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Bioethicist: Slashing funds for clean needles is risky for rest of us


Giving clean needles to IV drug addicts saves lives – and money. That’s why the federal government should be spending your tax dollars to keep drug users -– and the people who have sex with them -- from getting AIDS and hepatitis.

But Republicans in Congress have decided that despite a veritable mountain of scientific evidence showing that needle-exchange work, they are not going to pay for this sort of program any more.

They just yanked it out of the end-of-year spending package.

Shouldn’t public health policy be guided by the best evidence we have about what reduces the dangers and costs of AIDS and hepatitis?

Studies done over more than 15 years across the U.S. and in Australia, Hungary, Holland, Ukraine, Canada, Portugal, Switzerland, Brazil, Belgium and Germany show that there is no doubt that needle- exchange programs lower infection rates for HIV and hepatitis C.

Less infection not only means fewer deaths, but lower costs associated with caring for infected people. 

So what reason might Congressional Republicans or anyone else have for deciding to ignore the evidence and let people die, increase the infection rate and add to the cost of your medical insurance?

It’s not about the money. These programs are inexpensive for such a highly effective public health measure.

The reason is a belief that simply won’t go away: Giving out free clean needles sends the message that injecting drugs is OK.  That belief just happens to be completely unsupported by any evidence at all. 

Whatever leads people to decide to ruin their lives by becoming injection drug users, it is certainly not the chance to get free needles. 

Policy involves more than scientific evidence when it comes to touchy subjects like drug addiction. However, morality cannot ignore the facts. 

If needle-exchange programs do reduce risk, suffering, deaths and costs and it is beyond dispute that they do then it is bad ethics to insist on a moral message that is utterly disconnected from the harsh realities of drug abuse.

Art Caplan, Ph.D., is the director for the Center for Bioethics at the University of Pennsylvania.  Follow him on Twitter @ArthurCaplan.