The confusion which sees drug treatment as an alternative to needle exchanges. Drug treatment is vital and necessary. But not all people are ready for treatment. Having a needle exchange program is like having lifeguards at the beach. Then, when they are ready to stop using drugs, as many will, they will have their whole lives before them, not just a series of painful, expensive illnesses ending in death.
Needle exchanges can in fact become a vehicle in helping people seek drug treatment.
For hard core drug users who have few contacts outside the drug-using world, needle exchange workers are an important source of information about where to go to get drug treatment. In many ways our society protects people from their own bad judgment. For example, when we require people to use seat belts and buy cars with air bags, we are trying to protect reckless drivers as well as innocent victims. Unequal retribution is a hard concept to defend. And right now that is what we have.