Perceptions and Concerns

Health professionals Pharmacists

• Quality of health care services provided to noninjection drug user customers may suffer.;

• Subsequent negative effects on revenue.;

• Liability for occupational exposure of workers and adherence to rules and regulations set forth by DEA, EPA, FDA, and OSHA.;

• Disposal of used needles/syringes.;

• Lack or ambiguity of prescription laws.;

• Personal discretion.;

• Involvement in the development of site-specific programs is needed.;

• Education and training are needed.

Treatment service providers

• These programs promote a behavior destructive to the individual, family, and community.;

• Funding will be diverted from treatment.;

• Public and professional misperceptions about lack of efficacy of treatment.;

• Disincentive to participate in programs because of federal regulations dealing with drug treatment and degrees of drug use.;

• Largely strict abstinence orientation poses apparent contradiction to programs allowing the continuation of drug use.

and over time, is the major conclusion of this chapter. Many of their concerns stem from the view that needle exchange and bleach distribution programs are limited to one type of activity: the exchange or distribution of drug paraphernalia to injection drug users. It is therefore possible that programs taking a comprehensive approach could respond to some of this community opposition. Such an approach would include an overall strategy to improve the delivery of health services, including drug treatment services and social services, that address other important needs. It would also include an open public approach that clarifies the concept and explains the multifaceted and multilevel components of needle exchange and bleach distribution programs.

Focusing on the impact of needle exchange and bleach distribution programs on levels of drug abuse has been central to the discussions of these programs. This underlying focus has generated a multitude of hypotheses about their possible harmful effects. It is critically important to articulate these issues, reformulated as hypotheses, in the process of considering the program effects and operationalizing them in such a way as to steer carefully

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