Barbour Kyle, McQuade Miriam, Brown Brandon
UC Irvine School of Medicine, Irvine; Orange County Needle Exchange Program (OCNEP), Santa Ana, USA.
UC Riverside School of Medicine, Riverside, USA.
Subst Abuse Treat Prev Policy. 2017 Mar 17;12(1):15. doi: 10.1186/s13011-017-0099-0.
Needle exchange programs are safe, highly effective programs for promoting health among people who inject drugs. However, they remain poorly funded, and often illegal, in many places worldwide due to fear and stigma surrounding drug use. Continued advocacy, education, and implementation of new needle exchanges are thus essential to improve public health and reduce structural inequality.
We argue that students, and especially professional and graduate students, have the potential to play an important role in advancing harm reduction. Students benefit from the respect given to the professions they are training to enter, which gives them leverage to navigate the political hurdles often faced by needle exchange organizers, especially in areas that presently lack services. In addition, due to their relative simplicity, needle exchanges do not require much of the licensing, clinical knowledge, and infrastructure associated with more traditional student programs, such as student-run free medical clinics. Students are capable of learning harm reduction cultural approaches and techniques if they remain humble, open-minded, and seek the help of the harm reduction community. Consequently, students can generate tremendous benefits to their community without performing beyond their appropriate clinical limitations. Students benefit from organizing needle exchanges by gaining applied experience in advocacy, organization-building, and political finesse. Working in a needle exchange significantly helps erode stigma against multiple marginalized populations. Students in health-related professions additionally learn clinically-relevant knowledge that is often lacking from their formal training, such as an understanding of structural violence and inequality, root causes of substance use, client-centered approaches to health services, and interacting with clients as peers, rather than through the standard hierarchical medical interaction.
We therefore encourage students to learn about and consider organizing needle exchanges during their training. Our experience is that students can be successful in developing sustainable programs which benefit their clients, the broader harm reduction movement, and themselves alike.
针头交换项目是在注射吸毒者中促进健康的安全且高效的项目。然而，由于对吸毒的恐惧和污名化，在世界许多地方，这些项目资金仍然匮乏，且常常是非法的。因此，持续开展宣传、教育以及实施新的针头交换项目对于改善公众健康和减少结构性不平等至关重要。
我们认为，学生，尤其是专业学生和研究生，有潜力在推进减少伤害方面发挥重要作用。学生受益于人们对他们即将进入的职业的尊重，这使他们有能力应对针头交换项目组织者经常面临的政治障碍，特别是在目前缺乏此类服务的地区。此外，由于针头交换项目相对简单，它们不需要太多与更传统的学生项目（如学生运营的免费医疗诊所）相关的许可、临床知识和基础设施。如果学生保持谦逊、开放的心态，并寻求减少伤害社区的帮助，他们能够学习减少伤害的文化方法和技巧。因此，学生可以在不超出其适当临床限制的情况下为社区带来巨大益处。学生通过组织针头交换项目，在宣传、组织建设和政治策略方面获得实践经验。参与针头交换工作显著有助于消除对多个边缘化群体的污名化。从事与健康相关职业的学生还能学到他们正规培训中常常缺乏的临床相关知识，比如对结构性暴力和不平等、物质使用的根本原因、以客户为中心的健康服务方法以及与客户平等互动（而非通过标准的等级制医疗互动）的理解。
因此，我们鼓励学生在培训期间了解并考虑组织针头交换项目。我们的经验是，学生能够成功开展可持续项目，这些项目能使他们的客户、更广泛的减少伤害运动以及他们自己都受益。
