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their health and well-being.

Needle exchange programs are an example of harm reduction, an approach to drug use that respects the autonomy that people deserve to have over their own bodies. The traditional social services approach to drug use offers quitting drugs as the only positive option; in contrast, the harm reduction approach encourages service providers to strategize with drug users about how they can reduce the harmful effects of drugs on their lives. Needle exchange programs are an effective harm reduction intervention, as clean needles are a resource that many active drug users are interested in taking advantage of, and one that makes their lives safer. The Harm Reduction Coalition states that one principle of harm reduction is that it "affirms drugs users themselves as the primary agents of reducing the harms of their drug use."

This reflects the idea, central to harm reduction strategies, that people are experts on their own experience. The emphasis on the agency of drug users is crucial. When drug users seek out clean needles, they are taking control of their lives and taking steps toward self-care. A New Jersey health education worker said of drug users, "When they take part in needle exchange, it means they're starting to take an interest in their health. That's the first step." The presence of resources like needle exchange programs is an opportunity for drug users' to take control of their health; this process of taking control is a powerful antidote to the feelings of powerlessness endemic among people who struggle with addiction and whose very existence has been criminalized.

Needle exchange programs have a direct positive impact on the physical space of neighborhoods, because when used needles and syringes are exchanged, it reduces the number of needles and syringes littering the streets. The presence of dirty needles and syringes in communities is extremely unsafe for all community members, but especially children who may not understand the dangers of such objects. Dirty needles and syringes are dangerous not only because they can hurt people, but because they can be a source of disease transmission.

In September 2006, when needle exchange programs were still illegal in New Jersey, a resident of Camden, N.J. was quoted in support of legalizing the programs, explaining that "right now, they're disposing of these things in our back alleys, in our playground where our kids are getting pricked." (Jones 20) The presence of dirty needles and syringes in public spaces, especially spaces that children frequent, is a significant public health problem unto itself. The presence of needle exchange programs is at least a partial solution to this problem.

Needle exchange programs reduce the risk of HIV, provide a channel for other services and information to reach active injection drug users, support these individuals in acting as agents of their own self-care, and help fight the disposal of dirty syringes and needles in places where they could injure and/or infect people. Unfortunately, Congress is swayed more by political and economic power than the opportunity to prevent the infection of individuals who are seen as criminals. For the sake of injection drug users, whole communities that are affected by drug use, and indeed everyone impacted by the HIV/AIDS epidemic, Congress ought to follow through on their promise and reverse the federal funding ban on needle exchange programs.

Learn more about this author, Jamie Korf.
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