1. DrugEpi 5-2 Needle Exchange Programs Module 5 Overview Context Content Area: Policy Decisions about Drug Use/Abuse Issues Essential Question (Generic): What should be done when preventable causes of disease are found? Essential Question (Drug Abuse Specific): What should be done when preventable causes of drug abuse are found? Enduring Epidemiological Understanding: Policy decisions are based on more than the scientific evidence. Because of competing values - social, economic, ethical, environmental, cultural, and political factors may also be considered. Synopsis: In Module 5, students explore specific drug policy questions and become aware of the factors that influence their own and others' positions on those questions. Lessons: Lesson 5-1: Individual and Societal Decision Making Lesson 5-2: Drug Policy Question - Should needle exchange programs be implemented? Lesson 5-3: Drug Policy Question - Should high school students be drug tested? Lesson 5-4: Drug Policy Question - Should D.A.R.E. be taught in all schools? Lesson 5-5: Drug Policy Question - Should marijuana be legal for medical purposes?

2. DrugEpi 5-2 Needle Exchange Programs Module 5 - Policy Decisions about Drug Use/Abuse Lesson 5-2 Drug Policy Question Assignment Content How scientific literacy is connected to individual and societal decision-making Definitions and discussion about policy, risk perception and the acceptability or unacceptability of risk Application of Drug Policy question Assignment to question, Should needle exchange programs be implemented? Big Ideas In a democratic society, a scientifically literate population is better able to make informed decisions about issues of public health Societal decisions about acceptability versus unacceptability of risk often consider other factors besides the actual magnitude of that risk The issue of whether or not needle exchange programs should be implemented is controversial with powerful arguments on both sides

3. DrugEpi 5-2 Needle Exchange Programs Essential QuestionsEnduring Understandings 1.How is this disease distributed? Health-related conditions and behaviors are not distributed uniformly in a population. They have unique distributions that can be described by how they are distributed in terms of person, place, and time. 2.What hypotheses might explain the distribution of disease? Clues for formulating hypotheses can be found by observing the way a health-related condition or behavior is distributed in a population. 3.Is there an association between the hypothesized cause and the disease? Causal hypotheses can be tested by observing exposures and diseases of people as they go about their daily lives. Information from these observational studies can be used to make and compare rates and identify associations. 4.Is the association causal? Causation is only one explanation for an association between an exposure and a disease. Because observational studies are complicated by factors not controlled by the observer, other explanations also must be considered. 5.What should be done when preventable causes of disease are found? Policy decisions are based on more than the scientific evidence. Because of competing values - social, economic, ethical, environmental, cultural, and political factors may also be considered. Where are we?

4. DrugEpi 5-2 Needle Exchange Programs Enduring Understanding Policy decisions are based on more than the scientific evidence. Because of competing values – social, economic, ethical, environmental, cultural, and political factors may also be considered. Individual and Societal Decision Making

5. DrugEpi 5-2 Needle Exchange Programs Drug Policy A course or principle of action adopted or proposed by a government, party, business, or individual that affects drug use Individual and Societal Decision Making

6. DrugEpi 5-2 Needle Exchange Programs Needle Exchange Programs Individual and Societal Decision Making

7. DrugEpi 5-2 Needle Exchange Programs Needle Exchange Programs A system operated by public health authorities or voluntary agencies in many communities with the aim of reducing the risk of transmitting blood- borne infectious diseases, especially HIV/AIDS, by providing clean sterile hypodermic needles to illicit intravenous drug users on a no-questions- asked basis. This approach acknowledges the existence of illicit drug use, is not judgmental or punitive, and can provide a way to gain the confidence of illicit drug users as a preliminary step toward their rehabilitation. Individual and Societal Decision Making

8. DrugEpi 5-2 Needle Exchange Programs Drug Policy Question Position Should needle exchange programs be implemented? Individual and Societal Decision Making

9. DrugEpi 5-2 Needle Exchange Programs Drug Policy Question Position Should needle exchange programs be implemented? Individual and Societal Decision Making

10. DrugEpi 5-2 Needle Exchange Programs Chain of Infection Needle Exchange Programs Individual and Societal Decision Making

11. DrugEpi 5-2 Needle Exchange Programs Needle Exchange Programs Individual and Societal Decision Making

12. DrugEpi 5-2 Needle Exchange Programs “… no funds appropriated under this Act shall be used to carry out any program of distributing sterile needles for the hypodermic injection of any illegal drug unless the Surgeon General of the United States determines that such programs are effective in preventing the spread of HIV and do not encourage the use of illegal drugs, except that such funds may be used for such purposes in furtherance of demonstrations or studies authorized by the ADAMHA Reorganization Act (P.L. 102-321).” Surgeon General of the United States Needle Exchange Programs Individual and Societal Decision Making

13. DrugEpi 5-2 Needle Exchange Programs A system operated by public health authorities or voluntary agencies in many communities with the aim of reducing the risk of transmitting blood- borne infectious diseases, especially HIV/AIDS, by providing clean sterile hypodermic needles to illicit intravenous drug users on a no-questions- asked basis. This approach acknowledges the existence of illicit drug use, is not judgmental or punitive, and can provide a way to gain the confidence of illicit drug users as a preliminary step toward their rehabilitation. Needle Exchange Programs Individual and Societal Decision Making

14. DrugEpi 5-2 Needle Exchange Programs A system operated by public health authorities or voluntary agencies in many communities with the aim of reducing the risk of transmitting blood- borne infectious diseases, especially HIV/AIDS, by providing clean sterile hypodermic needles to illicit intravenous drug users on a no-questions- asked basis. This approach acknowledges the existence of illicit drug use, is not judgmental or punitive, and can provide a way to gain the confidence of illicit drug users as a preliminary step toward their rehabilitation. Needle Exchange Programs Individual and Societal Decision Making

15. DrugEpi 5-2 Needle Exchange Programs A system operated by public health authorities or voluntary agencies in many communities with the aim of reducing the risk of transmitting blood- borne infectious diseases, especially HIV/AIDS, by providing clean sterile hypodermic needles to illicit intravenous drug users on a no-questions- asked basis. This approach acknowledges the existence of illicit drug use, is not judgmental or punitive, and can provide a way to gain the confidence of illicit drug users as a preliminary step toward their rehabilitation. Needle Exchange Programs Individual and Societal Decision Making

16. DrugEpi 5-2 Needle Exchange Programs A system operated by public health authorities or voluntary agencies in many communities with the aim of reducing the risk of transmitting blood- borne infectious diseases, especially HIV/AIDS, by providing clean sterile hypodermic needles to illicit intravenous drug users on a no-questions- asked basis. This approach acknowledges the existence of illicit drug use, is not judgmental or punitive, and can provide a way to gain the confidence of illicit drug users as a preliminary step toward their rehabilitation. Needle Exchange Programs Individual and Societal Decision Making

17. DrugEpi 5-2 Needle Exchange Programs A system operated by public health authorities or voluntary agencies in many communities with the aim of reducing the risk of transmitting blood- borne infectious diseases, especially HIV/AIDS, by providing clean sterile hypodermic needles to illicit intravenous drug users on a no-questions- asked basis. This approach acknowledges the existence of illicit drug use, is not judgmental or punitive, and can provide a way to gain the confidence of illicit drug users as a preliminary step toward their rehabilitation. Needle Exchange Programs Individual and Societal Decision Making

18. DrugEpi 5-2 Needle Exchange Programs A system operated by public health authorities or voluntary agencies in many communities with the aim of reducing the risk of transmitting blood- borne infectious diseases, especially HIV/AIDS, by providing clean sterile hypodermic needles to illicit intravenous drug users on a no-questions- asked basis. This approach acknowledges the existence of illicit drug use, is not judgmental or punitive, and can provide a way to gain the confidence of illicit drug users as a preliminary step toward their rehabilitation. Needle Exchange Programs Individual and Societal Decision Making

19. DrugEpi 5-2 Needle Exchange Programs A system operated by public health authorities or voluntary agencies in many communities with the aim of reducing the risk of transmitting blood- borne infectious diseases, especially HIV/AIDS, by providing clean sterile hypodermic needles to illicit intravenous drug users on a no-questions- asked basis. This approach acknowledges the existence of illicit drug use, is not judgmental or punitive, and can provide a way to gain the confidence of illicit drug users as a preliminary step toward their rehabilitation. Needle Exchange Programs Individual and Societal Decision Making

20. DrugEpi 5-2 Needle Exchange Programs A system operated by public health authorities or voluntary agencies in many communities with the aim of reducing the risk of transmitting blood- borne infectious diseases, especially HIV/AIDS, by providing clean sterile hypodermic needles to illicit intravenous drug users on a no-questions- asked basis. This approach acknowledges the existence of illicit drug use, is not judgmental or punitive, and can provide a way to gain the confidence of illicit drug users as a preliminary step toward their rehabilitation. Needle Exchange Programs Individual and Societal Decision Making

21. DrugEpi 5-2 Needle Exchange Programs Drug Policy Question Assignment Individual and Societal Decision Making Distribute: Drug Policy Question Assignment

22. DrugEpi 5-2 Needle Exchange Programs Task 1 Individually, prior to doing any work on the assignment, describe your position on the drug policy and explain why you have taken the position. Drug Policy Question Assignment Rubric Description of initial position is candid, clearly articulated, and provides an accurate account of the student’s initial understanding of the drug policy question. Individual and Societal Decision Making

23. DrugEpi 5-2 Needle Exchange Programs Task 2 As a member of a Policy Group, read and submit, either in hard copy or electronically, 10 articles, from both popular (5) and scientific (5) sources, that address the drug policy question from different perspectives. Rubric Ten articles are submitted, from both popular (5) and scientific (5) sources, that address the drug policy question from different perspectives. Drug Policy Question Assignment Individual and Societal Decision Making

24. DrugEpi 5-2 Needle Exchange Programs Task 3 As a member of a Policy Group, write a summary of the drug policy issue and the most important factors influencing its possible adoption for someone who is unfamiliar with it. Rubric Summary gives an unfamiliar reader a quick, thorough, and unbiased overview of the major factors that may influence an individual’s position on the drug policy question. Drug Policy Question Assignment Individual and Societal Decision Making

25. DrugEpi 5-2 Needle Exchange Programs Task 4 As a member of a Policy Group, identify and describe the five most powerful arguments in favor of the drug policy and the five most powerful arguments against the drug policy. Rubric Descriptions of the five most powerful arguments in favor of and against the drug policy are logical, thoughtful, unbiased, and justifiable. Drug Policy Question Assignment Individual and Societal Decision Making

26. DrugEpi 5-2 Needle Exchange Programs Task 5 As a member of a Policy Group, identify five important gaps in our knowledge related to the drug policy question that you and others need to have addressed in order to take a more informed position on the drug policy? Explain why each gap is important. Rubric Selected gaps and the explanations for why the gaps that were selected demonstrate an understanding of what is and is not known about the drug policy question. Drug Policy Question Assignment Individual and Societal Decision Making

27. DrugEpi 5-2 Needle Exchange Programs Task 6 As a member of a Policy Group, prepare a plan to lead a 30 minute class discussion with the other members of the class about the drug policy question. Base the plan on the completed tasks (1-5) as well as those that follow (7-10). Rubric Plan is well crafted, leaves nothing to chance, and creates opportunities for interaction with and among the other students. Drug Policy Question Assignment Individual and Societal Decision Making

28. DrugEpi 5-2 Needle Exchange Programs Extension 1 Read Maria Angell’s article, "Physician-Assisted Suicide - The Ultimate Right" and become aware of how an advocate for a particular drug-related policy recognizes and addresses the arguments of those who oppose the policy. Individual and Societal Decision Making

29. DrugEpi 5-2 Needle Exchange Programs Extension 2 Watch a broadcast of The News Hour with Jim Lehrer and become aware of how advocates for particular points of view recognize and address the arguments of those who have a different perspective. Individual and Societal Decision Making

30. DrugEpi 5-2 Needle Exchange Programs Task 7 As a member of a Policy Group, lead a 30 minute class discussion about the drug policy. Rubric Discussion is a valuable, informative, engaging, and thought-provoking experience for other students. Drug Policy Question Assignment Individual and Societal Decision Making

31. DrugEpi 5-2 Needle Exchange Programs Task 8 As a member of a Policy Group, categorize the arguments for and against the drug policy (social, economic, ethical, environmental, cultural, political factors, and other categories). Rubric Categorizations are accurate, thorough, and creative when necessary. Drug Policy Question Assignment Individual and Societal Decision Making

32. DrugEpi 5-2 Needle Exchange Programs Task 9 As a member of a Policy Group, describe the degree to which the above tasks (1-8) apply to the statement: Policy decisions are based on more than the scientific evidence. Because of competing values; social, economic, ethical, environmental, cultural, and political factors may also be considered. Rubric Description of how tasks 1-8 apply to the above statement is thoughtful, accurate, nuanced, and insightful. Drug Policy Question Assignment Individual and Societal Decision Making

33. DrugEpi 5-2 Needle Exchange Programs Task 10 Individually, after completing the above tasks, describe and justify your position on the drug policy and compare your current position with your initial position (Task 1). Describe the degree to which scientific evidence or the lack of scientific evidence was a factor that influenced your position on the drug policy. Attach a copy of Task 1. Rubric Description and justification of drug policy position are clearly articulated and logical. Comparison is accurate and nuanced. Description of degree to which scientific evidence or lack of scientific evidence was an influential factor is candid. A copy of Task 1 is attached. Drug Policy Question Assignment Individual and Societal Decision Making

34. DrugEpi 5-2 Needle Exchange Programs Distribute: Drug Policy Question Assignment Tasks, Rubric, and Points Individual and Societal Decision Making

35. DrugEpi 5-2 Needle Exchange Programs Distribute: Drug Policy Question Assignment Cards Drug Policy Question Assignment Individual and Societal Decision Making

36. DrugEpi 5-2 Needle Exchange Programs Trade: Drug Policy Question Assignment Cards Drug Policy Question Assignment Individual and Societal Decision Making

37. DrugEpi 5-2 Needle Exchange Programs Task 1 Individually, prior to doing any work on the assignment, describe your position on the drug policy and explain why you have taken the position. Rubric Description of initial position is candid, clearly articulated, and provides an accurate account of the student’s initial understanding of the drug policy question. Drug Policy Question Assignment Individual and Societal Decision Making

38. DrugEpi 5-2 Needle Exchange Programs Distribute: Drug Policy Question Assignment Task 1 Drug Policy Question Assignment Individual and Societal Decision Making

39. DrugEpi 5-2 Needle Exchange Programs Policy Group Meeting Drug Policy Question Assignment Individual and Societal Decision Making

40. DrugEpi 5-2 Needle Exchange Programs Enduring Understanding Policy decisions are based on more than the scientific evidence. Because of competing values; social, economic, ethical, environmental, cultural, and political factors may also be considered. Individual and Societal Decision Making

41. DrugEpi 5-2 Needle Exchange Programs Big Ideas in this Lesson (5-2) In a democratic society, a scientifically literate population is better able to make informed decisions about issues of public health Societal decisions about acceptability versus unacceptability of risk often consider other factors besides the actual magnitude of that risk The issue of whether or not needle exchange programs should be implemented is controversial with powerful arguments on both sides This project is supported by a Science Education Drug Abuse Partnership Award, Grant Number 1R24DA016357-01, from the National Institute on Drug Abuse, National Institutes of Health. Re-Cap

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