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Hey, Don't Sit There!: The Story of San Francisco's Needle-Exchange Program

Ahh, I blogged about this a couple weeks ago:
The city finds the park is-- surprise!-- littered with used syringes after instituting a publicly funded program that provides syringes to junkies to prevent the sharing of needles and spread of HIV. City officials have found that-- suprise!-- giving away needles to jonesing addicts is easy. Getting them back from high addicts? Not so much.
The politics of enabling-- they're generally ineffective, really expensive, and the end result is that you, kindly taxpayer, pay a million bucks a year for the chance to go to the park and get some junkie's Hep-ridden needle stuck in your happy, picnic-ing ass.

I'm stuck on liberal public policy because it's stuck on me!
I smell a jingle!

Remember when this was a big discussion on a national level ($)? Presenting the unholy pseudo-alliance of Donna Shalala and the NYT:
Health and Human Services Secretary Donna Shalala says in a new report to the Senate that needle-exchange programs are an effective way to combat the spread of H.I.V., the virus that causes AIDS. But the Secretary does not go far enough. It is time the Clinton Administration lifted the ban on Federal funding for needle-exchange programs...
The consistency of these findings justifies Federal support to help pay for needle-exchange programs in communities that need and want them. Unfortunately, the debate continues to focus on politics and morality rather than public health needs. Opponents argue that providing addicts with needles implies approval of drug abuse. They forget that addicts can infect their spouses and offspring who do not abuse drugs and yet must live with the consequences of dirty needles.
Now, see the program in action in San Francisco:

Listen, I'm not ignoring the need to deal with addicts in some way, but when preventing AIDS and Hep-C in addicts leads to responsible citizens essentially paying to banish themselves from local parks as they're taken over by the druggies their taxes are subsidizing, we've arrived at ridiculousness.

The proponents of such programs should not get a pass because the programs are well-intentioned. Critics should not be scorned as "murderers" for disagreeing with the city's methods (as they undoubtedly will be by level-headed lefty activists whose rhetoric is often more unreasonable than their policies). Instead, if proponents think the system works, they should find a way to make it work without causing a whole other public health problem, like the newfound popularity of games such as "Ring-Around-the-Crackhead" and "Have You Had Your Flu Shot?" among park-going local youth.

Luckily, the San Francisco Chronicle's editorial board is smart enough to say, "Hey, it's time for you junkies to give back a little, huh?"

But the "exchange" element isn't working. The answer is not, as Homeless Youth Alliance Chairman Peter Davidson suggests, opening up city-sponsored injection centers where junkies can shoot up. A city that bans smoking in public should not accommodate heroin use.

Instead, it's time for exchange supporters to figure out how to coax the most self-destructive and anti-social residents of the city - not drug addicts per se, but users who blithely drop dirty syringes where they fall - to clean up after themselves. Failing that, supporters should find new ways to prompt other users to pick up discarded needles.

Currently, exchange programs give needles to people who walk in without used syringes for exchange - even though users can buy needles at city pharmacies. Davidson argues that studies show that requiring one-to-one (as opposed to one-to-none) exchanges do not cut down on syringe litter. But if it hasn't worked elsewhere, that doesn't mean the city should not test such a requirement to see if it could work.

This city, more than most, has worked hard to promote the health and welfare of drug addicts. Now it's time for users to pay the city back.


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