In defense of giving drug users free needles

Yellow Pad Inez Feria-Jorge

Posted on July 13, 2015

In 2007, less than 1% of Cebu’s population of people who injected drugs (PWIDs) tested positive for HIV (human immunodeficiency virus). In only six years that number grew to an alarming 48%.

Hoping to curb the epidemic of HIV and Hepatitis C, the local government of Cebu -- together with the Department of Health, the Dangerous Drugs Board, and several nongovernment organizations -- embarked in an operations research that provides PWIDs with clean syringes and other treatment and counseling services. As part of this research project, they established a “safe zone” where PWIDs and health workers cannot be arrested for possession of drug paraphernalia as long as it’s in relation to the study.

When officials advocating against illegal drugs caught wind of the study, there was an immediate call for it to be stopped, fearing that we were “sending the wrong message.”

On the surface, anti-drug advocates’ concerns may seem understandable. It did seem like we were surrendering to drugs by giving people the tools to use them. Yet, countries all over the world, Eastern and Western, have undertaken similar programs. What do they and local supporters of the program see that anti-drug advocates don’t?

HIV is primarily transferred among PWIDs through the sharing of infected needles, and crosses to other populations through sex among spouses and partners and sex workers. By providing clean syringes, we dramatically reduce the risk of HIV infections through needle sharing.

Decades of evidence the world over shows us that this is what needle distribution programs do: they help. They not only decrease HIV prevalence but they also decrease the number people who start injecting drugs, and they increase people pursuing further recovery, counseling and rehabilitation. This type of preventive intervention is also thousands of pesos cheaper than lifetime ARV (anti-retroviral) treatment. The cost to prevent one HIV infection has been calculated at $4,000 to $12,000, considerably less than the estimated $190,000 (listed in 1997 dollars) medical costs of treating a person infected with HIV .

This is the question Senator Vicente Sotto III raised when he brought this operations research to stand at the Senate, demanding its immediate cessation. With all the drug-related headlines plastered on the news and our government’s staunch crusade against the “drug menace,” why are we allowing a program like this to exist?

The reality is we’ve been trying to address the drug problem for decades now with our punishment-oriented policies, “Just Say No” education, and abstinence-focused treatment. Sen. Sotto himself has led anti-drug programs for more than two decades based on such dogma.

Yet, with 1.8 million people allegedly dependent on drugs in our country now from the mere 20,000 estimated in 1972, the evidence is clear: these traditional, moralistic approaches that focus on punishment do not work. All they have done was push people who use drugs to the margins of society when they need help most -- discriminated against or thrown into prison instead of being given the treatment and compassion they need.

And that is the message the needle distribution program hopes to change.

Human rights is at the core of needle distribution. It isn’t about condoning drug use. What needle distribution programs all over the world do is offer what society has denied -- acceptance and understanding.

Needle distribution is only one of the many harm-reduction interventions the world is turning toward as we turn away from the decades-long war on drugs.

Harm reduction isn’t just about giving away free needles to prevent HIV -- it’s a philosophy grounded in respect, human rights, and free will.

It’s teaching people how to drive or wear seatbelts so they don’t crash into pedestrians, or telling our kids to call us if they feel they might be too drunk to get themselves home. It’s giving people honest education so they’re better armed with facts instead of fear.

Harm reduction recognizes that everything we do carries risk. But instead of just telling people not to do something and reprimanding them when they do, it teaches people how to minimize that risk without moral judgment.

One problem that the needle distribution operations research faces is the legal repercussion of giving drug paraphernalia. Sen. Sotto believes that even under the banner of research, which the law expressly states the Dangerous Drugs Board and the Department of Health should be allowed to do, the program is in conflict with our drug laws.

But if legislation is what is needed to guarantee the Safe Zone for the study, then why shouldn’t lawmakers pursue it? Why shouldn’t we prioritize the lives of real people suffering a real problem?

We need to ask: What problem are we trying to solve by putting nonviolent people in jail? How would a congested jail cell help a person addicted to drugs or living with HIV?

The number of new HIV infections are rising every month. In 2014, we arrested 17,074 people for drug-related offenses. That’s more than half the capacity of our prisons that are already holding more than four times their capacity, almost half of which are people incarcerated for drug-related crimes.

Currently, more than 90% of people arrested for drug-related crimes have yet to see trial. They can languish in jail for years waiting for a sentence that might be shorter than the time they are detained. Some of them die without knowing how long they are supposed to be in jail, isolated from society, their friends, and their family.

Last June 26, we celebrated the UN International Day Against Drug Abuse and Drug Trafficking with the “Support, Don’t Punish” campaign. More than 150 cities all over the world joined the call for a health and human rights-based approach to the drug problem and an end to the war on drugs. Even the United Nations and the World Health Organization have globally called for alternatives to criminalizing and incarcerating people who use drugs.

It is time for the Philippines to join that call and embrace progress.

We need to look at other options proven to work instead of continually allowing ideology to trump evidence.

Our Constitution proclaims: “The State values the dignity of every human person and guarantees full respect for human rights.”

Harm reduction interventions like the needle distribution program do exactly that.

Inez Feria-Jorge is the executive director of NoBox Transitions Foundation. This essay, a team effort, excludes the list of references because of space limitations for columns. For those interested in more information, get in touch with NoBox Transitions Foundation, Inc. at sayhello@noboxtransitions.org.