Concerns have been expressed that needle exchange programs, which provide injection drug users with sterile replacements for their used needles and syringes, might contribute to an increase in the quantity of discarded needles found in public locations, thus posing a risk of needle stick injury to community members and sanitation workers (Doherty, 2000). Studies have fo

Politics have been the determining force in public health interventions every since the Jeffersonian-Democratic and Federalist parties split over whether yellow fever was contagious or not during the “Great Philadelphia Outbreak” of 1793 (Moss, 2000). Even today politicizing is extremely prevalent during infectious disease outbreaks. Because legislators are not scientist they do not fully respect the quality, extent, or the validity of research. The power of the political process is very seductive, but letting the political process decide what can be talked about is in the long run, giving up or limiting the power of empirical research (Moss, 2000). Activists are usually the force behind public awareness, especially when a particular group or groups are affected or disproportionately represented. Beginning AIDS research and treatment funding in the United States was a moral crusade driven by gay activism and powered by the idea that stigmatization should not prevail (Moss, 2000). Nevertheless, some states refuse to accept needle exchange programs as a preventative intervention method, thus helping to promote an infinite epidemic.

Because drug use has been associated with crime, there are concerns that the introduction of a needle exchange program may cause crime rates to increase in that area. In August of 1994, the Baltimore City Health Department opened a NEPs where program participants were exempt from the syringe possession laws within city limits. The immediate impact of the program was assessed and dates and locations of arrest and up to four criminal charges were abstracted (Marx, Crape, Brookmeyer, & Junge, 2000). With input from law enforcement, crime, and drug abuse experts, arrests were categorized as follows: (1) drug possession, (2) economically motivated offenses (property theft, etc.), (3) resistance to police autho

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