Talk:Needle and syringe programmes/Archive 3

Replace "addict" with "injection drug user" throughout
I am writing to propose replacement of all instances of the word "addict" with "injection drug user" (abbreviated to IDU). IDU is also used in this entry, however it is initially written as "injecting drug user in the first paragraph; this should be fixed.

The term "addict" is considered stigmatizing.
Here are a few of many sources which discourage the use of this word.

Data journalism chapter debuts in 2017 AP Stylebook avoid words like abuse, problem, addict and abuser in most uses.

Slate: Journalists, Stop Using Words Like Addict and Drug Abuser Finally, as someone who once had a heroin addiction, I would also argue that the AP’s change, and the shift it represents, could make it more likely that people with addictions will share their stories. For me, being called an “addict” defines my humanity with one small facet of my identity, essentially erasing the rest of me.

Government of Canada: Stigma around substance use avoid using slang and derogatory language such as "addict" and "junkie"

BC Centre for Disease Control: Language matters: reduce stigma, combat overdose

Always use person first language. Using stigmatizing terms like “abuser” or “addict” suggests these are the permanent, whole identities of people: Use ”a mother who is struggling with alcohol use”, rather than “addict” or “alcoholic” which misses other important parts of a person’s identity By saying someone is an “addict”, it’s implied they will always have this same behavior and change isn’t possible. Recovery is possible, and there is hope: the influence and effect of substances on someone’s life can change significantly Instead try using language like: Someone WITH a substance use disorder Someone WHO uses cocaine

Stigmatizing Harm Reduction Through Language: A Case Study Into the Use of “Addict” and Opposition to Supervised Injection Sites in Canada (full article behind paywall; quote from abstract): Within harm reduction discourse, the word "addict" can have detrimental effects on how the public perceives people experiencing addiction and their deservingness of pragmatic services. This article aims to draw attention to the inattention we give "addict" in language and explain how its routine use in society acts to perpetuate addiction stigma.

Appropriate alternative language
I would like to further advocate against any alternative term which references


 * Addiction, disorder, suffering, disease, problem, abuse, harm, misuse or dependence: the status, motivations and situation of any individual accessing this variety of service is not known and there is no requirement of a diagnosis of any sort to use them.


 * Specific drugs or categories of drugs: Many drugs can be used intravenously, not only opioids.

All we can infer about a person accessing a program which supplies equipment for injecting drugs is that they inject drugs. Therefor the only term which can accurately be applied is injection drug user. If variety is required, the term service user would also be OK.

WhatsBest (talk) 07:26, 3 May 2020 (UTC)
 * We should use whatever terms reliable sources use. We should avoid editorializing and neither label nor  censor, but instead should accurately relate what the sources say. I disagree with the assessment that saying someone is an addict "implied they will always have this same behavior and change isn’t possible". Saying someone is "a flu patient" does not imply that they will never recover from their flu. Also by that logic even calling someone "a mother" could be seen as reductive as it asserts that their only value lies in their having reproduced, and it just goes on and on. (also the present tense "is struggling" is inherently problematic we have no way of knowing when all we know is that they were at the point our sources wrote about them) Beyond that, and most importantly, it is not our place to make that assessment. We just follow the sources. Wikipedia is not here to shape the conversation, it is simply here to relate what is said. AmbivalentUnequivocality (talk) 06:26, 24 May 2020 (UTC)


 * , Wikipedia articles isn't a place to adopt the practices or traditions of any specific professions or circles. We try to convey what the source says accurately as possible without paraphrasing it so closely that it becomes a copyright infringement and while avoiding jargons. See WP:EUPHEMISM and WP:CENSOR just to avoid offending certain people. This said, if the source says "drug addicts", we don't write it as "tweakers", or doublespeak like "substance use disorder". We also don't want to make the article presented in the point of view of the "harm reduction" circle. Graywalls (talk) 06:07, 24 May 2020 (UTC)

proposing move to syringe service program or syringe service
There are programs that just hands out syringes without any being required to be returned. That, as well as those that require an exchange are both syringe service, but the needle distribution is not an "exchange". Graywalls (talk) 02:04, 12 March 2020 (UTC)
 * I came here from a note at WikiProject Medicine. Can you say something about what kinds of sources use which terms? Wikipedia generally mirrors the precedent of reliable sources.  Blue Rasberry   (talk)  23:02, 1 May 2020 (UTC)

✅ Graywalls (talk) 07:17, 24 May 2020 (UTC)
 * WHO uses "Needle and syringe programmes" as does this UK charity, suggest we go with that if we move. Doc James  (talk · contribs · email) 02:20, 3 May 2020 (UTC)
 * That sounds like a good target. "Needle and syringe programmes" it is. Graywalls (talk) 07:12, 24 May 2020 (UTC)

"Diversion" should be removed

 * It is under the heading "Arguments for and against". However there is no argument here and it's not obvious to me that it is favorable or unfavorable.
 * The term "diversion" is usually applied to controlled medication. Injection supplies are not prescribed, controlled medication.


 * "Diversion" carries a connotation of illicit, undesirable distribution. However, secondary distribution of injection equipment is not necessarily frowned upon by harm reduction workers. In fact, in Toronto, some health facilities use a satellite model which was developed to incorporate this kind of activity into programs because it was occurring spontaneously and was seen to be beneficial.

Existing sources
Neither of the mass media articles provided as sources are appropriate as sole sources in a science/health entry. Both of them contain mostly anecdotes and opinions.


 * I am not able to determine a date for the NPR link. Following the link goes to either a text-only version of the story with no date, or a generic NPR landing page with no date and no article.


 * The NPR story concludes that secondary distribution of equipment plays a useful role in enhancing beyond what the program is able to do alone. That is not consistent with the meaning of "diversion".


 * The Baltimore Sun article is 20 years old and the major science it cites was concluded in 1997. It is completely out of date. It uses the stigmatizing and inappropriate term "addict" in the title and throughout. The website is blocked when visiting from a European IP address.

WhatsBest (talk) 07:26, 3 May 2020 (UTC)
 * , Diversion in this context is obtaining them for flipping them. The citation formatting has been fixed so the date is visible. I added archived vefrsion for the Baltimore Sun, so it should be accessible globally. Graywalls (talk) 07:42, 24 May 2020 (UTC)

parked sources
2016 European disease stats https://www.emcdda.europa.eu/system/files/publications/2953/TDXD16002ENN_final_web.pdf Graywalls (talk) 08:12, 10 October 2020 (UTC)

Good-faith addition of a reference broke formatting
This good faith addition of a reference broke formatting. I removed the reference.
 * https://en.wikipedia.org/w/index.php?title=Needle_and_syringe_programmes&type=revision&diff=1031360050&oldid=1031359516

Here is the reference:

Can somebody figure out what was intended?

Thanks! Prokaryotic Caspase Homolog (talk) 16:13, 10 August 2021 (UTC)

Semi-protected edit request on 21 September 2021
In 1990 St. Ann's Corner of Harm Reduction (SACHR) was founded by Joyce Rivera, a National Science Foundation Fellow from 1981. SACHR is the oldest and longest running syringe exchange in the United States. Rivera is also a founding member of the National Harm Reduction Coalition (HRC), the North American Syringe Exchange Network (NASEN), and the Harm Reduction Care Network of New York (HRCNNY). Stemicher (talk) 15:16, 21 September 2021 (UTC)
 * Red question icon with gradient background.svg Not done: it's not clear what changes you want to be made. Please mention the specific changes in a "change X to Y" format and provide a reliable source if appropriate. ScottishFinnishRadish (talk) 15:30, 21 September 2021 (UTC)

Requesting the addition of a Tijuana/Mexico section
Tijuana is a hotbed for injection drug use, specifically along the US border where 60% of the population is mobile and a majority (67%) of drug users surveyed are mobile across the border, making this issue relevant to the American audience, it seems prudent to add sections from different countries when possible. .

Recently, the government has stopped providing funding for the syringe exchange programs within Tijuana, this is in relation to their new healthcare plan [|INSABI].

Many SEPs within Tijuana have not been, or are currently not planned on being replaced with government entities as of 2021, thus articles such as this one have popped up to tell NGOs how to finance their programs with donations as opposed to government funds

Brent Siegel (talk) 21:17, 21 April 2022 (UTC)

Brent Siegel (talk) 00:08, 22 April 2022 (UTC)== Requesting multiple edits/ citation additions ==

In the section community issues the quote: However, lack of control over what went on in the park caused a multitude of problems. Drug dealers and users arrived from all over Europe, and crime became rampant as dealers fought for control and addicts (who numbered up to 20,000) stole to support their habit." is improperly formatted and cited. — Preceding unsigned comment added by Brent Siegel (talk • contribs) 21:44, 21 April 2022 (UTC) Brent Siegel (talk) 00:08, 22 April 2022 (UTC)

Addressing the language and references in the drug use section and requesting to strike a source
Drug use According to a 2019 NBER paper by Miami University economist Analisa Packham, syringe exchange program reduce HIV rates up to 18.2 percent but lead to greater drug use.[83] Syringe exchange programmes increased drug-related mortality rates by 11.6 percent and opioid-related mortality rates by 25.4 percent.[83]

The article cited [83] is not peer reviewed. While this article is from a respected professor, the language used in the Drug Use section implies causality (specifically by saying "increased" as opposed to "was associated with") this difference between correlation and causality is important for wikipedia language. After reading the methods section of the study, I find the author also claims causality, however, based on the study design, causality cannot be claimed, but can be speculated to exist. The paper also only finds modest evidence that SEP's increase drug use, but before presenting this evidence it says that different variables used demonstrates a decrease in drug use, the proxy used was drug related arrests... a poor proxy for increase in drug use (p19)

Additionally, just as much research exists opposing the notion that SEP's are correlated with a decrease or no change in drug use by actual epidemiologists --not economists--. Thus in this section the negative views are over-represented Brent Siegel (talk) 00:08, 22 April 2022 (UTC)

Overall Review
The introduction is strong and unbiased.

In the United States section, biased language which seems to imply that the portland exchange was unsuccessful as SEP users did not have to exchange used syringes, the quoting of "exchange" makes it appear biased.

The funding portion, specifically: "In the United States, a ban on federal funding for needle exchange programs began in 1988, when conservate North Carolina Senator Jesse Helms led Congress to enact a prohibition on the use of federal funds to encourage drug abuse.[29]" seems to imply that these programs DO increase drug use when the jury is still out on that one. additionally it's conservative not conservate.

The orange county blurb in the california section deserves updating, an SEP named the orange county sryinge exchange program was created and then dismantled in 2020 after a court ordered injunction — Preceding unsigned comment added by Brent Siegel (talk • contribs) 00:29, 22 April 2022 (UTC)