Breakdown of Debate Topic #4:
"The US government should sponsor needle exchange programs, administered in local communities for intravenous drug users."
(Revised October 7, 2002)

Recognize that each topic we use for debates in Sociology 130 is complicated. It has valid arguments for both sides. To succeed in debates, students must understand both sides of the argument. You do not succeed simply by stating your opinion intensely and dramatically. You need to understand that the other side has strong arguments and good data. They will find weaknesses in your position and bring out information and arguments that hurt your point of view. Only if you can similarly attack the other side and only if you appreciate the difficulties of the argument for your side and figure out how to make your case strongly will you win the debate.

The first step in building a strong argument is to break down your topic. You need to lay out the pieces of information and the points of argument that people need to hear in order to understand what is going on, to know what information is significant, and to understand the several arguments or points of view that make your position a strong one. At the same time, you need to know the information the opposing side will use to inform the audience, give data to support their case, and to make various points to make their position convincing and believable.

One of the first things you need to do with your team is to break down your topic so you can understand what will go into the argument. Some of the most important avenues of argument will only become visible to you after you have done some research. At the same time, you can only begin researching your topic in depth if you have broken it down into subareas. Only then can you give different research assignments for your team members, avoid duplication of effort, and go deeply into your topic. If you stay skimming the surface your debate project will not be successful.

We prepared the following breakdowns for the debate topics we used in Sociology 130 for the Spring, 2000, semester. We hope they will provide you with a guide for breaking down your topic this semester.

Debate Question #4: "The US government should sponsor needle exchange programs, administered in local communities for intravenous drug users."

This question involves an intractable conflict of values and policies. On one side is the War on Drugs and "Just Say No" philosophy that the number one moral and social problem in America is drug abuse. We should not be giving out clean needles because it seems to encourage and legitimate drug abuse. On the other hand one of the fastest growing groups infected by the HIV virus are drug users who inject their drug of choice. HIV is transmitted when people share blood or blood products (like semen) and often when drug users share needles blood from the last user remains in the "works" when the paraphernalia are passed on. If our concern is with the public health of the community and the society we should do anything we can to prevent the spread of the fastest growing killer of young adults, the #2 killer in that age group overall.

For this debate to be effective the two sides have to understand these value positions and articulate them in an informed, logical, and not overly emotional way. It will not help if the two groups just yell at each other while talking past each other. So it's important for the pro and the con both to understand the arguments for each side.

Also, since we are dealing with this issue in class on October 19 it will look bad for your presentation if you do not make good use of the readings assigned for that day. That assignment represents the report of a national government committee and it both gives important information and has lots of references in it.

You need to understand what drug abuse is, how it happens, what people do when they use drugs, and why needle sharing is such an important part of the culture. You also have to understand clearly what the authors argue about the spread of AIDS and the importance of keeping the HIV virus out of communities where it is not yet endemic.

Needle sharing is not just a strategy to keep individual users from getting HIV. It is a strategy for keeping HIV from moving from one community to another. You also have to understand that if drug users are infected by HIV many nonusers will also be infected. You need to understand why that is the case to appreciate why limiting its spread in the HIV community is important.

The argument that we should not have needle-sharing programs requires that you understand the complicated arguments about why drug using is wrong and why it is important to prevent abuse. We are most familiar with the arguments that drug use leads to addiction and that more innocuous drug use leads to use of more addictive and dangerous drugs. We also are told that drug use is spread among peers, so that addiction is not just bad for the person involved but because of the peer group and network effects of that use. Users try to exploit young and inexperienced people so that they too become part of the abuser community. Part of this is the idea that being expensive abusers want to sell drugs and they want to expand the community of users to increase the market.

You will want to look critically at this argument. There is quite a bit of evidence that much of that argument is distorted. Bucknell students instinctively believe that the "just say no" campaigns are distortions and that control efforts are heavy-handed and not really fair.

On the other hand, whether or not the anti-drug campaign is completely accurate in its claims we are talking about behavior that is illegal. We might argue that simply because drug abuse is illegal it should not be done and enforcement is justified. If we just ignore it when laws are broken this could undermine the legitimacy of the legal system. (Of course, this argument applies to underage drinking too so 2/3 of Bucknell students are on shaky ground there.)
This argument about the legitimacy of the legal system is particularly important in this debate because now we have a question about whether government programs should take actions that directly support known illegal behavior. Should we give out needles so that people can break the law? If we do that it makes it seem as though we do not view illegal drug activity as a very serious crime. Whatever Bucknell students might think, police and lots of people in the community-especially more conservative and more religious people-think drug use is really terrible. Why should we support illegal behavior that often leads to more illegal behavior while we offend people who obey and support the law?

One of the points in the question is that we are talking about federally supported needle exchange programs. We can reasonably ask under what federal program or department would this happen and under what principle of social policy? Why would we hand out clean needles when we do not have other comprehensive federal health programs? Isn't it a bit crazy to be helping addicts when we are not helping the uninsured, often people who are low income but working full time? Nor are we helping mothers and young children get adequate health care.

If we're so gung-ho on public health, shouldn't we do some priority setting and figure out which public health problems are most serious and which will produce the biggest bang for our bucks? HIV would be up there, but I bet with a little research you could find some really convincing alternative candidates for federal spending on health.

Of course to be fair, you need to look at needle exchange programs and see how they work and what they do. From past student debates I know that the evidence about their effectiveness is mixed. That is, there are issues about how well needle distribution is controlled and whether there actually is a one-for-one exchange. Needles from programs seem to start circulating on the streets and to become part of the drug market rather than limited to a therapeutic program. It is easy to dramatize this and make a few cases seem like they happen in all programs. Good controls would probably take care of this problem, although we have had people talk in some detail about how needle exchanges work and they have suggested that it is really hard to perfectly control the system. You can get important information by looking at the experience of these programs in Europe.

While there are problems, the positive side of these programs is that they do seem to control AIDS, they do not seem to lead to increases in drug use, and importantly they seem to encourage drug abusers to enter into rehabilitation programs. So, ironically, rather than increasing drug abuse as anti-drug activists claim they seem to reduce it.

One of the important things you have to control in this debate is the tendency to fire research results at the audience. Understand that the audience has no way to evaluate the research results you cite so that when the two sides give contradictory findings it simply confuses the issue. My understanding of the efficacy studies is that we do not know if these programs work. There is evidence that they have some good effects. There is evidence that there are problems. It would help if both sides in this debate acknowledged this reality and tried to make the case based on analytic arguments more than on the citation of studies where the findings can be disputed and debated.