Drug decriminalisation for HIV
Came across an interesting article arguing for drug decriminalisation on the basis that it will help stop HIV/AIDS spreading amongst needle users. This is an angle I've never come across much before.
The heavyweight Global Fund to Fight AIDS, Tuberculosis and Malaria (a.k.a. "The Global Fund") is behind this message with its Executive Director Dr. Michel Kazatchkine raising the topic at the 20th International Harm Reduction Association conference in Bangkok. In 2006, the Gates Foundation contributed $500 million to the Global Fund, calling the fund "one of the most important health initiatives in the world."
I really like Kazatchkine's key message in regard to the pointlessness of criminalising users...
"A repressive way of dealing with drug users is a way of facilitating the spread of the [HIV/Aids] epidemic," Kazatchkine said. "If you know you will be arrested, you will not go for treatment. I say drug use cannot be criminalised. I'm talking about criminalising trafficking but not users. From a scientific perspective, I cannot understand the repressive policy perspective."
And the use of harm prevention tactics...
"The one population where [Aids] mortality has been untouched - and in fact has worsened - has been IV [intravenous] drug users. It's amazing, because what we call harm reduction, such as exchanging needles, has been scientifically proven as the most effective."
I can also understand how harm prevention tactics such as needle-exchanges are limited in their adoption with the "common sense" thinking along the lines of "you're going to give those junkies what!? needles!? but they'll just go and shoot up more - you're encouraging it!"
It's one of those things that doesn't make superficial sense but after thinking about it a little and looking at the results of studies it becomes clearer. A 2003 randomised controlled trial showed that needle-exchange programmes do not cause an increase in drug administration. And a 1998 study I found quickly showed an approximately 33% decrease in HIV amongst needle-exchange users.
Additionally, we're talking about addicts here. The changes in the reward and reinforcement mechanisms in their brains caused by the drugs have more than likely put them into habitual drug-taking mode. It isn't exactly a choice any more, they are going to shoot up with dirty needles if there are no clean ones around.
Yay for studies. Boo that it takes years and years to communicate the results and make sensible policy changes.