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Needle exchange programs could save thousands of American lives and reduce strain on the public health care system. But some politicians refuse to implement them, largely because of an old-fashioned stigma.

Through a needle exchange program, drug users can receive clean syringes in exchange for turning in used ones. Such programs remain illegal in 26 states, predominantly in the South and Midwest.

“In the South, syringes are still seen as a moral issue,” Tessie Castillo, who works at the North Carolina Harm Reduction Center, told The Huffington Post, noting that opponents of needle exchanges argue that giving drug addicts access to syringes encourages substance abuse. “The perception is that if we give someone a syringe, we’re helping them to continue to do something wrong. The debate doesn’t go much beyond that.”

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