March 31, 2014

What of Needle Exchanges?

When I studied media in college, my first radio doc piece was on the mobile needle exchange in Philadelphia, which operated out of a van like the one seen above.

The Stinkin-Thinkin Blog has asked me to weigh in on the question of needle exchange programs, and whether or not it’s “christian” to support them. I don’t know how well I can address the question because I am an atheist, and because I’m a libertarian who sees needle exchange programs as only a half measure to the ultimate harm reduction policy: legalize and allow a free market for all drugs (and paraphernalia, including needles). So what I’ll do, is just write in a bit of stream-of-consciousness style on the subject.

I was a problematic user of all sorts of drugs and alcohol, but my main focus for 5 years was injecting heroin and cocaine. At that time, I lived in Massachusetts, where it was illegal to possess hypodermic needles without a prescription from a doctor, and it was said that you could go to jail for 6 months for having a needle. Next door, in Connecticut, you could walk into any pharmacy without a prescription and purchase a 10 pack of needles for $2.50, which works out to 25 cents apiece. Not bad pricing, especially since I would usually be injecting about $25 worth of drugs at a time which would mean that if I used a fresh needle every time, then it would only cost 1% of the cost of the drugs it was being used to inject. That price would be ideal, because if I could scrape together that much money for the drugs (and I often came up with hundreds of dollars a day for drugs, through many illegal activities), then the needle shouldn’t be a problem. I must also mention, that in my area, individual needles could be purchased on the black market for 1-3 dollars each, which meant that most junkies were paying up to 12 times the price of what a needle cost in the free market in nearby CT. So in reality, needles aren’t really cost prohibitive – it’s the law that actually prohibits people from using clean needles.

Unfortunately, needles were still illegal to possess where I would be scoring and doing my drugs in Holyoke and Springfield MA at the time, and needles are much harder to hide than drugs. So driving around with them is risky, storing them is risky, and when you run out of needles because you ditched or broke them in a mad dash to hide them upon seeing the cops, a half hour trip into CT and back before you get your first dose of drugs for the day is really not practical for a fiend. And there were a lot of cops to dodge while buying drugs, being white is basically a crime in many parts of Springfield and Holyoke, and will result in getting you searched in a second.

So that’s my situation having a car, but half the time of this period of my life I didn’t have a car. So I was taking busses and walking long distances to keep up my addiction, which meant the needles needed to be kept directly on me, and that just compounded the situation. What’s more, most of the other junkies I knew, especially the ones who lived in these areas, didn’t have cars. It was unthinkable to cross the border into CT to buy needles. So, there was a giant black market for needles, and you never were quite sure if they were unused or not. Often, they were coming from diabetics who lived in the ghetto, and they were used. So you’d try to be careful, wash them out with hot water or bleach when possible, but everything about the whole situation actually incentivized either sharing needles, buying them from shady sources, or reusing them until they were so dull that they almost wouldn’t go into your arm. Sometimes, the needles were so damaged that after I did finally manage to get it into a vein, it was sort of hooked at the tip, and would tear at my vein and skin when I pulled it back out, resulting in a lot of bleeding.

So, do I support needle exchanges? Sure. But with a few caveats – I don’t think the government needs to fund them because they’re basically unnecessary if you can freely buy needles at any pharmacy, and you don’t have to worry about going to jail for possessing them. So what the government should do about it in my opinion, is to undo all the legal blockages to free and open needle use and trade. It seems that much of this has been done at this point, yet for example, you’ll still lose your license to drive for a full year if you’re convicted of possession of a hypodermic syringe, such penalties make it hard to use a steady stream clean needles, whether you have access to them or not.

Back when I was using needles (97- feb 02), there was a needle exchange program in Northampton MA, which was another 20 minute drive north of Holyoke. It wasn’t an exchange so much as it was just a needle giveaway, and they gave out bleach kits for cleaning needles, and condoms, and health info too. I went there a few times when I was driving, but again, when transportation became a problem, it was just as unrealistic for people bound to the ghetto areas to go to Noho as it was to take a jaunt down to CT. The one perk of the exchange was that they’d give you a card which would supposedly get you out of jail free from paraphernalia charges when you get caught with needles, but there were caveats. You could still be arrested for having needles, and an arrest is an arrest, it’s not fun, it stands in the way of you getting high for the day, and the needle gives the cops probable cause to do a full search. Also, even though many supposedly did, no courts were really legally bound to honor it, they could still put you away for having needles if they wanted.

Is it christian to support needle exchange? I don’t fully know. I feel like altruism is some part of christianity, and therefore giving clean needles to those in need would be ok – except for the fact that clean needles may not be what they really need. A way to get over their substance use problem is what they need. That’s a whole other issue, and that’s what I really try to address on this blog – how we can really help people to change their substance use habits. I believe exchanges could be a point of outreach to get people help, but at this point, the help which is offered isn’t very helpful at all, and by filling people with self-defeating beliefs, it may actually be harmful instead.

In general, I’m all for harm reduction approaches to addiction, and the best step we could take towards reducing harm is to move towards full legalization of all drugs and paraphernalia. All of the practical difficulties and mixed-up incentives that the law creates around possessing and using syringes which I described in my experience above are nothing compared to the problems created by drug prohibition. Sure, if IV drug users didn’t have to struggle to get, keep, and use clean needles, then they would be at less risk for contracting various diseases – but if they didn’t have to involve themselves in a criminal underworld and black market in the first place in order to voluntarily use drugs on their own bodies (which is not a crime that violates anyone’s rights), then they wouldn’t waste their lives away on this nonsense of the drug chase, they wouldn’t get involved in crime, they could probably get their daily fix for the price of a pack of cigarettes and go about living their lives. It wouldn’t be ideal, and I don’t think it would be a great life, but it would seriously reduce the harm of drugs, which mostly comes from the problems imposed by the law. So if I had to choose a pet harm reduction cause, it would be legalization – but that’s not a battle I think I can win on this blog.

Practically, it would be far easier for IV drug users to simply buy their needles from the countless pharmacies already in operation everywhere. The monetary cost is cheap, and not out of reach for drug users, and the points of distribution are accessible. It wouldn’t make sense to try to set up a bunch of needle exchanges all over the place, and the regulation involved would make this a slow moving and impractical solution. The infrastructure to get clean needles is already in place, it just needs to be freed up, and the users need to be freed up to possess needles without fear of being punished for it.

With all of that said, I support anyone’s right to set up a needle exchange program – it’s just not something I get too excited about. I think there bigger and more effective fish to fry. In my personal view of morality, which is a decidedly Objectivist one – if you objectively judge needle exchange programs as something that would benefit you either directly or indirectly, and as a value high on your list as weighed against your other values, then you should support them in any way possible, as long as you don’t force others to pay for the programs. Thus in my life, I don’t do anything to financially support any needle exchange programs, and I wouldn’t support any legislation which would dedicate tax dollars towards them. I think far more could be done by simply removing the penalties for possessing syringes and allowing for the free trade of syringes.  But who will fight for that?  Slashing laws and decriminalizing syringes doesn’t create any new government jobs, and the people who would benefit most by decriminalization aren’t in a position to fight for it.


  1. Steven, That’s an awesome article. Also, I really appreciate your perspective on this. You offered a big picture exploration of the idea by explaining the how the necessity of a needle exchange is evidence of a really short sighted system. Excellent.

    I thought that the question the pastor asked was interesting because it got me thinking about how so many of our policy makers are religious and might filter their decisions through a Christian filter. How could they not? And if they do, it might be useful to figure out how to help them reconcile it.

  2. I have mixed emotions on needle exchanges. I can see both points of view, but I am leaning heavily in favor of it. It appears that the “powers that be” are attempting a process called “natural selection”, where they are making sure that the intravenous drug user dies of the disease. In my opinion this is wrong. People have a right to protect themselves, regardless if it is considered wrong in the society they are a part of. This can be considered a victimless crime that is a matter of choice. In some societies this is legal. Outlawing needle exchanges forces the user to hit bottom very quickly. That may be why these laws are enacted. If this is the intent, which I believe it is, it is very wrong.

Speak Your Mind