Narcotics policies and drug use risks

A now classic examination of the ecological risks associated with injection drug use was reported by Hurley and colleagues (Hurley et al., 1997), who performed a large ecologic study of 81 cities globally with and without needle and syringe exchange programs (NSEPs). Those without NSEPs saw an HIV prevalence rate increase among injection drug users of roughly 6 percent per year; those with NSEPs saw an average decline in HIV prevalence in injection drug users of 5.8 percent per year. This study, now almost 10 years old, and a great volume of subsequent work have demonstrated that these ecological factors can play powerful roles in control of infectious diseases. However, they continue to be resisted aggressively. As an example, in 2005 the United States Congress Subcommittee on Criminal Justice, Drug Policy and Human Resources held hearings (at which one of the current authors, Chris Beyer, testified) entitled "Harm Reduction or Harm Maintenance: Is There Such a Thing as Safe Drug Abuse?" in which a range of Republican witnesses were brought forward to question the evidence for harm reduction and to call it an ideological rather than an evidence-based approach to prevention. The positions put forward in support of the evidence for harm reduction from the American Medical Association, the American Nurses Association, and the American Public Health Association were all discounted. Advocates were told by sympathetic staffers that the federal needle and syringe exchange ban had become a "sacred cow," and that advocacy efforts to change the policy had little or no chance of success. With the US still the single largest funder of HIV/AIDS activities globally, this inability to respond to the evidence for harm reduction has global implications.

0 0

Post a comment