Vermont Legislative Research Shop

The goal of needle exchange programs is to play a role in reducing the transmission of the HIV virus and other blood-borne infections associated with drug injections. An individual can exchange a used, potentially contaminated needle for a sterile one. "Seventy one percent of all AIDS cases among women are linked to injection drug use; 58 percent of children with AIDS were infected through their mothers who injected drugs or had sex with an injection drug user. The yearly cost of a syringe exchange program is often less than the cost to treat a single person with AIDS. Needle exchange programs have been shown to reduce HIV transmission by as much as 33 percent" (http://www.state.nh.us/gencourt/bills/chaptered/97chapters/0315-hb0225.htm). In 1998 Congress permanently banned federal funding for any needle exchange programs. The 134 needle exchange programs in existence are funded by a combination of state, local, and private funds (National Conference of State Legislatures, http://www.ncsl.org/ programs/health/list.htm).

American Academy to Pediatrics, American Academy of Psychiatrists in Alcoholism and Addictions, American Medical Association, American Pharmaceutical Association, American Psychiatric Association, American Public Heath Association, American Society of Addiction Medicine, Association of State and Territorial Health Officials, National Academy of Sciences, National Association of Psychiatric Health Systems, National Association of Social Workers, National Association of State Alcohol and Drug Abuse Directors, National Black Caucus of Legislatures, U.S. Conference of Mayors, and the World Health Organization (U.S. Conference of Mayors, http://www.usmayors.org).

University of California at Berkley and San Francisco study:

Conducted in 1993 for the Department of Health and Human Services, this study, reviewed and analyzed current literature on needle exchange programs. The study found that:

• Needle Exchange Programs (NEPs) served as a bridge to other health services, particularly drug abuse treatment.
• NEPs are effective in reaching long time drug users with limited exposure to drug abuse treatment.
• There was no evidence that NEPs increased the amount of drug use among participants.
• NEPs did not result in an increase in the number of discarded syringes in public places.
• The rates of HIV drug risk behaviors were reduced in needle exchange participants.
• NEPs were associated with reductions in Hepatitis B among injection drug users. (Department of Health and Human Services, 1998, http://kali.ucsf.edu/topics/needle _exchange/2098.3fe5.html)

• NEPs are effective in removing used, sometimes HIV-contaminated needles and syringes from circulation and replacing them with sterile ones.
• NEPs are effective in recruiting IDUs to entered drug treatment.
• HIV prevalence in syringes returned to NEPs decreases.
• Mathematical models of NEPs estimate substantial decreases in HIV transmission among NEP clients, (http://www.caps.ucsf.edu/publications/needlereport.html#Q).

National Institute of Health (NIH):

In 1997 NIH published a report that concluded that NEPs: "show a reduction in risk behaviors as high as 80% in injecting drug users, with estimates of a 30% or greater reduction in HIV." The report also found no change in current levels of drug use associated with needle exchange programs. (National Institute of Health, 1997, http://www.hhs.gov/news/press/1998pres /980420b.html)

United States Conference of Mayors (USCM): (http://www.usmayors.org/uscm/ uscm_ projects_services/health_HIV_AIDS/documents/syrng_exchng_97.html)

During their meeting in July of 1997 a resolution was adopted calling for an end to the federal ban on needle exchange programs. They noted that needle exchange programs can serve as a bridge to drug treatment and are also helpful in HIV prevention, (AIDS Information Exchange Volume 13, Issue 3, August 1997).

National Conference of State Legislatures. 1998. "Tracking Trends: Needle Exchange Programs." Issue Brief, 6/17/98. http://www.stateserv.hpts.org/public/issueb.nsf/970e745f9e50ddca852564f0007b3abd/b65107addb14db9d85256626005e1954?OpenDocument

National Institute of Health. 1998. "Needle Exchange Programs: Part of a Comprehensive HIV Prevention Strategy." NIH Fact Sheet. http://www.hhs.gov/news/press/1998pres/980420b.html.

U.S. Conference of Mayors. 1997. "AIDS Information Exchange (Volume 13, Issue 3, August 1997) http://www.usmayors.org/uscm/uscm_projects_services/health_HIV_AIDS/documents/syrng_exchng_97.html

U.S. Department of Health and Human Services. 1998. "Review of Scientific Data on Needle Exchange Programs." http://kali.ucsf.edu/topics/needle_exchange/2098.3fe5.html. Memorandum, April 9, 1998.

Public Health Impact of Needle Exchange Programs in the United States and Abroad, Prepared by the School of Public Health, University of California, Berkeley and the Institute for Health and Policy Studies, University of California, San Francisco—Prepared for the Centers of Disease Control and Prevention, (http://www.caps.ucsf.edu/publications/needlereport.html#Q)

*As of July 15, 1998

Source: (http://www.ncsl.org/programs/health/list.htm)

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Completed by Paul Kapsch, Matt Landi, Sarah Schwartz, April 8, 1999