This volume addresses the interface of two major national problems: the epidemic of HIV-AIDS and the widespread use of illegal injection drugs. Should communities have the option of giving drug users sterile needles or bleach for cleaning needs in order to reduce the spread of HIV? Does needle distribution worsen the drug problem, as opponents of such programs argue? Do they reduce the spread of other serious diseases, such as hepatitis? Do they result in more used needles being carelessly discarded in the community? The panel takes a critical look at the available data on needle exchange and bleach distribution programs, reaches conclusions about their efficacy, and offers concrete recommendations for public policy to reduce the spread of HIV/AIDS. The book includes current knowledge about the epidemiologies of HIV/AIDS and injection drug use; characteristics of needle exchange and bleach distribution programs and views on those programs from diverse community groups; and a discussion of laws designed to control possession of needles, their impact on needle sharing among injection drug users, and their implications for needle exchange programs.

This book reports on research on and experience with needle exchange and bleach distribution programs and their effects on rates of drug use, the behavior of injection drug users, and the spread of HIV and other infectious diseases among injection drug users. It discusses U.S. needle exchange data, international evaluations of needle exchange programs, legal issues and drug paraphernalia laws, evaluation methods, and bleach distribution programs.

Syringe exchange programs and safe injection services are outside-the-box interventions increasingly being used by governments, nonprofits and citizens to address dire issues percolating in tandem with America's burgeoning opioid epidemic. People who inject drugs (PWID)--almost a million Americans annually--commonly use painkillers such as heroin and fentanyl, as well as methamphetamine, benzodiazepines, barbiturates and cocaine. Yet the users themselves are often obscured or marginalized by the bigger picture. This collection of essays covers policies and practices aimed at preventing both opioid-related deaths and related infections of hepatitis and HIV.

One doctor's courageous fight to save a small town from a silent epidemic that threatened the community's future--and exposed a national health crisis. When Dr. Will Cooke, an idealistic young physician just out of medical training, set up practice in the small rural community of Austin, Indiana, he had no idea that much of the town was being torn apart by poverty, addiction, and life-threatening illnesses. But he soon found himself at the crossroads of two unprecedented health-care disasters: a national opioid epidemic and the worst drug-fueled HIV outbreak ever seen in rural America. Confronted with Austin's hidden secrets, Dr. Cooke decided he had to do something about them. In taking up the fight for Austin's people, however, he would have to battle some unanticipated foes: prejudice, political resistance, an entrenched bureaucracy--and the dark despair that threatened to overwhelm his own soul. Canary in the Coal Mine is a gripping account of the transformation of a man and his adopted community, a compelling and ultimately hopeful read in the vein of Hillbilly Elegy, Dreamland, and Educated.