An ongoing opiate use epidemic has given drug use and policy new importance in public discourse. This paper provides an historical overview of American drug history, questioning how policy became and remains generally punitive. But many opponents of imposed abstinence consider a certain amount of addiction unavoidable and advocate for "harm reduction," or to mitigate the personal and social consequences of some inevitable drug use. The second half of this paper considers an especially controversial idea in harm reduction, needle exchanges, and outlines the arguments against wider implementation of these programs.
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