Dear Dr. Bob,

First off I want to say I think you are an absolutely delightful man and a wonderful, caring doctor. This website does great things. But I have to say something in regard to programs to hand out clean needles to those who abuse drugs intravenously. I think Bush is a joke of a president and I'm not defending his actions, I just want to give my 2 cents on the situation. I think it's pretty sick to give drug abusers clean needles to do their drugs with. I don't believe that tax dollars should go into giving addicts paraphernalia. Instead, those tax dollars should go into EDUCATING and REHABILITATING drug users about not only their drug of choice, but the DANGERS associated with sharing dirty needles. I'm not comfortable with establishments that say "Here's a clean needle, go do some drugs". Don't you agree that centers for drug abuse education, counseling, rehab, and HIV testing and education would do more to help these people than giving them tools to help destroy their lives and bodies by shooting up? I feel that's a much more noble thing than simply handing out needles to addicts. YES, that clean needle might save a life by preventing HIV. But that same needle could also be the one that is used to inject a fatal overdose. It's a real catch-22, and it's not even COMPARABLE to giving out free condoms to prevent HIV. Last time I checked, no one has been killed by a condom. People DO die from shooting drugs. My bottom line is that prevention education, counseling, and rehab centers would be a far more productive and beneficial use of tax payers' dollars with regards to the subject of IV drug use and HIV prevention.

-Jessi

Hey Jessi,

HIV prevention and drug rehabilitation are not an "either or" situation. They are not mutually exclusive and the pots of money funding these two critical health issues are quite separate. Not funding clean-needle exchange programs does not mean we'll get more drug rehabilitation services or facilities. Multiple scientifically rigorous epidemiological studies have definitively shown that clean-needle exchange programs do not promote increased drug use, but they do decrease new cases of HIV infection. To not fund them is not only illogical; it's morally unconscionable. Overdosing is not a logical argument, as that can occur with a dirty needle as easily as with a clean one. Clean-needle exchange programs are not the establishment saying, "Here's a clean needle, go do some drugs." Rather it's a way to reach the drug-injecting community to encourage them to get tested and to offer ways for them to connect up with treatment services while decreasing the risk of further spread of HIV and hepatitis C. To me this really is a no-brainer! There really is no downside. This is a prevention strategy proven to work and be highly cost effective. I agree with you that more drug rehab centers are urgently needed. Unfortunately Dubya fails on that score as well. No surprise there. Is it Nov 20, 2009 yet?

Dr. Bob

Addendum. Jessi please see the post below which gives further credence to my position.

Dr. Bob

Response to Feb 18 Post Re: Needle Exchange Feb 20, 2008

I just want to thank you, Dr. Frascino, for your answer to this post. If I may be so bold, I would also like to expand on it. I want to emphasize the fact that not only are needle exchanges and drug rehabs NOT either or, as you stated, but they often go hand-in-hand. I work for an agency in central NY that runs a highly effective needle exchange program. With every clean needle we hand out, we provide education (yes, even about possible ODs and how to avoid them!) and referrals to drug rehabilitation centers. In our experience, the drug users that frequent the needle exchange are much more likely to get into a rehab, because they literally have someone they know and trust sitting there with them, helping them get into whatever treatment they are ready for. I have also met with many individuals that are former "customers" of the needle exchange, and more than one have credited the program with "saving their lives." So anyway, *stepping off soapbox* thanks for letting me get that out. And thanks for all the wonderful work you do! -K.L.

Response from Dr. Frascino

Hello K.L.,

I'll gladly post your comments.

And now it's my turn to thank you for the wonderful work you do! BRAVO!

Dr. Bob