Megan McManus discusses whether or not safe injecting spaces are a valid use of limited NHS funds.
The past few months have seen a steady rise in awareness around the UK opioid addiction crisis, as well as a greater public interest in harm reduction campaigns. A byproduct of both is an increase in the attention received by clean needle spaces and safe injecting spots, provided in the UK by Needle and Syringe Programmes (or NSPs). The aim of this is to reduce the transmission of bloodborne viruses caused by the sharing of injecting equipment. Of course, a society that enables and initiates members of its population into intravenous drug use equally has a duty to disable such activity, as well as a duty to care for the vulnerable individuals involved. The question is, however, whether such programmes are helping or hindering the fight against intravenous drug use and the alleviation of suffering associated with it.
Although there is an argument that NSPs encourage drug use and are in fact fuelling the opioid crisis, both common sense and statistical evidence prove otherwise. NSPs are thoroughly monitored and officiated by local authorities and the NHS, ensuring their compliance with NICE guidelines around treatment for drug addiction. They are not some kind of illegal backstreet operation, they are in reality completely the opposite. NSPs enable struggling addicts to remove themselves from harmful environments associated with drug use and addiction, and take an important step towards self-preservation and potential recovery. By participating in NSPs, drug users are able to take sensible and appropriate measures in combating their habits in a safe environment where support and acceptance is guaranteed. In this sense, NSPs are to be seen as integral in providing more effective safety measures for those struggling with drug habits.
Not only do NSPs provide a safer environment for intravenous drug users, they are also proven to prevent the spread of diseases transmitted by infected needles, such as HIV and Hepatitis B and C. Studies, such as the one conducted by the World Health Organisation in 2004, found a “compelling case that NSPs substantially and cost-effectively reduce the spread of HIV among IVDUs and do so without evidence of exacerbating injecting drug use at either the individual or societal level.” To summarise, NSPs were found to help existing drug users, with no negative effect on the wider community or any rise in drug use. When balanced with the cost of HIV treatment to the NHS, for example, and thus the taxpayer, NSPs are to be considered not only morally worthy, but economically efficient in the fight against drug use, often kick-started by the desperation of poverty. In this way, the instating of NSPs within communities has a “two birds one stone” effect. It tackles both the immediate effects of intravenous drug use by preventing the spread of disease, as well as one of the main root causes: poverty.
NSPs are not only beneficial in terms of the clean needles they stock. Many programmes across the UK also provide testing for HIV and Hepatitis B and C, access to counselling, and other preventative safety measures. These include the distribution of free male and female condoms and birth control. Through measures such as these, NSPs benefit not only the individual but also the wider community. The sexual partners, family and friends of the person injecting drugs all benefit from the support that the drug user receives. NSPs should be seen as an investment for the entire community. Whilst the most direct beneficiaries, the drug users, of course receive the highest level of support, this triggers a domino effect within the community. As the drug users benefit, so do much of their social circle, with a positive effect on the wider populace becoming evident in as little as several months.
In taking the drug user out of the stereotypical backstreet drug-den environment, NSPs create a safer space within which to combat intravenous drug use and the health problems associated with it. More than this however, NSPs work on tackling the stigma and dehumanisation of the drug user as an individual. They are people, and perhaps the element of humanising a traditionally demonised group is what irks some opponents of the schemes so much. Intravenous drug users are no longer to be seen as simply proponents of the issue of drug use. Instead of the villains of the story, they are increasingly, and correctly, seen as not only victims of drug addiction, but as worthy people, deserving of help and support. NSPs play a vital role in not only aiding the recovery and increasing the safety of intravenous drug users but also in reintroducing them into the community with a sense of self-worth and value. Not only do NSPs help and educate the intravenous drug users they work most closely with, they also contribute hugely to the harmony of the wider community. For this, they should be praised, not only as an excellent use of funding but as a harbinger of long-overdue change in the way that we, as a society, treat drug use and its sufferers.