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Opponents of needle-exchange programs should think about their message to drug users

tin also translates the problem into dollars. A 2005 report from the Centers for Disease Control and Prevention (CDC) estimates that the lifetime treatment cost for a person with HIV is $155,000. With 40,000 people being infected with HIV each year, lifetime treatment for those infected in just the past five years is projected to cost $31 billion. "The CDC estimates that only 1,300 cases would need to be averted annually to make a full-scale program of syringe exchange and disposal for IDUs economically effective," Martin said.

Other countries, particularly the Netherlands and Australia, have demonstrated that supplying drug addicts with clean needles in exchange for their used ones is an effective means of reducing the incidence of blood-borne diseases. Addicts receive a clean needle for every used one they turn in; this limits careless and dangerous disposal of contaminated needles. A 2002 report from Australia estimates that over the decade of the 1990s, Australia's NEP helped avoid 25,000 cases of HIV and 21,000 cases of hepatitis C. In U.S. dollars, Australia's investment of more than $71.8 million for the NEP resulted in a savings of between $1.3 billion and $4.1 billion.

Martin noted that the contrast between Australia and the United States is "particularly striking," as evidenced by a presentation that physician Alex Wodak made during a 2002 Baker Institute conference on "Moving Beyond the War on Drugs." Wodak, who helped persuade the Australian government to support NEPs, reported that in 2000, the rate of 14.7 new AIDS cases for every 100,000 Americans was dramatically higher than the rate of 1.1 new AIDS case for every 100,000 Australians.

During the 1990s, a small number of U.S. cities experimented with NEPs. The most carefully studied program was in New Haven, Conn., where researchers estimated that the HIV and hepatitis B transmission rates dropped by approximately one-third during the first two years of the program.

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Contact: B.J. Almond
balmond@rice.edu
713-348-6770
Rice University
23-Mar-2005


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