An opponent of needle exchange, Rep. Todd Tiahrt (R-KS), cited studies that purportedly show needle exchange to be ineffective at reducing the spread of AIDS during the Congressional debate yesterday, according to the Associated Press. Tiahrt was probably referring to research in the Canadian cities of Vancouver and Montreal, which found rising rates of HIV among the injecting population. This study has been used frequently by opponents of needle exchange repeatedly in recent months, including drug czar Barry McCaffrey, who repeated this claim on the Diane Rheim show on National Public Radio two weeks ago.
The authors of this study, however, took to the pages of the New York Times last April to say that needle exchange opponents have "misinterpreted" their research, which in reality found that the programs in those cities succeeded in reaching the most at-risk populations, but weren't large enough to provide enough syringes to enough users to stem the growing problem of injection-related AIDS in places where cocaine had become the drug of choice over heroin. The average cocaine injectors requires many more syringes each day than a heroin injector would require.
A article in last month's Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology provides some quantitative understanding of the situation in Montreal. It cites a 1995 study which estimated the number of injection drug users to be 10,000 and that about 10.68 million syringes would be needed annually to provide one-time syringe use for all of them. The researchers also calculated that approximately 338,000 syringes were distributed in 1994, meeting only about 3.2 percent of the estimated need. It was noted that the total number of sterile syringes could have been higher, due to underground distribution within the injection-using community and the illegal drug trade. Still, the numbers are adequate to illustrate that the problem in Montreal was not needle exchange, but that there was not enough of it. Another problem was that the program had a limit on the number of syringes it would provide to any given client on any given occasion.