the United States are attributed to injection drug use or male-to-male sexual contact and injection drug use".

Instead of ignoring or criminalising drug-related activities, NSPs return human rights to people who use drugs by giving them a safe place to turn in used needles in exchange for new ones.

Additionally, most NSPs are overseen by medical professionals who can provide health resources to those who want help or are in need of medical attention. They provide support without judgment or legal consequences, whether the service user seeks to stop using drugs or not.

In the US capital of Washington DC, there was a 70 per cent decrease in new HIV cases among people who use drugs within two years of the city’s first NSP opening, according to the CDC.

Studies demonstrate that NSPs not only encourage safer injecting practices, but also serve as a bridge of communication, allowing people who use drugs to access treatment programmes. In addition, despite popular belief, there is no evidence that NSPs increase people’s drug use, or increase the likelihood that people will begin using drugs.

NSPs also benefit society more broadly, as they can improve the economy and reduce pressure on first responders. A study from the National Center of Biotechnology Information estimated that an investment of $10 million into NSP programmes would save over $65 million that would otherwise be spent on medical expenses treating HIV.

While there are still laws banning the federal funding of NSPs in the US, many such programmes are funded privately or through state legislation. A Kaiser Family Foundation infographic shows that nearly 320 such services exist in the US today, but hesitation still exists, as there are still some states – such as Kansas and Mississippi – where NSPs are illegal. One of the first steps in increasing the prevalence of NSPs is for the federal government to pass legislation making NSPs legal across the country, and eligible for federal funding.

Though NSPs have proven to decrease blood borne pathogens among people who use drugs, stigma still surrounds these programmes – partly as it is believed that they encourage drug use. However, from my experience, some people who use drugs will do so whether they have sterile equipment or not. The evidence backs this up. That’s why it is vital for everyone who uses, or may use, drugs intravenously to have easy access to sterile injecting equipment.

Harm reduction plays an important role in creating a safe environment for individuals to either get help if they want it or, at the very least, be able to stay alive. It is vital to continue fighting against the stigma of drug use, and for the public and governments to support NSPs.


*Kate is an avid writer from Memphis, Tennessee. She does freelance writing as well as writing for PAX Memphis in order to shed light on addiction.

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