This article is about the substance produced in the mouths of humans. For genus of a plant Salvia, see Salvia. For other uses, see Saliva (disambiguation). Saliva is the watery substance produced in the mouths of humans and most animals. Saliva is a component of oral fluid. In mammals, saliva is produced in and secreted from the three pairs of major salivary glands: the parotid, sublingual, and submandibular glands. Hundreds of other minor salivary glands also contribute to the production of saliva. Human saliva is composed of 98% water, while the other 2% consists of electrolytes, mucus, glycoproteins, enzymes, and antibacterial compounds such as secretory IgA and lysozyme. The enzymes found in saliva are essential in beginning the process of digestion of dietary starches and fats. These enzymes also play a role in breaking down food particles entrapped within dental crevices, protecting teeth from bacterial decay. Furthermore, saliva serves a lubricative function, wetting food and permitting the initiation of swallowing, and protecting the mucosal surfaces of the oral cavity from desiccation. Various species have special uses for saliva that go beyond predigestion. Some swifts use their gummy saliva to build nests. Aerodramus nests are prized for use in bird's nest soup. Cobras, vipers, and certain other members of the venom clade hunt with venomous saliva injected by fangs. Some arthropods, such as spiders and caterpillars, create thread from salivary glands.''
Digestion
The digestive functions of saliva include moistening food and helping to create a food bolus. This lubricative function of saliva allows the food bolus to be passed easily from the mouth into the esophagus. Saliva contains the enzyme amylase (also called ptyalin), and is thus capable of breaking down starch into simpler sugars that can be later absorbed or further broken down in the small intestine. Salivary glands also secrete salivary lipase (a more potent form of lipase) to begin fat digestion. Salivary lipase plays a large role in fat digestion in newborn infants as their pancreatic lipase still needs some time to develop. It also has a protective function, helping to prevent bacterial build-up on the teeth and washing away adhered food particles.''
Disinfectants
See also: Wound licking
A common belief is that saliva contained in the mouth has natural disinfectants, which leads people to believe it is beneficial to "lick their wounds". Researchers at the University of Florida at Gainesville have discovered a protein called nerve growth factor (NGF) in the saliva of mice. Wounds doused with NGF healed twice as fast as untreated and unlicked wounds; therefore, saliva can help to heal wounds in some species. NGF has not been found in human saliva; however, researchers find human saliva contains such antibacterial agents as secretory IgA, lactoferrin, lysozyme and peroxidase. It has not been shown that human licking of wounds disinfects them, but licking is likely to help clean the wound by removing larger contaminants such as dirt and may help to directly remove infective bodies by brushing them away. Therefore, licking would be a way of wiping off pathogens, useful if clean water is not available to the animal or person.
The mouth of animals is the habitat of many bacteria, some pathogenic. Some diseases, such as herpes, can be transmitted through the mouth. Animal and human bites are routinely treated with systemic antibiotics because of the risk of septicemia. Recent research suggests that the saliva of birds is a better indicator of avian influenza than are faecal samples.''
Hormonal function
Saliva secretes hormone gustin, which is thought to play a role in the development of taste budscitation needed. Saliva is not a harmful substance but a bacteria killercitation needed. Saliva kills unwanted bacteria in the mouth, and throatcitation needed.''
Iodine in salivary glands and oral health
The trophic, antioxidant and apoptosis-inductor actions and the presumed anti-tumour activity of iodide might also be important for prevention of oral and salivary glands diseases.''
Stimulation
The production of saliva is stimulated both by the sympathetic nervous system and the parasympathetic. The saliva stimulated by sympathetic innervation is thicker, and saliva stimulated parasympathetically is more watery.''
Sympathetic stimulation of saliva is to facilitate respiration, whereas parasympathetic stimulation is to facilitate digestion. Parasympathetic stimulation leads to acetylcholine (ACh) release onto the salivary acinar cells. ACh binds to muscarinic receptors and causes an increased intracellular calcium ion concentration (through the IP3/DAG second messenger system). Increased calcium causes vesicles within the cells to fuse with the apical cell membrane leading to secretion formation. ACh also causes the salivary gland to release kallikrein, an enzyme that converts kininogen to lysyl-bradykinin. Lysyl-bradykinin acts upons blood vessels and capillaries of the salivary gland to generate vasodilation and increased capillary permeability respectively. The resulting increased blood flow to the acinar allows production of more saliva. Lastly, both parasympathetic and sympathetic nervous stimulation can lead to myoepitheilium contraction which causes the expulsion of secretions from the secretory acinus into the ducts and eventually to the oral cavity. Saliva production may also be pharmacologically stimulated by so called sialagogues. It can also be suppressed by so called antisialagogues.''
Daily salivary output
There is much debate about the amount of saliva that is produced in a healthy person per day; estimates range from 0.75 to 1.5 liters per day while it is generally accepted that during sleep the amount drops to almost zero. In humans, the submandibular gland contributes around 70–75% of secretion, while the parotid gland secretes about 20–25 % and small amounts are secreted from the other salivary glands.''
Information
Joint health: Jointsjoints
Sunday, July 1, 2012
Saliva Production
What is Gumboil? (Cause Swollen Gums)
Gumboil, known medically as Parulus is defined as a drainage point for abscessed teeth. This is a dental infection that occurs around the root of the tooth. It can be caused by a number of reasons, the most common among them being tooth decay, gum infections or a failed root canal. Gum boil appears as a small red bulging in the gum which when pressed drains out pus or occasionally blood. This condition is very painful and may also cause fever, swelling of the face and earache. The patient may experience a foul salty taste in his mouth and bad breath due to the pus draining out.''
Causes of gum boils
One of the main reasons of gum boil is tooth decay. Tooth decay causes the nerves to die and these dead nerves cause infection. As a defense mechanism against the infection, the body produces more white blood corpuscles to get rid of the toxins in the affected area. When the white blood corpuscles die off, their remains accumulate and they form an abscess.
Another cause of gum boil is gingival abscess, which is painful swelling of the gum caused by infection of bacteria that enter the gum possibly through an injury caused in the gum. The infection may sometimes spread to surrounding tissues and if not treated properly may lead to long term complications.
Gum boils can also be caused by weak immune system.
Symptoms of gum boils
Following are the symptoms associated with gum boils
Tooth ache
Nausea
Fever
Mild to extreme Pain
Bad breath
Swelling of mouth or face
Swelling of glands
Ear ache
Diarrhea
Prevention of gum boils
Most gum diseases are caused by improper dental hygiene which leads to the buildup of bacteria and plaque. Gum boils can be prevented to a great extent by taking proper care of your teeth strictly on a daily basis. Even though we brush our teeth daily, it is important to do it the right way. A minimum of at least two minutes should be spent to brush your teeth using fluoride toothpaste. Also make it a habit to brush your teeth twice daily, in the morning and at bedtime. Nighttime brushing is a must, because it is at this time that the bacteria grow in large numbers increasing the risk of gum diseases. Apart from brushing dental flossing, at least once a day can keep your teeth and gums clean and healthy. Using an antibacterial mouthwash to rinse your mouth will help to remove any food particles or plaque that might be present in the teeth.''
Maintaining a proper diet rich in nutrients will keep your teeth healthy and strong. Smoking, consuming food and drinks that contains high sugar content are a few things to be avoided to prevent gum diseases. Last, but not least, it is highly essential to visit your dentist once in every six months for a thorough check up and cleaning of your teeth.''
This is a PSA video about the importance of proper dental hygiene. In this video I show an abscess on the gums because of poor dental hygiene, and I also show a very easy way to help prevent this from happening.''
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Bleeding Tongue
Bleeding Tongue
Tongue is a muscle which consists of soft tissues. There is a dense network of blood vessels inside the tongue. Tongue, being one of the most utilized muscles of the body, is susceptible to various injuries. Due to the heavy network of blood vessels underneath, the damage easily causes them to rupture. This results in profuse bleeding of the tongue. Although, the cause of bleeding tongue can be as minor as biting a tongue, the presence of large number of bacteria in mouth makes it an issue of concern. More often than not, it leads to infections of serious consequence, if not treated in time.''
Causes
There are myriad causes for bleeding tongue, most common causes include, biting of tongue while eating or talking. Ill fitting dentures or dental implants may also cause bleeding of tongue. A broken teeth may often result in deep cut on tongue which leads to heavy bleeding. Sometimes, tongue ulcers may develop on the tongue which are extremely painful and bleed occasionally. Sometimes, cold sores and canker sores may also develop on the tongue, which may cause bleeding. Rarely, the cause of bleeding tongue can be something as serious as tongue cancer.''
Symptoms
The most important of all symptoms is obviously blood flow at the sight of damage. Sometimes, when the impact of the injury is not enough to rupture the underlying blood vessels, it may only lead to redness of tongue. The area becomes tender to touch and is very prone to further damage while eating or talking. If the cause of bleeding tongue is tongue cancer, then you may experience a slight growth at the base of the tongue, at the back of your mouth. This growth is in the form of a white or red spot, which bleeds frequently and without any apparent reason. In addition, you may have a persistent bad breath and a bad taste in mouth.''
Remedies
When you accidentally bite your tongue while eating or talking, you first need to attend to the blood flow. Before touching your tongue with your hand, wash it with a disinfectant soap, because tongue is prone to all kinds of infection. Then press the wound with a clean gauze pad or a cloth. Tilt your head forward to avoid chocking due to blood that accumulates at the back of throat. Apply a cube of ice on the tongue for some time. It will constrict the blood vessels and eventually stop the blood flow. You may also place a cold tea bag containing black or green tea. The tannins in black and green tea facilitates the coagulation of blood. You can also use some herbs for treating bleeding tongue. These herbs are as follows.''
Alum Root: Alum root has amazing antiviral and astringent properties. It is very effective against bleeding, tongue ulcers and skin abrasions. It is available in capsules, which can be ground to make a mouthwash.''
Calendula: Calendula tea has great healing properties and promotes the repair of damaged tissues. Drink calendula tea thrice a day to treat bleeding tongue.
Lemon Balm: Lemon balm is a herb which has effective antiviral properties. It is mostly used in mouth washes for its disinfectant properties. Swish lemon balm mouthwash at least 3 to 4 times a day.
Licorice: Licorice is a great remedy due to its anti-inflammatory properties. Consume licorice until the symptoms of bleeding tongue disappear.
Bleeding tongue can be extremely painful and difficult to treat due to continuous saliva production in the mouth. If you have severely injured your tongue, you should immediately consult a medical practitioner, who may initiate the treatment without further delay.
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What Causes Tongue Ulcers
You don't have to be a stressed-out CEO of a large corporation to develop an ulcer. Even those spicy foods won't cause an ulcer. In the past, it was believed stress and diet caused peptic ulcers. Later, researchers stated stomach acids (hydrochloric acid and pepsin) contributed to the majority of ulcer formation. Today, however, research shows that most ulcers develop as a result of infection with a bacterium called Helicobacter pylori. Research studies have shown that most ulcers are caused by an infection by a bacteria called Helicobacter pylori -- also referred to as H. pylori. While the other factors listed below can also cause ulcers, H. pylori is now considered the cause of most ulcers. The H. pylori bacterium is found in the stomach, and along with acid secretion, can damage the tissue of the stomach and duodenum, causing inflammation and ulcers.''
Acid and pepsin
These powerful digestive fluids are believed to contribute to the formation of ulcers. In ideal situations, the stomach can protect itself from these fluids in several ways. These are:
* The stomach produces a lubricant-like mucus that coats the stomach and shields stomach tissues.
* The stomach can produce a chemical called bicarbonate that neutralizes digestive fluids and breaks them down into less harmful substances.
* Blood circulation in the lining of the stomach, as well as cell renewal and repair, help protect the stomach.
NSAIDS
NSAIDS are non-steroidal anti-inflammatory drugs. The most commonly known NSAIDS are aspirin, ibuprofen and naproxen sodium. Others are prescription NSAIDS used to treat several arthritic conditions. NSAIDS can make the stomach's defense mechanisms to fail in a couple of different ways:
* They can make the stomach vulnerable to the harmful effects of acid and pepsin by interfering with the stomach's ability to produce mucus and bicarbonate.
* They can affect cell repair and blood flow to the stomach.
Smoking
Studies show that cigarette smoking can increase a person's chance of getting an ulcer. Smoking also slows the healing of existing ulcers and contributes to ulcer recurrence.''
Caffeine
Beverages and foods that contain caffeine can stimulate acid secretion in the stomach. This can aggravate an existing ulcer, but the stimulation of stomach acid can't be attributed solely to caffeine.''
Alcohol
While a link hasn't been found between alcohol consumption and peptic ulcers, ulcers are more common in people who have cirrhosis of the liver, a disease often linked to heavy alcohol consumption.''
Stress
Emotional stress is no longer thought to be a cause of ulcers, but people who are experiencing emotional stress often report increased pain of existing ulcers. Physical stress, however, is different. It can increase the risk of developing ulcers, especially in the stomach. Examples of physical stress that can lead to ulcers are that suffered by people with injuries such as severe burns, and people undergoing major surgery.''
What is a Toothache? (Toothache Treatment)
* Over-the-counter pain medications such as acetaminophen (Tylenol) or ibuprofen (Advil) may be used. Take these as directed on the package and around the clock on a schedule while you arrange a dental appointment.
* Avoid very cold or hot foods because this may make the pain worse.
*Relief may be obtained from biting on a cotton ball soaked in oil of cloves. Oil of cloves is available at most drug stores.''
"Toothache" usually refers to pain around the teeth or jaws primarily as a result of a dental condition. In most instances, toothaches are caused by tooth problems, such as a dental cavity, a cracked tooth, an exposed tooth root, or gum disease. However, disorders of the jaw joint (temporo-mandibular joint) can also cause pain that is referred to as "toothache." The severity of a toothache can range from chronic and mild to sharp and excruciating. The pain may be aggravated by chewing or by cold or heat. A thorough oral examination, which includes dental X-rays, can help determine whether the toothache is coming from a tooth or jaw problem and the cause.''
Sometimes, a toothache may be caused by a problem not originating from a tooth or the jaw. Pain around the teeth and the jaws can be symptoms of diseases of the heart (such as angina or heart attack), ears (such as inner or external ear infections), and sinuses (air passages of the cheekbones). For example, the pain of angina (inadequate supply of oxygenated blood to the heart muscle because of narrowing of the arteries to the heart) is usually located in the chest or the arm. However, in some patients with angina, a toothache or jaw pain is the only symptom of their heart problem. Infections and diseases of the ears and sinuses can also cause pain around the teeth and jaws. Therefore, evaluations by both dentists and doctors are sometimes necessary to diagnose medical illnesses causing "toothache."
What are dental causes of toothaches?
Common dental causes of toothaches include dental cavities, dental abscess, gum disease, irritation of the tooth root, cracked tooth syndrome, temporomandibular joint (TMJ) disorders, impaction, and eruption.''
Dental cavities & dental abscess
The most common cause of a toothache is a dental cavity. Dental cavities (caries) are holes in the two outer layers of a tooth called the enamel and the dentin. The enamel is the outermost white hard surface and the dentin is the yellow layer just beneath the enamel. Both layers serve to protect the inner living tooth tissue called the pulp, where blood vessels and nerves reside. Certain bacteria in the mouth convert simple sugars into acid. The acid softens and (along with saliva) dissolves the enamel and dentin, creating cavities. Small, shallow cavities may not cause pain and may be unnoticed by the patient. The larger deeper cavities can be painful and collect food debris. The inner living pulp of the affected tooth can become irritated by bacterial toxins or by foods and liquids that are cold, hot, sour, or sweet, thereby causing toothaches. Severe injury to the pulp can lead to the death of pulp tissue, resulting in tooth infection (dental abscess). A small swelling or "gum blister" may be present near the affected tooth as well. Toothaches from these larger cavities are the most common reason for visits to dentists.''
Treatment of a small and shallow cavity usually involves a dental filling. Treatment of a larger cavity involves an onlay or crown. Treatment for a cavity that has penetrated and injured the pulp or for an infected tooth is either a root canal procedure or extraction of the affected tooth. The root canal procedure involves removing the dying pulp tissue (thus avoiding or removing tooth infection) and replacing it with an inert filling material. The procedure is used in an attempt to save the dying tooth from extraction. Once a root canal procedure is done, the tooth is more prone to fracture and will oftentimes require a crown to protect it.''
Gum disease
The second most common cause of toothache is gum disease (periodontal disease). Gum disease refers to inflammation of the soft tissue (gingiva) and abnormal loss of bone that surrounds and holds the teeth in place. Gum disease is caused by toxins secreted by certain bacteria in "plaque" that accumulate over time along and under the gum line. This plaque is a mixture of food, saliva, and bacteria. An early symptom of gum disease is gum bleeding without pain. Pain is a symptom of more advanced gum disease as the loss of bone around the teeth leads to the formation of deep gum pockets. Bacteria in these pockets cause gum infection, swelling, pain, and further bone destruction. Advanced gum disease can cause loss of otherwise healthy teeth. Gum disease is complicated by such factors as poor oral hygiene, family history of gum disease, smoking, and family history of diabetes.''
Treatment of gum disease always involves oral hygiene and removal of bacterial plaque and tartar (hardened plaque). Moderate to advanced gum disease usually requires a thorough cleaning of the teeth and teeth roots called "scaling and root planing" and "subgingival curettage." Scaling and root planing is the removal of plaque and tartar from exposed teeth roots while subgingival curettage refers to the removal of the surface of the inflamed layer of gum tissue. Both of these procedures are usually performed under local anesthesia and may be accompanied by the use of oral antibiotics to overcome gum infection or abscess. Follow-up treatment, if necessary, may include various types of gum operations. In advanced gum disease with significant bone destruction and loosening of teeth, teeth splinting or teeth extractions may be necessary.''
Tooth root sensitivities
Toothache can also be caused by exposed tooth roots. Typically, the roots are the lower two-thirds of the teeth that are normally buried in bone. The bacterial toxins dissolve the bone around the roots and cause the gum and the bone to recede, exposing the roots. The condition of exposed roots is called "recession." The exposed roots can become extremely sensitive to cold, hot, and sour foods because they are no longer protected by healthy gum and bone.''
Early stages of root exposure can be treated with topical fluoride gels applied by the dentist or with special toothpastes (such as Sensodyne or Denquel) which contain fluorides and other minerals. These minerals are absorbed by the surface layer of the roots to make the roots stronger and less sensitive to the oral environment. Dentists may also apply "bonding agents" to the exposed roots to seal the sensitive areas. If the root exposure causes injury and death of the inner living pulp tissue of the tooth, then a root canal procedure or tooth extraction may be necessary.''
Cracked tooth syndrome
"Cracked tooth syndrome" refers to a toothache caused by a broken tooth (tooth fracture) without associated cavity or advanced gum disease. Biting on the area of tooth fracture can cause severe sharp pains. These fractures are usually due to chewing or biting hard objects such as hard candies, pencils, nuts, etc. Your dentist can usually detect the fracture by painting a special dye on the cracked tooth or shining a special light on the tooth. Treatment usually involves protecting the tooth with a full-coverage crown made of gold and/or porcelain. However, if placing a crown does not relieve pain symptoms, a root canal procedure may be necessary.''
Temporomandibular joint (TMJ) disorders
Disorders of the temporomandibular joint(s) can cause pain which usually occurs in or around the ears or lower jaw. The TMJ hinges the lower jaw (mandible) to the skull and is responsible for the ability to chew or talk. TMJ disorders can be caused by different types of problems such as injury (such as a blow to the face), arthritis, or jaw muscle fatigue from habitually clenching or grinding teeth. Habitual clenching or grinding of teeth, a condition called "bruxism," can cause pain in the joints, jaw muscles, and the teeth involved. Bruxism is often due to life "stress," family history of bruxism, and poor bite alignment. Sometimes, muscles around the TMJ used for chewing can go into spasm, causing head and neck pain and difficulty opening the mouth normally. These muscle spasms are aggravated by chewing or by stress, which cause the patients to clench their teeth and further tighten these muscles. Temporary TMJ pain can also result from recent dental work or by the trauma of extracting impacted wisdom teeth.''
Treatment of temporo-mandibular joint pain usually involves oral anti-inflammatory over-the counter (OTC) drugs like ibuprofen (Motrin or Advil) or naproxen (Aleve). Other measures include warm moist compresses to relax the joint areas, stress reduction, and/or eating soft foods that do not require much chewing. If bruxism is diagnosed by a dentist, a bite appliance (night guard) may be recommended that is worn during the night to protect the teeth. However, this bite appliance is used mainly to protect the teeth and may not help with joint pain. For more serious cases of joint pain, a referral to a TMJ specialist may be necessary to determine further treatment.''
Impaction & eruption
Dental pain can come from teeth that are erupting (tooth growing out or "cutting") or are impacted (tooth has failed to emerge into its proper position and remains under gum and/or bone). When a molar (the large teeth at the back of the jaw) tooth erupts, the surrounding gum can become inflamed and swollen. Impacted teeth cause pain when they put pressure onto other teeth or bone and are inflamed and/or infected. Treatment for impacted teeth is usually pain medication, antibiotics (for infections), and surgical removal. This most commonly occurs with impacted molar (wisdom) teeth.''
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Monday, June 25, 2012
Does Needle Exchange Reduce HIV? Needle Exchange Programs
Do They Help Prevent HIV Infection?
Why Do We Need Needle Exchange?
More than a million people in the United States inject drugs, at a cost to society (in health care, lost productivity, accidents, and crime) of more than $50 billion a year. Obviously, people who inject drugs imperil their health. But if they become infected with HIV or Hepatitis C they also imperil their needle sharing partners, sexual partners and offspring as well.
One-third of all AIDS cases are linked to injection drug use. For women, 64 percent of all AIDS cases are due to injection drug use or sex with partners who inject drugs. Injection drug use is the source of infection for more than half of all children born with HIV.
Around the world and in more than sixty locations in the United States, needle exchange programs have sprung up to address drug injection risks. These programs:
• distribute clean needles
• safely dispose of used needles
• offer referrals to drug treatment
• offer HIV counseling and testing
Why Do Drug Users Share Needles?
The answer is as simple as supply and demand. Needle sharing is common in part because there are not enough needles and syringes to go around. The overwhelming majority of intravenous drug users (IVDUs) are aware of the HIV risk associated with sharing contaminated equipment. However, sterile needles are not always available or affordable and their physical and emotional need for injectable drugs clouds their better judgement.
Most US states have paraphernalia (items used to inject or use drugs) laws that make it a crime to possess or distribute drug paraphernalia not for a "legitimate medical purpose". If caught those that break these laws are subject to prosecution. In addition, ten states and the District of Columbia have laws that require a prescription to buy a needle and syringe. Even where over-the-counter sales of syringes are permitted by law, pharmacists are often unwilling to sell to IVDUs.
In July of 1992, the state of Connecticut passed a law permitting the purchase and possession of up to ten syringes without a prescription. After the new law went into effect, the sharing of needles among IVDUs decreased, indicating a shift from street needle and syringe purchasing to pharmacy purchasing. It's believed that such a shift could decrease HIV infection due to needle sharing.
How Can Injection Risks Be Reduced?
Getting drug injectors into treatment and off drugs is the best answer. Unfortunately, not all drug injectors are ready to quit. Even those who are highly motivated may find few drug treatment services available. Drug treatment centers frequently have long waiting lists and fewer than 15 percent of IVDUs are in treatment at any given time.
For those who cannot or will not stop injecting drugs, the best way to avoid spreading HIV is to use a sterile needle for each injection, or at the very least not to share needles. Users who share should disinfect their injection equipment thoroughly with bleach, although this is not as safe as always using a sterile needle and syringe.
Does Needle Exchange Encourage Drug Use?
There is no evidence that needle exchange programs increase the amount of drug use by needle exchange clients in the community in general. A study of a San Francisco needle exchange program that opened in 1988 found that from 1987 to 1992, frequency of injecting drugs among street-recruited IVDUs declined from 1.9 to 0.7 injections per day. The mean age of IVDUs increased from 36 to 42 years, and the percentage of new initiates into injection drug use dropped from three percent to one percent. Drug abuse and the recruitment of new or younger users did not increase in the presence of the exchange; in fact, the exchange may have helped decrease the amount of drug abuse in the area.
Does Needle Exchange Reduce the Spread of HIV?
Simply put, the answer is yes, almost certainly. Needle exchange programs are based on a sound public health principle; the principle of eliminating the item that helps transmit infection from one person to another, just as, for example, reducing the number of mosquitoes helps prevent malaria.
Needle exchange programs have also achieved reductions in the rate of hepatitis infection, which can also be spread through sharing needles. In Tacoma, WA, clients of a needle exchange program were up to eight times less likely to contract Hepatitis B or C than non-client IVDUs.
Finally, needle exchange programs can act as a bridge to:
• drug treatment
• HIV testing and counseling
• primary medical care
• tuberculosis and sexually transmitted disease screening
Source: Lurie, P. and DeCarlo, P., The Center for AIDS Prevention Studies at the University of California San Franciso, 2005.
Should Needle Exchange be Funded?
The key to slowing the HIV epidemic is HIV prevention. There are several prevention techniques that slow the transmission of HIV from one person to another. One such prevention method is needle exchange.
Needle exchange involves providing clean, sterile needles and syringes to IV drug users in exchange for their used syringes and needles. If IV drug users can't stop injecting recreational drugs, then providing them with sterile needles and syringes should decrease the incidence of sharing needles. As we know, sharing needles is a source of HIV infection. Decrease needle sharing and HIV transmission will decrease. But how should needle exchange programs be funded? Right now, it's illegal to use federal monies to fund needle exchange programs. Because of this, funding is difficult and programs struggle to survive. Should needle exchange programs be funded by the federal government? There are two schools of thought.
Current Status
Globally, sex between men and women is by far the most common way of passing on HIV. But a second transmission route drives the epidemic in many countries outside Africa; transmission among men and women who inject drugs. Injection of any sort is a more efficient way of spreading HIV than sexual intercourse. Since injecting drug users are often linked in tight networks, sharing injection equipment is common. But because the injection equipment is rarely disinfected, HIV infection among this population is common.
Also, people who inject drugs may acquire HIV infection through their sexual partners while having unprotected sex. In the United States, it's estimated that 9 out of 10 cases of heterosexual transmission of HIV occurring in New York City is related to sex with a drug user. In some places, including much of China and parts of India and Myanmar, more women are infected through sex with drug users than any other way. Injecting drug use also contributes to mother-to-child transmission of HIV. In Uruguay, 40 percent of babies with HIV are born to mothers who inject drugs.
So it's clearly obvious that transmission of HIV by way of sharing dirty needles must be addressed. The way to address the issue is through needle exchange. But how do we pay for exchange programs?
What's all the Fuss About?
If needle exchange is the answer, then why all the fuss? Programs should be funded and put in place across the country. If only it were that easy. The fact of the matter is, needle exchange is a politically charged issue that few want to take on. It's because of the controversial nature of needle exchange that programs are not federally funded. In fact, the law states that needle exchange programs can't be paid for with federal monies. And because of the politics involved, few government leaders are willing to risk their careers by fighting for change.
Arguments For
Proponents of needle exchange site several reasons why the federal government should get involved and offer funding for such programs.
• Data shows that upwards of 90 percent of heterosexually transmitted HIV is related to IV drug use and the sharing of dirty needles.
• Data shows that in several communities in the US and around the world, HIV transmission has increased where needle sharing and injecting drug use is common.
• Many studies have proven that needle exchange programs lead to decreased rate of HIV transmission among IV drug users.
• Studies have concluded that needle exchange does not increase the incidence of IV drug use.
• Some studies have shown that entrance into drug treatment programs are increased in the presence of needle exchange programs.
Arguments Against
Opponents of federally funded needle exchange point out several concerns.
• Funding needle exchange programs sends the "wrong message" to children.
• Clean needle exchange will lead to an increase in IV drug use among populations already ravaged by recreational drug use.
• Federal funding of exchange programs would allow tax dollars to be used to increase the amount of drug paraphernalia in areas already overburdened with IV drug use.
• Distributing drug paraphernalia is in stark contrast to the accepted morals of our culture.
Where it Stands
While acceptance and funding of needle exchange programs has continued in the private sector as well as the state and local level, the federal government continues to balk at offering funding of any sort. Yet, studies continue to show that needle exchange programs are successful in decreasing HIV transmission. So the debate continues.