Syringes: a public health hazard

My colleague Adrian Vassallo wrote in The Stemming Of Values (August 13) that last year over 349,707 syringes were handed out to drug addicts, compared to 150,000 in the year 2000 and 145,000 in 1996.

This is an alarming figure indeed; the amount more than doubled in eight years. One may also ask: Where are all these used needles ending up? As far as I know, no needle exchange programme (NEP) was ever tried in Malta.

Drug addicts can walk into a government health centre and demand a number of syringes. The number of syringes given is noted but the users are not asked to return the used syringes. How are these syringes disposed of? Probably they are thrown away at the way side, in domestic garbage bags, on the beaches, in public gardens or near playing fields posing a danger to other persons including innocent children.

In the Netherlands, a nation with a large number of drug addicts, an NEP was started in 1984 and by 1987 only 700,000 needles had been distributed through existing social agencies and treatment facilities in 40 municipalities.

Comparing the size and population of Malta with the Netherlands, our stated figure of 350,000 syringes is sky-high and beyond any proportions. 

In another AIDS prevention needle exchange project in Seattle, 4,000 syringes used to be distributed per month. In Malta we are distributing 29,142 syringes per month! It may be that not all drugs addicts make use of the NEP programmes but it is definitely shocking to state that as many as 29,142 syringes are given out per month. Are our addicts injecting themselves every minute? How is it possible to allow the distribution of such a hefty number of syringes? Is our drug problem that big?

The primary aim of an NEP is to reduce the sharing of needles and, hence, the spread of hepatitis, AIDS and other crippling, sometimes fatal, needle-borne diseases. Needle exchange programmes also differ in scope. Some only exchange needles, while others are more comprehensive and provide counselling, referral to testing and drug treatment, bleach to clean needles and safe sex information.

From our health centres we only hand out syringes and a couple of leaflets! Some argue that by distributing free syringes to drug addicts we are actually facilitating the addicts' continued use of drugs and undercut the credibility of society's message that drug use is illegal and morally wrong. What is the stand of Sedqa and Caritas on the introduction of an NEP? 

Unfortunately, there is no compelling research that needle exchange programmes are effective in preventing intravenous drug users from sharing needles, reducing the spread of AIDS or encouraging addicts to seek drug treatment! Research does show, however, that aggressive outreach is an effective way to get intravenous drug users to end their high-risk behaviour and seek treatment. Is this being sought at the point of contact at the health centres?

There are no such workers trained to help these poor individuals. Sedqa is doing sterling work in the prevention of addiction but as far as I know no outreach programme exists to help these addicts. In Malta it is not that difficult to locate the drug-injecting population (100,300 syringes were distributed from Paola health centre). Is this population so high that it requires 350,000 syringes annually?

One place to reach these individuals is where they get the needles. It is here that a number of trained workers should be posted to encourage these individuals to enter drug treatment programmes. From a public health point of view we must be sure that needles are safely discarded after they have been used. A total of 30,000 syringes in circulation per month is not a joke. Is this issue being taken seriously?

The amount of syringes being dished out to the man in the street is frightening. These constitute a public health hazard.