Needle Exchange Program Research Paper

Needle Exchange Program

Needle exchange program (NEP) is a project where injectable drug users could exchange their used needles for sterile injection equipment. This ultimately reduces the reuse of HIV contaminated injection equipment among this population (Delgado, 2004).

Introduction

The prevalence of human immunodeficiency virus (HIV) among drug users has been a long concern. When the drug users share needles that are contaminated with HIV it increase the likelihood of that person being infected with the virus. NEP dramatically reduce if not eliminate sharing of used needles and as a result that reduces HIV transmission (Tempalksi et el, 2007). This impacts the adult and elderly population due to increase drug use among people in

their fifties and early sixties. This might be due to the aging of the baby boomers and their drug usage is higher than that of previous population (National Institute on Drug Abuse, 2015). Conversely, there are also opposing views which state that these types of programs promote drug use and have negative impact on communities. However, research has shown that these programs are effective in reducing the spread of HIV which could lead to AIDS and be fetal (Jarlais, 2009). It is important to note that this could impact not only the drug user but also non-drug user who would engage in sexual activity with the infected individual. Ultimately the whole society is affected by the needle sharing behaviors among drug users.
Issue Development 1
At the end of 2009 1,148,200 people in United States were living with HIV. Among the new infected it is estimated that 61% were attributed to male-to-male sexual contact, 25% to heterosexual contact and 8% to injection-drug use (Broz et el., 2014) . Among the drug users the virus is spread by sharing of contaminated needles. Drug use is associated with increase sexual behavior due to some drugs ability to increase libido. This leads to exchange of body fluids from semen and vaginal secretion. This ultimately can lead to the transmission of the virus to the offspring if fertilizations occurs (Haley, 2006). Therefore, one way to decrease the transmission of HIV is the NEPs in which sterile needles are exchange for used and potentially HIV contaminated needles and syringes and this conclusively leads to harm reeducation in this population (Jarlis, 2009). These programs also give the health care providers chance to provide education about HIV and AIDS, condoms, skin ointments as well as information about sexually transmitted illnesses, vein care (Delgado, 2004). Furthermore, the drug user could be encourage to attend a substance abuse treatment. Health care personal has the time and opportunity to encourage treatment enrolment for this hard to reach population (Kidorf, 2009). In any case, the program has led to substantial reduction in HIV transmission among drug users. Out of all states 33 reported that their new HIV diagnosis declined by 10% per year and incidence declined from 4/100 persons-year to under 1/100 a year. Further studies have indicated that it is more common to transmit HIV through sexual contact than unsafe injection behavior (Jarlais, 2009).
Ethical Principal
There are ethical issue that arise from implanting needle exchange program vs. not implementing the program. The three components that help us asses ethical dilemma are beneficence and nonmaleficence, autonomy and justice.
Beneficence means that we will do things that will lead to greater good or produce the least harm to the client.

Nonmalefiecniecne mean that we avoid actions that may cause harm to the patients (Arnold & Boggs-Underman, 2011). Therefore, in a clinical setting it is the caregiver duty to act at all times for the benefit of their client. Consequently, if we do established the NEP we reduce the drug users’ chance of being infected with the HIV which could lead to AIDS and be fatal (Loue, Lurie & Lloyd, 1995).

Autonomy is the person right to be able to decide for themselves (Arnold & Boggs-Underman, 2011). In this case individual are not force to use NEP or stop taking drugs. But, the health care providers seek ways for the drug user to make a healthy decision by using sterile equipment rather than used possibly contaminated equipment (Loue, Lurie & Lloyd, 1995).

Justice in the ethical analysis is aimed at the patients right to fair treatment (Arnold & Boggs-Underman, 2011). Only about 15 percent of drug users are in treatment and most of the societies lack residential or outpatient treatment. Individuals that do not have insurance have to wait longer periods of time for admission to a treatment program. The society is not doing much in founding the drug treatments NEPs have only $2,500 per year to spend while hospitals spend $33,000 a year for inpatient and outpatient treatment for individuals with AIDS (Loue, Lurie & Lloyd, 1995).

Points supporting opposite

positon
Most of the opposing arguments are directed toward the ethical principle. But also, at the impact that the needle exchange programs have on communities.
Nonmalefiecniecne mean that we avoid actions that may cause harm to the patients (Arnold & Boggs, 2011). Hence, this could only be done by not supporting the needle exchange programs. Yet another argument against the program is that it actually encourage the individual to continue to use drugs due to the facile access to the sterile syringes. When in fact, there is no research that backs up this theory (Delgado, 2004).
The society fears that NEPs will impact their communities by attracting individual that are more prone to illegal activity and as a result putting the individuals in the community at risk. Also, residences fear that the presence of NEPs might make the outsiders think that there is a drug problem in that neighborhood where the NEP is located. Yet, another problem might be that the residence fear that the drug user will consume the drug in public. To gain the community acceptance it is important to involve the community in the planning process as much as possible. Another solutions would be to encourage the community to report any behavior that would not be accepted, like consumption of drugs in local parks. It is important to inform the residence that there are regulations that are mandatory for the NEPs location area. NEP could not be located close to schools, churches, playgrounds and day care centers. Lastly, it is important to present research to the residence which shows that NEPs do not contribute to public safety problems (Strike, Myers & Millson, 2004).
Nursing Implication
Addiction is define by use of a substance by an individual even though they know that the substance is harmful. Over the time they develop resistance to the particular drug and they start to increase dosages and usually when they stop they experience withdraw. The harm redaction collation that advocates for the people who abuse drugs recognizes that nurses and health care providers play a vital role in care of patients with addiction. It is important that nurses approach these patients without rejection and negative behaviors. The nurse has to recognize the importance of aboding such behaviors and care for the patients with evidence based approach. The needle exchange programs gives the nurses opportunity to provide the individual with information about HIV and why it is important for them to not share used needles. Furthermore, harm redaction information could be provided like wound care, phlebotomy skills or over dose prevention. Teaching about safer injection could also be important because usually the drug user does not know the difference between the artery and the vein and what they need to do if the