Deflating the Controversy over Needle Exchange Programs

One of the great joys of being an NU student is learning from the amazing experiences of your peers. My friend Michael Rossi is a Northwestern senior who studies Cognitive Science and wishes to pursue a career in medicine. Last summer he volunteered in a needle exchange program (NEP) at The Free Medical Clinic of Greater Cleveland. The clinic works through a van that visits two locations every day, one in the morning and one in the afternoon. Needle exchanges happen in a “one for one” manner, meaning that for every one dirty needle that a client hands in, he receives a clean needle. Every clean needle costs about ten cents. The clinic also offers HIV and hepatitis C testing. Over the summer Rossi recorded information, interacted with the clients, and handed out other needed items including bandages, alcohol swabs, and condoms. Ninety-nine percent of the population that The Free Medical Clinic of Greater Cleveland serves is 200% below the poverty line.

Intravenous drug users, who are believed to inject themselves over 1,000 times a year, are at high risk for contracting pathogens such as HIV and hepatitis C. NEPs are initiatives that are meant to keep dirty needles that may possibly be infectious out of circulation. The National Academy of Sciences, CDC, and WHO believe that NEPs help reduce the spread of HIV while not encouraging drug abuse. When Cleveland first legalized needle exchange in the city in 1995, 17% of new HIV infections were associated with intravenous drug use. The Cleveland Department of Public Health says that number has since fallen to 3.4% in 2009.

Image Courtesy of cleveland.com

Image Courtesy of cleveland.com

NEPs seem like a public health no brainer right? Not all politicians think so. Currently the United States is the only country in the world to prohibit the use of federal funds for NEPs. Though the lack of federal funding is clearly an obstacle, many programs can exist through local and private funding. The state of Ohio has even greater challenges, for The Free Medical Clinic of Greater Cleveland is the only legal program in the whole state. In comparison, Illinois has a number of programs in Belleville, Champaign, Chicago, Kankakee, Rockford, and Springfield. Unlike the rest of Ohio, NEPs are legal in Cleveland because the city’s health department declared a state of emergency. At the time heroin use was spreading out of the city and to a younger, more affluent demographic in the suburbs.

Ignoring health issues among stigmatized populations is not new. AIDS was underemphasized for years because it was primarily seen in homosexual men. In the 80s it was greatly questioned whether mental health was even a concern among the homeless. People want to ignore issues that they do not understand and that are so far removed from their own (more affluent) way of life. During his administration President Clinton tried to lift the ban on federal funding for NEPs, but he said, “It simply would have been reversed in Congress if I’d done it…politically the country wasn’t ready for it.”

Over a decade later, the ban still exists. How do we make the general public care about more taboo health issues like intravenous drug abuse? I would take a lesson from Michael Rossi: GO VOLUNTEER! According to him, “[My experience] totally changed my way of thinking…there was no single type of person that would come to the clinic.” Rossi explained that one client had a particular impact on him. The man was in his late twenties and had grown up in a family that abused heroin. He sold his body on the streets starting at the age of 11 in order to have drug money. Rossi would see him bring in hundreds of needles used separately by him, his mother, and his two sisters. Despite the man’s difficult upbringing, Rossi described him as “just the nicest guy, who also would bring us breakfast sometimes.” It is necessary to meet the people that these issues affect in order to humanize them and understand how they affect people just like us. By taking the time to establish a human connection, we can become a better, more empathetic society.

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