Needle exchange

The patterns of anabolic-androgenic steroid use by sportspeople and body-builders, and their physical and psychological side-effects and dependence potential, have been very well reviewed by Brower (2002). Much of the use is by injection, and so many of this population attend needle exchanges, with the advice on reducing infection risks relevant. To increase energy, burn fat and to go through the pain barrier some will use amphetamines and opiates, either street preparations or illicit pharmaceutical supplies. In the UK the opioid nalbuphine (Nubain) has been abused in this way and, in cases where dependence becomes established, detoxification treatments can be necessary. 

Advice and information Telephone help-line Drop-in service Needle exchange Outreach... 

More information is needed about the efficacy of needle-exchange schemes—and for this to happen, more schemes need to be set up. If they prove a failure, we may see extreme legal sanctions on IV drug abusers possessing illegal equipment. 

Guidelines for a needle-exchange scheme set up in the Portsmouth area in 1987, plus notes for users, are given in Tables 8.2 and 8.3. 

The CDT helped establish a practical needle-exchange scheme, utilising chemists shops, and had to consider how to operate a policy of harm reduction in co-ordination with a service aimed at abstention. Even before the ACMD (1988) report on drugs and AIDS was produced, the team reached the conclusion that preventing the spread of HIV must come before any drug-specific goals. This has raised the issue of the attractiveness of the abstinence-oriented service to many users. 

Needle exchange is not the only example of harm-reduction strategies. Another example is providing a safe area where people can use drugs without exposing themselves to being preyed upon by criminals. However, the most famous example of this approach, the needle park in Zurich, Switzerland, was eventually closed due to increases in crime. 

Phrases should be put in quotes if you want them to be matched as phrases rather than as individual words. Examples include needle exchange, harm reduction, and medical marijuana. ... 

Byrne, Andrew. Lessons from 20 Years of Addiction Treatment Look After Individuals and Public Health Improvements Follow. Journal of Addiction and Mental Health, vol. 7, Autumn 2003, p. 20. Drawing on his considerable experience, the author suggests that standardization of treatment is important in order to make programs widely available, but that treatment strategies must also be tailored to the individual. Harm reduction and public health-oriented measures have reduced overdose deaths in Switzerland and HIV transmission rates in Australia, but the United States has been slow to adopt needle exchange programs. 

This section covers advocacy for and implementation of various harm reduction strategies such as needle exchange programs. 

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