Similar to Portugal, legalizing all drug use, with a focus on treatment and pretrial diversion into treatment rather than the unending failure of Prohibition 2.0: The War on Drugs is what works. Needle exchanges are a component of reducing infectious disease rates rather than addressing drug use. The problems are the US continues the costly and ineffective War on Drugs, grossly-unequal poverty, and doesn't have healthcare, mental healthcare, or drug treatment for all. Until those all happen, hating on drug users or use a strawman about efforts to reduce infections in that population won't solve the bigger problems, and don't justify criminalizing drug use.