IDUs: (Intravenous Drug Users); this is groups of identified drug users, who uses needles to inject themselves with drugs, and were incorporated in a needle exchange program whereby, they were able to start getting sterilized needles to avoid sharing of contaminated needles that escalated the spread of HIV Aids amongst them.NEP: this is a special program created under the umbrella of Aids education program; which ensured that the government funded the provision of sterile needles and other injection apparatus such as Swabs so as to lower the danger of infection of HIV and other disease amongst drugs users.
Intravenous drug use: the use of drugs by drug abuser by means of injecting the drug using needles into their body through the muscles, under the skin, as well as directly into a vein.
Sterile syringes: these are treated syringes and needles that can safely be used by drug users to inject drugs into their bodies without infection and spread of a disease.
HIV aids has been a growing epidemic in the last three to four decades, as the number of infected people grew from ten million in the early 1990s, to over 40 million by the year 2000. Such a rapid trend in HIV Aids spread triggered a huge concern from groups across the world, and people started to debate on ways that HIV Aids spread could be prevented. By 2000, it was identified that in Africa and large part of Asia, HIV Aids was largely spread through heterosexual ways, whereas in the United States and other parts of Europe, the primary factor in the spread of such deadly disease was intravenous drug use.
This was the moment that the US government, as well as various activist groups began to come together to create a program that would see the spread of Aids slowed. As a result, Aids education program was established, and the needle exchange program was put in place to help reduce the spread of HIV Aids. This way, the IDUs were put into a program, whereby, they would get sterilized needles from various NEP centers, so as to avoid sharing of drug injecting needles amongst the population. This way, the spread of HIV Aids through drug injection was reduced.
For decades, millions of drug addicts inject drugs such as heroine into their bodies using syringes and needles. Millions of these drug abusers across the world have found to be using unsterilized needles, as they complain that sterile syringes are not easily available; as well as due to the fact that in some nations, it is illegal for such drug abusers to be caught distributing or in possession of syringes for non-medical use. Due to such restrictions, millions of these drug abusers have been forced to share needles, a trend that has resulted to rapid spread of infections such as HIV and Hepatitis C; diseases that have largely spread in many nations thus reaching the pandemic levels. The spread of HIV and other diseases that are spread through needle sharing had become a key factor of concern amongst communities and groups of people by the end of the 1980s, that some community activist groups started initiating campaigns on needles exchanges.
This way, there was an initiation of government funded programs in many countries including the United States, whereby the government avail funds that help in purchase and supply of uncontaminated needles to drug users, to reduce the risk level of HIV and other diseases spread amongst the drug addicts. However, while the needle exchange program has been termed by millions as a smart move for combating HIV spread amongst drug addicts in the world, a huge group of opponent to the program argues that the needle exchange program is an irrational move that create a serene environment for people to continue using and abusing drugs. In fact, the argument of the opponent group clearly uphold the view that through the use of government funds to provide clean needles is a way of the same government to say that it is tolerating the continued exercise of immoral and illicit behavior. To the opponent group, any government should be vigorously be focused on fighting and punishing drug abusers, discouraging them from abusing drugs, as well as funding programs that provide treatment for the group that is quitting the drugs. This way, a heated debate is created in regard to the rationale of the needle exchange program, as various questions arise on the impact of this program on the overall welfare of a community or a country. Many people ask whether the program helps to reduce the spread of diseases or not; they also want to know whether such programs help increase or decrease drug abuse in the communities. With such questions, this paper will keenly look at the needle exchange program. The fact remains that the needle exchange program is very important, and throughout, I will vehemently discuss the pros and cons of this program, and the reasons as to why it was initiated.
Pros of needle exchange program
One of the key pros of the needle exchange program is that it helps fight HIV/AIDS. According to Tribune de Geneve (2005), it is evident that the needle exchange program yields a number of health benefits to the drug abusers in the world. First, it helps in the deterrence and decrease of IDUs contact to various diseases such as HIV, HCV as well as HBV. For instance, a research done in New Haven, Connecticut in regard to the needle exchange program found out that when the program was initiated, a 33% reduction 9n HIV prevalence was recorded in the a quarter a year after launch. In addition, researches have indicated that there is an 18% yearly reduction in HIV seroprevalence in metropolises that have started using the NEP; as opposed to around 10% increase in HIV seroprevalence in cities and towns that have not adopted the needle exchange program. In addition, research from James (2009); has found out that IDUs who have formerly been integrated into needle exchange program (NEP) are more likely to stop drug injection behavior as well as remain in drug treatment than the IDUs who have not been introduced to NEP. This clearly shows that NEP program is a very vital program in communities, as it helps fight the spread of HIV and other disease spread through injection. This largely impacts on the nursing profession, as they should largely device a mechanism on which they leverage on the NEP program to realize the health concept of harm reduction. They should use their know-how to rightly create impact through NEP in line with the harm reduction concept. This will entail them getting more involved on daily lives of the IDUs, through counseling apart from issuing them with sterilized needles only. This way, the nursing professionals will be able to impact positively on the IDUs welfare in the long-term. Harm reduction concept states that the well-being of a person is of principal importance.
This means that in any society, if the drug addicts groups are not willing to leave their immoral behavior of abusing drugs, they should not be denied services. What should be done is attempt and initiatives to reduce the harm that their habits cause to them and the rest of the world as a whole. Through this point of view, it is evident that the NEP is a program that does not really tolerate drugs, but helps to offer care to the drug users and the general society. The above statistics and argument clearly shows that there is a need to introduce NEP amongst communities in the United States as well as in other nations across the world. With over 100 people in the United States getting HIV infection through drug injection practice daily, it is evident that NEP should be supported and welcomed by all.
The issue of support impact on the nursing profession. Apart from being health care service givers, nurses should use their knowledge and know-how to engage in advocacy campaigns so as to ensure NEP is accepted and supported by various stakeholders across the world including governments and private sector. While there is a lot more that need to be done, including increased education of persons about the ills of drug use, predominantly injection drug usage, in the present day, people and governments should pay attention to the know-how and of nurses who argue that the use of disinfected needles should be made lawfully accessible to the IDUs.
Secondly, NEP improves communities’ welfares and not only the drug abusers, but also their families and the areas of implementation. A critical look at the NEP by Ibrahim (2000) reveals that the NEP function on a one for one basis, and thus they help lessen the presence of infested needles in the roads, community playground as well as in the trash receptacles. This means that through such a program, the number of infected needles thrown away by IDUs are reduced in the playgrounds and thus safeguarding the children who goes out on the open playground to play, as well as safeguarding the welfare of sanitation workers who are always prone to accidental needle sticks. This way, it can clearly be stated that through NEP, there is an improved level of public protection from disposed needles. In addition, NEP also reduces the country’s burden of treating the sickly drug addicts, whose health deteriorate as a result of increased disease infection through injection. For instance, as stated by James (2009); in his medical journal, the United States could have stopped around 10,000 new HIV infections amongst its intravenous drug users between 1987 to 1995; if it heeded to the US activist groups call for universal adoption of Needle Exchange Program. This way, the US as a nation would have saved an estimated budget of around $500 million in healthcare cost. In addition, it is also estimated by the same author that had the US taken actions to adopt and implement Needle Exchange Program in 1997 as it was advised by the activist groups then, it could have prevented an additional 11,000 new HIV infections, a move that could have saved it over $600 million in health care cost. The argument is based on the fact that through a needle exchange program, HIV infections among drug addicts, their children and their spouses could be prevented at $9,400 per person prevented. This is way below the total cost of pay the bill for medication of an HIV infected individual; which comes to around $200,000 over an individual’s lifetime.
In addition, through the needle exchange program, there is an increased protection of families of drug abusers in the world. As Dawn Day, a key global figure who juggles as a catholic priest, as well as “the New Jersey Governor’s Advisory Council on Aids” states, countries should make it their obligation to allow drug abusers, who inject themselves with drugs using needles to have easier access to sterile needles, so as not only to protect their own health, but also protect the health and welfare of their families. Such an opinion is based on the fact that millions of the drug addicts in the world have families. They have wives, babies as well as husbands; whom they affect directly in their drug injection behaviors. So, in case the world abandon this group, and allow them to inject drugs with HIV infected needles, then what as a world we will be doing is exposing their non-drug injecting partners ( wives, babies and husbands) to the risk of contracting these diseases too. This largely impact the nursing profession, as they should not only use NEP to reach the drug addicts, but also create a close connection and relations with the addicts close family members, so as to come up with customized health support for the addicts.
Close ties between the nurses and the addict family members will end up creating a supportive network for the addicts to not only receive sterilized needles, but also medical help and rehabilitation. Given that NEP helps to decrease the level of HIV Aids infection, it is rational that each and every community, city, and country to support it, as it helps not only the health and welfare of addicted drug users, but also their families.
Lastly, a research by Tribune de Geneve (2005); indicate that the needle exchange program helps bring the drug addicts to the rehabilitation centers and treatment programs. Largely, in many states and countries, needle exchange program requires the drug addicts to register themselves with identifiable health centers and community clinics. What this approach does is that it helps to bring the addicts into health centers whereby, they are able not only to get sterilized needles, but also to get other health services such as counseling, rehabilitation services as well as treatment for their addiction. For instance, “The St. John Ambulance building” situated in Pandora Avenue is strategically located two blocks away from Cormorant Street; where the needle exchange program is offered to all drug addicts in the area. This way, the St. John Ambulance building has been made a center where the government offers outreach programs, and social services. The building also houses over 50 nurses and outreach team members; who delivers various social and health care services to the drug addicts who are registered in the Cormorant street needle exchange program. This clearly means that the Needle Exchange Program can be used to bring the drug addicts groups of people closer to social services as well as to key outreach programs.
Cons of NEP
Needle exchange program increases crime. As argued by Strathdee (2004), needle exchange program escalates the crime level in Area of needle exchanges. The fact remains that due to NEP, drug abusers continues abusing drugs, and this results to increased crime. It is evident that when a NEP moves in, drug related crimes and violence such as prostitution, which result to spread of HIV Aids, escalate. A research done in New York City, identified that since NEP programs were introduced in the city, New York had experienced an increase in crime such as loot, shoplift, as addict try to get easy money to buy drugs. Such a trend result to deterioration of communities’ welfare, as investors shy away from such areas, as the illegal activities carried out by the large number of drug addicts’ scares away consumers and law-abiding citizens from doing their business in serene environments. This harms their local businesses thus leaving the place poorer than before.
Secondly, it has been argued that the introduction of NEP programs facilitates the increase of immoral behavior amongst the locals in a certain location. For instance, NEP is linked to increased level of sale and use of drugs in key areas such as Chicago town. Giving drug addicts’ clean needles is not the ideal way to resolve drug addiction crisis in a community. In areas where NEP programs are, drug dealers tend to escalate their levels of drug sale and distribution. Evidence shows that drug dealer largely operate near NEPs, and they tend to go their business of selling hard drugs without impediments from the local police officers, as long as they operate in NEP zone. The nurses involved in NEP, should not only be involved in delivery of sterilized needles, but also in identification of drug sellers, who create this whole problem in the first place. So, nurses should be trained on intelligence gathering, so that they can collaborate with addicts to identify the people who sell drugs, and ruin the lives of millions of people. For instance, a research done in Chicago Downtown; where NEPs are largely located, it was found out that the drug dealers largely hanged around those centers with impunity as they went by with their drug selling business. This clearly shows the level of impunity that arises, in regard to sale of drugs when NEP zones are established. It gives the drug dealers an ample time to easily reach their customers, and thus making it difficult for the police to fight drug trafficking and sale.
Lastly, NEP programs result to low referrals to treatment for drug users. The critics of NEP programs argue that the states may have succeeded in getting the contaminated needles out of addicts reach, but have not resolved the crisis of drug menace and addiction in our societies. The NEP program focus less on drug treatment and this means that in the long-term, it fails to resolve the drug addiction crisis in the world. For instance, since Atlantic City NEP program was launched, only 74 treatment referrals have been made, thus showing the low level of treatment and determination by the program agents to get a permanent solution to drug use and addiction in the communities. This impacts nursing profession, as it requires nurses involved into NEP program to heavily take other new roles such as the role of convincing the drug addicts to not only register for sterilized needles, but also to enroll for counseling sessions and treatment.
Conclusion and recommendation
From the above paper, it is evident that NEP program has largely contributed to the welfare of not only the drug users, but of the entire society as a whole. What this means is that the program helps drug users avoid infections such as HIV Aids, thus safeguarding their welfare and the welfare of their families. However, in a similar manner, such approach has been said to encourage and promote drug use. So, to ensure there is more benefit to it, the nurses involved in the program, need to largely create awareness on the importance of using sterile needles, but also engage the drug users in training and education on the dangers of using such drugs, apart from the infections that the program aims to prevent. This way, the program impact on nursing profession, as it demands them to develop better communication and counseling skills, so as to be able to adequately engage the registered NEP members in creating awareness in regard to treatment of their addictions, as well as importance of rehabilitation from their addictions. So, nurses should not only be involved in collection of used needles, and issuance of newly sterilized needles, but also drug addiction treatment awareness and rehabilitation campaigns.