broader view of drug addiction; they do not view drug abuse as exclusively a criminal justice issue. Addiction is seen as a health care problem with many negative medical and social consequences. The risk of HIV infection is one of many consequences of injection drug use, and needle exchange programs should be viewed as one strategy that may help reduce that risk. However, these programs should not deflect attention from addressing the underlying causes of addiction. As such, treatment and prevention strategies must be the critical components of any drug abuse policy.

  • Within the law enforcement community, the prevailing reaction to needle exchange is negative. The primary reasons for such a reaction are that: (1) police officers understandably have difficulty endorsing something that is illegal, (2) it sends a mixed message and may worsen society's drug problem, and (3) needlesticks to police officers may increase due to an increase in the number of needles in circulation.

  • Given that drug addiction is a health issue, the requirement of a prescription to purchase needles and syringes in pharmacies does provide for at least some degree of control. Medical supervision does provide some assurance that the users are properly instructed about how to use these devices.

The following comment by one of the participants illustrates the complexity of the needle exchange issues as perceived by career law enforcement officers:

When I look at needle exchange, I split it into two sides. One side is a poor public drug abuse policy and the other is a public health care policy that has some merit. So it becomes a war of priorities in terms of which problem is worse, the drug problem or the AIDS problem? I don't feel that needle exchange is good for both of these problems. Being a police officer I cannot support anything illegal, but I also realize that people are dying of AIDS and that is about as serious as you can get. I cannot come out and say that I am absolutely opposed, but I can say I am very concerned about it. Also, there is so much diversity in this country that federally permissive programs will not work unless it is able to be tailored to specific regions.… If someone could convince me that legalizing needle exchange programs will not make the drug problem worse, then I could probably move more toward the support side.

Another important issue raised at the workshop was whether prescription and paraphernalia laws are a practical tool for police officers and prosecutors to use to convict drug offenders. These laws are tangential to the problem at hand, which is to prohibit the sale, possession, and use of controlled substances. However, they do provide police officers and prosecutors with another tool for charging drug dealers and users with a criminal offense when there is no direct evidence of a sale, possession, or use of the

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