In this volume, international contributors discuss the philosophical basis and history of harm reduction policies and examine their outcomes. They also cover controversial topics related to harm reduction especially conflicts between the public health system, where most programs are located, and a worldwide criminal justice system that further marginalizes drug users. The book describes programs from the United States, the United Kingdom, Canada, Brazil, The Netherlands, Switzerland and Australia.
Chapter 3: The Coming of Age of Needle Exchange: A History Through 1993
The Coming of Age of Needle Exchange: A History Through 1993
Needle exchange programs (NEPs) emerged in the mid to late 1980s as a strategy to address rapidly increasing rates of HIV and other infections among injection drug users (IDUs). In many parts of the United States, when they began, NEPs were illegal, often unwelcome in the very communities that were hardest hit by injection drug use and opposed by leaders in public health and drug treatment. The social history of how and why these programs developed not only provides a context for evaluating the public health costs and benefits of NEPs but also illustrates the interaction of public health officials, community and activist ...