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After two decades, the United States congress has voted 



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to lift the ban on the federal funding of needle exchange programs.



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This finally allows organisations providing this harm reduction service



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to apply for federal funds.  



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This short movie explains why and how needle exchange programs



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save lives and protect communities.



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Can you define what a needle exchange is



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and how it protects communities?



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Syringe exchange arose out of the HIV epidemic



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that emerged among injection drug users.



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Injection drug users were sharing contaminated syringes



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and other injection equipment.  



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So syringe exchange is an opportunity for a drug user to get clean,



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sterile new syringes and to dispose of their old, used syringes.



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That becomes a way in which we can establish contact with drug users, 



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who traditionally are outside of all kinds of social services,



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and begin to build a relationship.



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People come in and they all have a code. 



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I get the code from them and enter it into  the AIRS (AIDS Institute Data Reporting System). 



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I ask them if they are returning any.



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This is where used syringes go



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If you are using a syringe exchange you are not sharing needles, 



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you are getting fresh, clean needles and you are disposing of them properly.



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So you don t have to worry about no one stepping on them 



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or them being in parks, or being in places they shouldn t be.



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You re putting 50 in, right?



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Yes.



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How many would you like?



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50.



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Back in the mid 80s, New York City was known as the epicentre 



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for HIV and injection drug use in the world.



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More than 50% of the drug users in New York



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  there were about 200 thousand of them   had AIDS. 



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You didn t really have HIV in those days, 



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know one knew what HIV was, you had AIDS.



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The New York City Department of Health began to investigate 



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starting a syringe exchange in New York City, back in 1986. 



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Now we have about 17 programs in New York City 



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that supply syringes to drug users 



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and it has had an enormous impact. 



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As I said, over 50% of our drug users had AIDS in the late 80s 



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and now it s down to under 10%.  



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And that is solely because of the impact of syringe exchange. 



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5-10% of people who inject drugs in this country 



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are accessing syringe exchange programs, 



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which would translate to maybe 50-100 thousand people a year.



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We re probably in the rage of 25 million syringes going out



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through syringe exchange programs in any given year. 



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& 3, 4, 5, 6, 7, 8, 9, 10...



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I benefited personally from using needle exchange services 



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in the fact that I was able to obtain clean syringes



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and use them without being a danger to myself



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  by damaging my skin or re-injecting materials from a used syringe   



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and I was able to live a healthier life. 



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I am healthier now than I have ever been in my life.



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When I was active, shooting heroine and cocaine, 



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I came here to get my syringes and I credit that 



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for saving me from STDs, AIDS and everything.



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We re talking about a quarter of a million dollars on upwards, 



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for every case of HIV, for lifelong medical costs; 



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whereas the cost of a syringe is more in the realm of a dime, 10 cents. 



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So if you re looking at cost-effectiveness, 



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obviously investing in prevention is going to save you a lot of money.



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I grew up around injectors.  My mother and father were both injectors



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for the vast majority of my life, early life.  



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My mother is co-infected, so I feel very connected to this movement.  



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I believe that if harm reduction had been around as a principle,



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or if an organisation like this had been around, she wouldn t be



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having to deal with the diseases she s dealing with now. 



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And more importantly, I wish people had treated her with the respect



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 that we make our trademark here.



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What are the other services that syringe exchanges provide for drug users?



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Through the syringe exchange, you can begin to build things 



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into drugs users  lives that they were previously not associated with: 



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medical care, getting people into medical systems,



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mental health care, because mental health is a serious and major issue 



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  often   for people who use drugs, and are maybe living on the street.  



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We provide a lot of support groups for people. 



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We can do a lot of HIV testing, STD testing. 



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We can do a lot of TB testing 



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and provide medications for both managing people s HIV



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and managing their tuberculosis.  



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We are beyond just a needle exchange. 



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I think we look at the drug user   we have a more holistic approach.  



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It s not just the harms associated with using drugs 



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but the harms associated with being poor and homeless, 



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or being hungry   are social determinates of health that 



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we really miss out on.  Also, needle exchanges are also a lot of  times



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staffed by users themselves. So they are the experts. 



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They have groups here.  One was hepatitis C. 



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I suspected I had it and I enrolled in a group 



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and they hooked me up with a doctor and 



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the doctor put me on Interferon



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and now my viral load is very low.  



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This is our overdose prevention kit.  



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We hold trainings for our participants on Tuesdays and Fridays. 



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So they can be able to carry this and save a life of someone 



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they re injecting with or vice versa, someone can save their life.  



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It comes with two alcohol swabs.



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This is the magic formula that reverses the opiate overdose.



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This is what happens in each kit: we give two of each just to be sure. 



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This is a muscle shot, not a vein shot and gloves, for sanitary reasons



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and if it comes to that, rescue breathing, which is part of the training.



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We give them a quick knowledge of it.  



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The fact that many people think that syringe exchange 



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empowers people to use drugs is a myth. 



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First of all, it s a well known fact that drug use 



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will occur whether we have syringe exchanges or not. 



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What we are propagating is that we want people to use safely 



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and not spread disease or do harm to themselves or others: 



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their community or their family members 



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and everybody who can be affected by it.



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If an individual is going to use, they re going to use. 



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But they re not going to use any more or any less 



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-  If an individual chooses to use more drugs, 



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that s a conscious choice that they make,



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whatever the situation may be - 



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But they re not going to do that due to the fact 



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that someone is giving them a syringe.  



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And, an individual that does not use a syringe,



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is not going to just pick up a syringe and say 



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 oh, let me try a syringe because there s 



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a syringe exchange in the area.  



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A lot of the people I ve worked with previously, 



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when I ran a needle exchange program 



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had been to drug treatment many, many, many times. 



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If it worked and if it was that simple,



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they wouldn t have been coming back.



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Once people slowed down around a chaotic drug scene,



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perhaps they could begin to strategize about 



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what else they wanted to do with their lives,



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and begin to think about what their drug use means to them,



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and how they might want to change their relationship 



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to the drugs they use.  



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So there re people always available at syringe exchange programs



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to provide counselling, and case management.  



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One of the things that I learnt very quickly



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from doing needle exchange is that people came for needles, 



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but that was the first step.  



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They asked for other things and one of the big things



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they asked for was help with drug treatment.



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Long standing syringe exchange programs have not had community opposition.



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Any kind of fears the community have begin to go away after a while,



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when they begin to in see the benefits.  



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The ways that HIV is transmitted, link all of us together. 



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Even though the proportion of people in the United States



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who inject drugs is relatively small



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  you know, in the ballpark of a million people  -



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what happens to their health is important to all of us.



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Subtitles: Arielle Reid, Tamás Kardos, István Gábor Takács