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POSIT: " Over the counter sale of needles and syringes is an economical and efficient way to reduce the incidence of Hepatitis B, C, and HIV without condoning or encouraging drug abuse." "In my many years treating IV drug abusers, the availability of needles has not seemed to be a factor in their decisions to start or resume IV drug use. Though I am I psychiatrist, I was often the physician who identified their hepatitis C exposure - even for patients who had assured me they had always cleaned their needles well. Making the purchase of clean needles easy should help in decreasing the spread of lethal diseases and should not add to the spread of intravenous drug use." - Marlene Mirassou, MD "I would need to see a good longitudinal study to support the effectiveness of needle exchanges or over the counter sales decreasing the prevalence and incidence of these diseases. Sometimes the logical solution is not the right solution. And it certainly makes it easier for those who might not use because of the dirty needles or difficulty of obtaining needles." - Charles Perry, MD "Although I believe that a few studies show reduction in infection rates with making needles available this is not an easy solution. Firstly we must accept that there are reasons to keep needles only available by prescription including risk of encouraging or condoning IVDU. Ethical reasoning must include an understanding of both sides: it is wrong to not try to prevent further cases of serious infections, and it is wrong to encourage behaviors that can harm. Secondly, the voting public has mixed thoughts about how to treat and whether to permit or tolerate certain addictions. There is a very long-standing and strong aversion to tolerating IVDU.This would probably make it difficult to pass such laws. Clearly, permitting availability of needles should only be part of a larger, more comprehensive program to prevent the spread of viral hepatitis, and HIV. These programs are underfunded currently." - Al Massey, MD "The first part of the statement is certainly true. The second part is the controversy. But even there, experience in other countries, e.g. Australia, has found it to be true. There is no compelling reason to believe that experience in the US would be appreciably different." - Ed Panacek, MD "Harm reduction programs have demonstrated effectiveness in several other countries e.g. Australia and Canada. It would important in the US to implement harm reduction programs within correctional facilities as HIV and HCV are at epidemic levels within facilities." - Ilene Lewis, MD FACS. "Allowing for over the counter needles is essential for the reduction of Hep C, Hep B, HIV spread and that not allowing over the counter needles encourages unsafe sharing and spread of disease." - Darin Chambers, MSII " I think it is very important that we have this discussion because we are not making the impact on reducing HIV and Hepatitis B or C transmission that we could be making if only we'd get off the moral high horse and start looking at real, practical and effective risk reduction strategies." - Teresa Flores, MSI "CSAM, the California Society of Addiction Medicine has a long standing policy of support needle exchange programs. This position is supported by medical literature and been shown to reduce the incidence of communicable diseases. There has been no evidence that availability of needles increases or encourages drug abuse." - Lee Snook, MD "Over the counter" appears to give carte blanche to anyone. It tacitly condones/encourages drug abuse. While not minimizing the widespread problem of drug abuse/dependence nor the difficulty in getting indivuals to acknowledge it as a problem, I feel that any available funding needs to be invested in education and treatment of the problem. " - Ralph Sett, MD "Illegal behavior is illegal. Although giving away needles may seem like an easy thing, it is only a band aid over a cancer. Public policy and programs should reflect law and appropriate behavior. Irresponsible drug addicts are not going to act responsibly just because we give them clean needles. Just like giving out condoms to under age teens is a stupid idea, giving away needles to drug addicts only makes immoral and illegal activity easier." - Donald Hause, MD "My friends in law enforcement disagree with selling needles and syringes over the counter, but I feel "needles and syringes" have nothing to do with drug abuse and everything to do with disease and death." - Allan H Galbreath, MD "This is an opinion and is not based on evidence. Needles and syringes are available from Veterinary suppliers." - Gerald N. Rogan, MD "All studies show this is a safe and effective way to prevent needle-borne disease. There is no increased incidence of IV drug use in countries or areas where clean needles are available." - Joanne Berkowitz, MD "It is not our duty as physicians to encourage people to perform illegal and unhealthy activities in a possibly less dangerous manner. To do so sends a very mixed message, and affects our credibility. Would we do the same thing with regard to other illegal/unhealthy activity? E.g., how about encouraging terrorists to wear gas masks and radiation suits when they detonate dirty bombs; or providing rapists with condoms, or even stun-guns so they don't have to injure their victims with more lethal weapons such as guns or knives ; or drunk drivers to drive with both hands on the wheel, or to stick to beer instead of whiskey when they plan to drive." - John Gisla, MD "It probably will facilitate and hence encourage drug abuse but the health benefits far exceed this negative aspect." - Richard Myers, MD "I fear it will be considered an acceptance of drug abuse." - Dennis Marks, MD "Reality dictates that injection drug use cannot be legislated away. See how effective we were with alcohol and how effective we are currently with prostitution." - Craig Yamata, MD "The advantages outweigh the disadvantages of selling needles/syringes OTC especially in a free society." - William Fenton, MD "Yes I agree that easy of obtaining needles would reduce needle related disease." - Robert Talkington, MD "John, I have an intellectual problem with outlawing drugs and then giving away or selling needles to use them. That is the classic ambivalent behavior that causes one to wonder." - Paul Kelly, MD "It is absolutely essential that we try to institute this policy as soon as possible. I think the major obstacle has been and will continue to be the far religious right. I see this not as a religious or moral issue but as an issue of protection for the remainder of the population. The addicted person will get his 'hits' any way. We may as well try to keep the incidence of diseases down as much as possible to prevent his acquiring and spreading these diseases even further. We will also have fewer diseases that we have to spend money to treat." - Kuo-Liang Yu, MD "Intravenous drug abusers will always find a way to inject their drug. Why shouldn't they be allowed to do it with clean rather than with infected needles and syringes?" - John Musicant, MD "It's time we gave up our Puritan past and recognize that we have serious problems that must be addressed in an intelligent medically sophisticated manner. Dispensing clean needles to addicts is one major way to cut down the spread of some very serious diseases. That is the moral imperative." - J Rabinovitz, MD "(This) posit is contradictory. OTC sales of needles should be reserved for those chronically hooked on and damaged by drugs, and so identified and certified. In this group, Society is not "condoning" nor "encouraging" drug abuse but recognizing that these individuals are beyond medical redemption. For those less physically and mentally incurable, available OTC syringes indeed enhances drug abuse and the implements for doing so should not be made available. Having agreed that those beyond medical rescued might benefit from Available OTC syringes and needles; there must be in the law, mandated responsible accountability for those needles and syringes "checked out" or issued. No responsible behavior, no needles nor syringes! No way. These implements must not get out into the drug prone nor the black market; nor should they get into the dumpsters and landfills. Having limited those elegible and placed responsible controls on the practice, yes, I believe such OTC availability would reduce the spread of blood-born infectious diseases which must be monitored to warrent continuing the risks with the OTC practice." - Cleve Baker, MD "I strongly agree that needles and syringes should be available OTC. I'm a doctor, not a federal narcotics agent. The "war on drugs" has been waged for five thousand years and it hasn't made a damn difference in human behavior. Unless you count the spread of AIDS and hepatitis throughout the entire world." - W. Forrest, MD "I don't agree or disagree, as I don't know enough about this yet, but what I have heard is that a lot of people don't take advantage of free needles and syringes handed out by clinics, so I thinking that selling them would help, but probably no that much. " - Tim Weaver, MSI "It's time physicians practice Preventive Medicine - that's why it's our ethical professional duty not just to treat STD's but to instruct patients how to avoid re-infection." - Geoffrey Woo-Ming, MD A posit is a statement intended to promote discussion. Posits do not necessarily reflect the views of SSV Medicine, the SSVMS, the Board Of Directors, Executive Director, editors, or editorial committee. |
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Copyright © 2000-2008 Sierra Sacramento Valley Medical Society - All Right's Reserved
5380 Elvas Avenue #100 • Sacramento, CA 95819
916.452.2671 PH • 916.452.2690 FX • Email: info@ssvms.org
Copyright © 2000-2008 Sierra Sacramento Valley Medical Society - All Right's Reserved