Needle exchange is one of those weird areas where bourgeois morality is actually very expensive for the state to enforce.
Probably, needle exchange does lead to more drug use by lowering the cost of doing drugs. But most of us (all of us, I hope) recognize that no matter how screwed up you are, no one deserves to die of AIDS or hep C.
Okay, a conservative or libertarian might argue, but drug users bring this trouble on themselves; why should I a) pay for clean syringes and b) implicitly sanction their irresponsible and self-destructive behavior? Well, okay, leave aside the morality of forcing people to use dirty syringes (really forcing, since as I pointed out in the last post, junkies use dirty works partly because the government won't let them buy clean ones legally). The problem is, needles are cheap, and treating AIDS isn't. Given that we're not going to let them die, it makes much more fiscal sense just to give them the needles.
The libertarian answer is to eliminate both the restrictions on needle purchase, and the government program to distribute them, and I'd support that. But given that we are clearly not going to eliminate the syringe restrictions any time soon, we might as well save money by giving junkies some clean needles.
This reminds me of U.S. abstinence education for school children. Perfect is always the enemy of the good. Yes, it would solve everything if people stopped getting addicted to drugs and only had sex with their soul-mate after marriage. Of course that will NEVER happen, no matter how many spiffy "educational" advertisements the government commissions.
Given that we're not going to let them die
C'mon, now: Aren't you eliminating the real "libertarian answer" there?
So, just to get this straight, you're saying that the Government should just allow the sale of needles (or, in libertarian-speak "not prohibit") freely, assuming they would be relativey cheap as they won't contain anything, and the problem takes care of itself, right?
Oops, I thought I was commenting on your first needle post. You answered that. My bad.
The government should hand out needles to drug users for the same reason it spays and neuters cats for free - its a matter of public health. And yes, drug addicts have about the same level of free will and judgement as stray cats.
Now if society were truly interested in reducing drug use, and the demand that feeds the traffic, it would have local governments poison those needles.
If someone likes to have sex with prostitutes, but doing so endangers public health (spread of disease) is it ok for the government to hire disease free prostitutes and give them condoms if the math simply works out to be "cheaper" this way?
Is there any point to saying, "I condemn your actions, but will help you undertake them anyway because its cheaper for everyone if I do?"
What's real-world impact in between the difference of that statement and drug use is a-ok with me?
If it's wrong you shouldn't do it and if you do the consequences suck and are severe, and I'm sorry you have to suffer them.
Where are the "liberals" who believe its ok to distribute needles and condoms because people are going to do drugs and have sex anyway on positions of gun control?
People are going to have guns anyway, so why not give them government issue ones to protect themselves? I would not argue for that but at least you can see the public good in supporting the right of people to protect themselves who are acting in a law abiding manner.
Why are we facilitating people who do things against the law?
You'd rather not see them die of disease. I'd rather not see them ruin their lives with drug abuse to begin with.
So if we're talking about forcing standards on people, why not just go the next step. Force them not to do drugs rather than forcing me to supply them with needles.
I’m not sure that this is necessarily a “given.” Besides the obvious point that we let junkies suffer the logical consequences of their lifestyle choice (i.e. death) all of the time, it seems to me that with the expansion of “shall-issue” concealed carry permits in 38 States and the growing popularity of expanding the castle doctrine beyond just the home and the workplace, we may be moving towards a place where people are so fed up with crime, that junkies (and hopefully drug dealers) lose their ability to intimidate and threaten decent people who increasingly have both the means (and eventually the will) to start thinning the herd.
There are two public health reasons to have needle exchange programs. The first, is to prevent disease in the IV drug using population. For the state this is most important from a cost standpoint. Most addicts of the heavy IV drugs usually don't carry Blue Cross, if they get ill, the bills will be borne by public hospitals, state and local governments, and finally the taxpayers in these areas that have to suffer from increased taxes or health care fees to keep these hospitals open.
The second reason to allow the needle exchange programs is to protect the general populations health. Unprotected populations like these are a breeding ground for diseases of all kinds. Especially the more exotic ones. We have seen in New York a large increase in the number of cases of drug resistant TB, largely coming out of AIDS patients. If we allow diseases to spread in these communities unchecked, they will eventually spread out into the general population. Just like what happened to the AIDS virus. It started in homosexuals and IV drug users. It quickly spread to hemophiliacs and eventually to the general population.
Dirty needles spread communicable disease. Communicable diseases are the definition of a negative externality. Needles are much, much cheaper than the losses suffered by nonusers who are inadvertently brought into contact with Hep C and AIDS by users. Ergo, society should pay for needles regardless of the health care costs of users, even if we're perfectly content to let them die. Wham, bam, no touchy libertarian toes stepped on, thank you ma'am
"Now if society were truly interested in reducing drug use, and the demand that feeds the traffic, it would have local governments poison those needles."
Or, it could take a page from Australia which is handing out free injections of heroin to addicts at police stations. It has certainly helped their heroin rate for a multitude of reasons. It gets the drug off the streets where it's more likely to get somebody addicted. Addicts aren't committing crimes to get their fix, and there's no money in drug dealing so no crime from that either.
The question we have to ask ourselves is, do we want to reduce the number of addicts or punish them?
MM wrote: Well, okay, leave aside the morality of forcing people to use dirty syringes (really forcing, since as I pointed out in the last post, junkies use dirty works partly because the government won't let them buy clean ones legally).
That's not so much us forcing them, as the addiction they voluntarily assumed, forcing them. Small but significant difference.
While needles are indeed very cheap, it seems to me that:
(1) the risk of increasing drug use is a very serious one, and should not be dismissed with a fallacious "some are going to do it anyway";
(2) if the goal is to deal with the more fundamental social problem, a free rehab/job-placement program with voluntary check-in but stringint, militaristic requirements on the inside -- i.e., food and shelter are provided, but you WILL live by a 10p-6a sleep schedule, you WILL accept medical help to deal with the withdrawal problems, you WILL participate in a designated skillset-builder curriculum from 8a-5p, and you WILL NOT have the option of leaving again for at least three months, etc. -- would be more effective use of the money.
As the old saw has it, you always get more of what you subsidize. Thus, pick the subsidies carefully.
What is the point of making needles illegal for sale if the gov is just going to give them away for free?
If someone likes to have sex with prostitutes, but doing so endangers public health (spread of disease) is it ok for the government to hire disease free prostitutes and give them condoms if the math simply works out to be "cheaper" this way?
Ahhh--but that's the point. The government doesn't give them away free--it gives them away IN EXCHANGE FOR DIRTY NEEDLES. That gets the dirty needles out of circulation--which is the point.
"What is the point of making needles illegal for sale if the gov is just going to give them away for free?"
More Government, Higher Taxes, and less Liberty for those that make communities worth living in.
Rob, you ask a good Q, I really would care to understand if there is an alternate answer than my own.
A libertarian argument in favor of needle exchanges:
1. Government made drugs and needles illegal, making said drugs and needles prohibitively expensive.
2. This action creates all sorts of unintended consequences by leading addicts to act in ways that are immoral or otherwise irrational, including the use of dirty needles.
3. The resulting use of dirty needles causes a major public health problem, not just amongst addicts, but also amongst people who have contact with addicts, and eventually people who have contact with people who have contact with addicts.
4. Thus, government's prohibition of drugs and needles has had the unintended, but reasonably foreseeable, consequence of creating significant harm to society.
5. Since the ultimate cause of this harm is the government's decision to ban needles, government has an obligation to correct or mitigate the harm it has caused.
6. Government is unwilling to undo the act that causes the harm in the first place, but retains the obligation to correct or mitigate the harm it caused.
7. Needle exchange programs do some good in mitigating the harm, therefore government is at least partially meeting its obligation to correct or mitigate the harm it caused.
As much as I don't like government using taxpayer dollars to give things to others for free, I can think of worse things on which to spend taxpayer dollars. At least in this case, you could make an argument (as I just did) that government is actually taking responsibility for its actions.
"If someone likes to have sex with prostitutes, but doing so endangers public health (spread of disease) is it ok for the government to hire disease free prostitutes and give them condoms if the math simply works out to be "cheaper" this way?"
Maybe prostitution shouldn't be illegal, which would allow for STD testing of prostitutes to help prevent a public outbreak. I think there is a correlation here. Government bans a personal choice, people do it anyways, now people are doing it but there is no oversight and public health concerns arise.
What the hell?
I have two diabetic animals which require twice-daily shots of insulin. For the last four or five years, I've either walked up to the counter or gone through the drive through of any number of random pharmacies, asked for a box of needles, paid my money, and gone about my merry business without so much as a by your leave.
I'm in Texas. Where the hell do you folks live? Whatever laws are keeping you from your needles, it ain't federal.
Exchange or give junkies clean needles, and of course they will use them responsibly and not share them.
Because addicts share our concern for the health of others.
Yeah right.
The only problem with junkies (and AIDS) is that it takes too long to die--too much opportunity to spread their diseases to others. Perhaps the public health goal should be to accelerate the disease progression to thin the herd.
Mark,
with this "6. Government is unwilling to undo the act that causes the harm in the first place, but retains the obligation to correct or mitigate the harm it caused."
how do you square it with: "A libertarian argument..." ?
sounds more like a sop to a totalitarian state..
The only problem with junkies (and AIDS) is that it takes too long to die--too much opportunity to spread their diseases to others.
The only problem with moralists is that it takes too long to die -- too much opportunity to force their viral memes on others.
Heck, local lefties should be making this rejoinder, not me.
The only problem with junkies (and AIDS) is that it takes too long to die--too much opportunity to spread their diseases to others.
As the brother-in-law of a former heroin addict, I am really overjoyed to hear that you wish my sister-in-law had died before she managed to kick.
Merry Christmas!
Max: hope that's what you were looking for.
Brooksfoe: yes, thank you! Force driven by ideology is something I very much despise irrespectively of the origin.
Not only should all prohibitions against easy access to needles be lifted, but all drugs should be legalized, or at least decriminalized. All other measures, including needle exchanges and mandatory rehabs, are just further complicating the state's role in personal behavior.
I have some former IV heroin users in my extended family. Heck, one guy may be back to chasing the dragon. Two guys have Hep C stemming from it. None are worthless people. They have families and productive careers. I don't see how government prohibitions at every level have served them at all.
Should the government hand out salads to meat addicts?
The government's failure to buy meat eaters a salad is one of those weird areas where bourgeois morality is actually very expensive for the state to enforce.
Probably, buying a salad for meat-eaters does lead to more carnivorous meals by lowering the cost of each meal. But most of us (all of us, I hope) recognize that no matter how screwed up you are, no one deserves to die of colon cancer and heart disease.
Okay, a conservative or libertarian might argue, but meat eaters bring this trouble on themselves; why should I a) pay for salads for them and b) implicitly sanction their irresponsible and self-destructive behavior? Well, okay, leave aside the morality of forcing people to eat too much fat without roughage (really forcing, since as I pointed out in the last post, carnivores pass on salads partly because the government won't leave them enough of their own money to afford a full meal). The problem is, salads are cheap, and treating heart disease isn't. Given that we're not going to let them die, it makes much more fiscal sense just to give them the veggies.
The libertarian answer is to eliminate both the restrictions on salad purchases, and the government program to distribute them, and I'd support that. But given that we are clearly not going to eliminate taxes any time soon, we might as well save money by giving meat eaters a healthy salad.
I think there are assumptions here that are not valid. Although it seems believable, the assertion that you cannot readily buy syringes and needles is likely flawed. I think there are only 4 states that disallow their sale without a prescription--Delaware, Massachusetts, Pennsylvania, and New Jersey (seems that the East Coast is behind the times here). Sterile needles and syringes are readily available at the pharmacy without prescriptions already--and, better yet, they are relatively cheap. I actually have personal experience out here in Colorado--I need syringe needles for my line of work and since the scientific supply company was being sluggish about their delivery, I went to Wal-mart (who were willing to sell them, but didn't have the correct kind) and Walgreens, that actually had them and sold them to me.
So my take here is, if sales are already widely allowed over the counter, it seems that needle exchange programs are there for the benefit of drug users that are too lazy and wacked out to actually go and buy their own syringes--it most likely isn't due to lack of money or access.
I had a post here that never made it through "this post is being held by the blog owner for review". I'm not that crazy about that system. I expect the blog owner is too busy to actually review posts.
The post basically noted that syringes are legal over the counter in Vietnam and cost 50 cents each - libertarian paradise! - yet the country has a pretty bad and growing heroin epidemic with massive sharing of needles that's driving a rising HIV epidemic. Users share needles because they're too lazy and disorganized to go buy a fresh one for themselves, and protecting their long-term health is the last thing on their minds when they've got a fix -- i.e., they're drug addicts. Needle exchange programs are much more than a way to obtain syringes; they're outreach programs intended to make sure that lazy, disorganized drug users have fresh needles on hand, in order to protect all of us from HIV. (Notably, in Vietnam, they protect the users' wives, who often don't know their husbands are using and have no effective way to protect themselves given Vietnamese cultural norms.) And, indeed, needle exchange outreach programs, which employ former (and, though they don't admit it, current) addicts to go out and find their addict friends and make sure they turn in old needles for new ones, have been proven effective in reducing the spread of HIV in the neighborhoods where they're in effect.
We're talking about drug addicts. Any solution based on trusting individuals to pursue their own self-interest -- and I'm afraid virtually all libertarian "answers" rely on this model -- is simply not adequate in this case. The libertarian perspective is valuable here because it speaks to how ineffective it is to try to control individuals' drug use behavior through compulsion. But trusting drug users to behave rationally isn't acceptable; it leads to IDU-driven disease epidemics. To protect the public health, the government needs to do more than leave drug addicts alone. It needs to go out, find them, and make sure they're not using dirty works. It's a lot cheaper than treating them, and everyone they've infected, for AIDS.
Obviously, as JordanT said, the best solution of all is the Australian and Dutch one, which puts all of the solutions to the various IDU-related health problems under one roof for efficiency, and leads to dramatically reduced rates of heroin use.