responses to such programs. The community is not some monolith; rather, it is a dynamic interaction of groups whose views and actions vary with location and time.

The panel undertook a wide range of activities to gather pertinent information about the views of various groups on the issues relating to the implementation of needle exchange and bleach distribution programs. We reviewed the literature systematically to gather the range and extent of opinions for two groups in which the expression of viewpoints has been extensive: the African American community and the treatment community. In fact, a special workshop was held, to which representatives of the community groups covered in this chapter were invited. The panel members conducted site visits to Chicago and San Francisco to discuss issues with community outreach workers. We also solicited information from pertinent professional organizations to identify formal positions on needle exchange and bleach distribution programs. Finally, a number of public opinion surveys were identified and reviewed.

In this report, we embrace a broad definition of community, which includes ethnic groups, business and religious organizations, government bodies, and professional groups. Understandably, the information presented in this chapter focuses primarily on those who have been most vocal in expressing their concerns about needle and bleach distribution programs. Other views have not been overlooked intentionally.

The chapter begins with a brief consideration of the moral and ethical arguments that come into play in these issues. We then discuss public opinion polls, which are informative to broadly gauge community attitudes toward needle exchange and bleach distribution programs over time. The chapter goes on to discuss the perspectives of a number of community groups and their responses to needle exchange and bleach distribution programs:

  • minority communities, which are disproportionately affected by drug abuse,

  • law enforcement officials, who are sworn to enforce laws,

  • pharmacists, who hold supplies of sterile needles, and

  • drug abuse treatment providers, who work with limited funding to impact the difficult processes of addiction.

The material presented in this chapter contributes to the panel's overall assessment of the effectiveness of needle exchange and bleach distribution programs, and its findings and conclusions are integrated in the recommendations that appear in Chapter 7. As stated in the Introduction, this approach reflects the development of the panel's deliberations on the issues.

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