Now that HIV is no longer a death sentence and opioids are more fatal than ever, the costs of drug addiction are far higher than they were—and the benefits of reduced HIV infections are lower
Save time by listening to our audio articles as you multitask, one of 185 syringe-exchange programmes across America. Having started as an underground effort by non-profit groups in the 1980s, such exchanges took off as theepidemic burgeoned. The logic was simple: if barriers to obtaining needles were removed, drug users would stop sharing them and rates ofinfections would fall.
Critics feared that harm reduction would encourage drug use. Upon launching a pilot needle-exchange programme in New York City in 1988 the city’s health commissioner was accused of running a genocidal campaign against black constituents. That same year Congress banned the use of federal funds for syringe exchanges.
Decades of research prove that these programmes curtail disease. Junkies are in fact less prone to sharing needles when they get free ones. That sharply decreases rates of blood-borne illnesses. In 2014 an analysis found that every dollar spent on syringe exchanges spares the government around $7 in-related health-care costs. Needle exchanges opened across America and Europe. For years no one detected the feared rise in substance abuse.
That was before the opioid crisis plagued America and economists started looking into the trade-offs. A new study by Analisa Packham published in theuncovers an uncomfortable truth: this particular harm-reduction tool does lots of harm. Ms Packham compares how drug users fared in counties that opened syringe exchanges between 2008 and 2016 with those in counties that did not. Before the clinics opened, upticks indiagnoses or overdoses in one set of counties were mirrored in the other.
Ms Packham notes that when fentanyl hit the market in 2013 the danger posed by needle exchanges increased. The synthetic stuff, which is 50 times more potent than heroin, is responsible for most American overdoses.