Needle exchange, a famous example of harm reduction in drug policy, trades off prevalence of heroin/opiate use against prevalence of communicable diseases that are transmitted through dirty needles (most prominently, HIV). Tina Rosenberg has an excellent post on the surprisingly progressive drug policy in Iran of all places. Is it fear of dirty needles that is keeping you from shooting heroin? First, there is far stronger evidence that needle exchange reduces disease rates than there is for a resulting increase in heroin prevalence. Even if we admit that a non-negligible fraction of readers may answer "yes, but for dirty needles I'd be shooting up right now," is the deterrent value of maintaining the danger of heroin use really worth that added danger? Remember to factor in the high risk of exponential population-wide mortality increases.
(Source: http://whyy.org/cms/radiotimes/2010/01/22/needle-exchange/)
And yet, dirty needles endure. The issue is not the public health merits of such programs, for which there is sufficient evidence of benefit to convince most health policy scholars. Rather, as Rosenberg writes:
"The problem is the politics. It seems wrong for the government to be muddying a 'don’t-do-drugs' message by supplying the equipment for an illegal and dangerous activity. But to oppose harm reduction only provides the illusion of morality. Surely it is more moral to choose a strategy that does not increase drug use, but does save lives."
BIO:
Zachary Cahn has been in various places doing various things and now does public health policy at the Emory Rollins School of Public Health with a focus on substance control policy.
