The needle exchange program is a social program that facilitates the provision of clean needles for use during drug administration and safe disposal of used needles and used condoms beside provision of health advice and treatment services to the sick. The program was activated by the spread of Hepatitis B and the spread of HIV pandemic that were claiming more lives. The program helped in reducing the spread of HIV and Hepatitis through the provision of sterilized needles and syringes to the health facilities besides providing clean and safe disposal of used needles.
The needle exchange was delivered differently to the people and other medical facilities in the society. This included fixed sites, mobile and outreach programs, syringe vending machines and pharmacists as discussed hereunder. The sole purpose of this article is to analyze and discuss the needle exchange program, its mode of application, barriers and the impacts it had on the community. The research is based on the analysis of the academic journals and articles and the findings analyzed as detailed in this article.
The needle exchange program is a social program that facilitates the provision of clean needles for use during drug administration and safe disposal of used needles and used condoms beside provision of health advice and treatment services to the sick (Pillips, 2018). It is a community based-program that aims at creating awareness of the importance of safe disposal of used needles and condoms (Widell & Flamholc, 2017). The program aims at reducing the harm, blood and body fluid transmitted diseases in the community besides providing a clean and safe environment to the people in the community.
Many people in society illegally possessed a lot of drugs and needles that were used for different purposes (Delfosse et al, 2018). Their use in administering drugs to the users was a health hazard. The disposal of the used needles and other tools like syringes and condoms led to increased health hazards (Agrawal et al, 2017). In the 1980s, there was an increased infection of HIV/AIDS among the people in the world (Sharp & Hahn, 2011). This was attributed to the use of infected and unsterilized needles that were used. Some infected needles that were disposed of poorly and unsafe. Apart from HIV infection and spread, the poorly disposed of needles were also reported to be an agent for the spread of other diseases that are transmitted through body fluids like hepatitis (Sharp & Hahn, 2011). The people also experienced dangers of being injured by the naked needles and experienced disease like tetanus that claimed more lives. This catalyzed the need for a needle exchange program that will provide safe drug administration to the drug users and clean and safe environment free from health hazards.
The needle exchange program commenced in the 1970s as informal initiatives undertaken by the people (Pillips, 2018). The Netherlands government was the first to approve the program being undertaken by mid-1980s followed by other initiatives. The program was activated by the spread of Hepatitis B and the spread of HIV pandemic that were claiming more lives. The program helped in reducing the spread of HIV and Hepatitis through the provision of sterilized needles and syringes to the health facilities besides providing clean and safe disposal of used needles (Widell & Flamholc, 2017). The awareness programs through the umbrella of needle exchange programs facilitated the education of the drug users on the safer injecting practices that minimize harm, management of drug dosage and safe handling and disposal of used needles and condoms. This program helped the patients manage themselves and took caution during the drug administration and the end result was reduced HIV and Hepatitis infections (Bruneau et al, 1997). Other services provided in this program included the supply of fresh condoms and safe disposal of the used ones. This helped in the prevention of HIV and another sexually transmitted disease like HPV, syphilis, and Gonorrhea that was spreading at a higher rate and claiming the people’s lives.
The needle exchange was delivered differently to the people and other medical facilities in the society (Gilchrist et al, 2017). This included fixed sites, mobile and outreach programs, syringe vending machines and pharmacists as discussed hereunder. To begin with, the fixed sites where drugs are sold and bought openly. They are shops with the receptionists that help the clients by receiving the used needles and issue them with new sterilized ones. They also facilitate delivery of other health services like healthcare testing and counseling of the HIV and other STDs victims and condom supply.
In addition, mobile programs are offered through vans and buses that facilitated the exchange of the needles and syringes (Gilchrist et al,2017). The outreach programs are also carried out when there is inadequate funding for the needles. This outreach program is mainly carried out to supplement the fixed and mobile programs, especially where the drug users do not engage with established services. During this program, the outreach workers in encourage people who inject drugs to use the already existing fixed and or mobile sites in acquiring and disposing of the used needles and condoms. Furthermore, the program is facilitated through syringe vending machines especially in Netherlands, Germany, Italy, and Australia to supplement the other modes of delivery (Noroozi et al, 2015). These machines accept coins and tokens in exchange for harm reduction packs. They pack several clean sterilized needles, syringes, sterile water, spoons, cotton wool and alcohol swaps, and educational materials. These machines are usually mounted outside the fixed sites and provide the services 24 hours a day and 7 days a week.
Finally, the services can also be accessed through pharmacies through direct selling of the needles and syringes to the drug users besides exchanging harm reduction kits for vouchers (Fernandes et al, 2017). This mode accessed many people since its network is well established and the large group of people can easily access these services. They are operational to only some hours although they are more convenient to the users. This mode is only limited to low-income countries and some of the pharmacists are reluctant to sell and dispose of the used needles and condoms.
The global coverage of the program is inadequate covering only 43% of the countries with documented injecting drugs providing 200 clean and sterilized needles per person per year. As per 2016, there were 158 countries which reported people that inject drugs but with only 90 countries embracing the needle exchange program (Noroozi et al, 2015). Countries like Kenya, Dominica Republic, Jordan, Senegal, and Colombia implemented the program between2012-2014 although there was a halt in the implementation of these noble programs. The coverage of the program worldwide based on the research conducted by the world health organization (WHO), a total of 17 countries have established the sites for the programs that integrates all modes of delivering the needle exchange programs (Joseph et al, 2014).
In Eastern Europe and central Asia, all the 29 countries and territories have the program working (O’Keefe et al, 2017). The report by Eurasian Harm Reduction Network estimates that only 10% of people who inject drugs in Eastern Europe and 33% in Central Asia are able to access the services. In addition, only 19 out of 23 countries of western and central Europe and North America have the programs working in their established sites that have the integrated modes of delivery. Furthermore, only 2% of people that injects drugs access the services in Latin America with only 0.3% syringes distributed per person per year as per 2010 review (McCormack et al, 2016). The same program is being embraced in the Middle East and North Africa although the services are not adequate to serve all the persons that inject drugs (Noroozi et al, 2015). In sub-Saharan Africa, only five countries out of 54 have the program running including Kenya, Mauritius, Senegal, South Africa, and Tanzania.
This noble program besides helping in curbing the spread of blood and body fluid transmitted diseases and reducing the harm to people, its implementation has continually faced a lot of challenges and barriers both legally and physically (Dawson et al, 2018). Legally, the initiative is challenged through legal restriction where only the persons injecting drugs of 18 years and above can only access the services making the young ones do it secretly exposing them to danger and hazards besides the drug users being detained in centers. Additionally, the program receives inadequate or no political support and funding in many countries (Goodin et al, 2018). This results when the priorities are changed by the government for example in 2016, the amendment changed the resources used for needle exchange program locally and internationally to human resources and syringe disposal. In addition, stigma and discrimination in places where the needles are purchased increase community disapproval preventing many people who are drug users from accessing the services (Dawson et al, 2018). The increased stigma and discrimination from the health workers make the drug users get the services in a sensitive less manner.
Furthermore, many countries worldwide have criminalized injection of drugs and this contributes to a major barrier to the drug users from accessing the services of the needle exchange program (Peters et al, 2016). Most people using the criminalized drugs substances have to use their types of equipment in secrecy and this is a very unsafe way of administering and disposing of the needles. The drug users found are usually threatened, abused, extorted, arrested and charged in a court of law making it very difficult for the drug users to freely access the services and face the dangers of health hazards (Goodin et al, 2018). Geographically, the places where the needle exchange sites are located are limited posing challenges as the people have to go long way especially in interior and rural areas and in places where they are, the operating hours are limited and this poses a great barrier for the drug users.
The program has had both positive and negative impacts as established by the united state General accounting office (GAO) and the University of California (Beletsky et al, 2015). This is because the program operates in a rapidly changing environment and with strong evidence that emerged from recent research by the two above bodies proves that both positive and negative impacts have been experienced. Positively, there have been reports of reduced pools of infected needles that immensely reduced the drug-related risks (Treloar et al, 2015). This has led to the reduced spread of blood and body fluid transmitted disease and curbed new infections (Delfosse et al, 2018). The program has negatively increased drug usage that led to increased contaminated needles that were unsafely disposed on streets and in villages, especially where the drug users encountered some barriers.
The needle exchange program is a social-based program that facilitates the provision of clean needles for use during drug administration and safe disposal of used needles and used condoms beside provision of health advice and treatment services to the sick. The program helped in reducing the spread of HIV and Hepatitis through the provision of sterilized needles and syringes to the health facilities besides providing clean and safe disposal of used needles. The awareness programs through the umbrella of needle exchange programs facilitated the education of the drug users on the safer injecting practices that minimize harm, management of drug dosage and safe handling and disposal of used needles and condoms. The program has global coverage of 43% of the countries with documented injecting drugs providing 200 clean and sterilized needles per person per year. As per 2016, there were 158 countries reported people that inject drugs but with only 90 countries embracing the needle exchange program. This program faced a lot of challenges and barriers both legally and physically beside helping in curbing the spread of blood and body fluid transmitted diseases and reducing the harm to people, its implementation has continually. This has led to the reduced spread of blood and body fluid transmitted disease and curbed new infections although it has negatively increased drug usage in the community that led to increased contaminated needles that were unsafely disposed on streets and in the village.
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