Needle Exchange

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Important Exchange Re: Clinton & Obama on Needle Exchange

Ben Smith's blog on The Politico web site today discussed an important exchange of comments between Hillary Clinton and Charles King, the executive director of Housing Works, at a private appearance earlier this month, as well as comments by Barack Obama at a different meeting in the same series. King had asked Clinton if she would lift the ban on use of federal AIDS funds to support needle exchange programs, an issue that previously came to a boil in 1998 during her husband's second term. (Some activists believe that Bill Clinton would have lifted the ban if Donna Shalala rather than Barry McCaffrey had boarded a certain Air Force One flight.) According to Smith:
Clinton responded to King's question, after some prodding, by saying, "I want to look at the evidence on it" to see whether needle exchange would prevent the spread of HIV without increasing drug abuse. Shalala, King responded, had "certified" the safety and effectiveness of the programs. "And then she refused to order it, as you remember," Clinton said. King replied that that had been her husband's decision. "Well, because we knew we couldn't maintain it politically," Clinton said, and went on to discuss the trade-offs in that dispute with Congress. "I wish life and politics were easier," she said. King then referred back to Clinton's opening remarks. "You made a great comment earlier about how our next president needs to have some spine," he said. "We’ll have as much spine as we possibly can, under the circumstances," Clinton responded.

Obama, by contrast, had responded that he supports lifting the ban. Click here to read Smith's full post, which includes the video footage. A little background: Housing Works has for years been a stalwart in the harm reduction movement. (Harm reduction is the idea that people who use drugs should be helped in reducing the harm they do, to themselves or others, whether they are about to stop using drugs or not.) The organization is very well known in New York City, which successfully beat back a late 1990s attempt by then Mayor Rudy Giuliani to bankrupt them. In 2000, activists from Housing Works stormed the Ashcroft confirmation hearings to denounce his record on needle exchange. King's co-founder and co-executive director of Housing Works for years, the late Keith Cylar, was a member of DRCNet's board of directors (and a friend).

(This blog post was published by StoptheDrugWar.org's lobbying arm, the Drug Reform Coordination Network, which also shares the cost of maintaining this web site. DRCNet Foundation takes no positions on candidates for public office, in compliance with section 501(c)(3) of the Internal Revenue Code, and does not pay for reporting that could be interpreted or misinterpreted as doing so.)

Location: 
New York, NY
United States

Harm Reduction: Jersey City Signs Up for Needle Exchange

The Jersey City, New Jersey, City Council Wednesday unanimously passed an ordinance allowing for the creation of a needle exchange program in the city. The move came after the city hesitated earlier this year because Mayor Jeremiah Healey, a needle exchange supporter, balked at a part of the state's pilot program that would have included a needle exchange van.

Jersey City becomes the fifth Garden State city to pass a needle exchange ordinance since Gov. Jon Corzine (D) signed a bill allowing them into law in December. The other cities are Atlantic City, Camden, Newark, and Paterson. None have functioning needle exchange programs yet. All have either just passed ordinances or have applications to join the pilot program under review by the state.

New Jersey has the highest rate of cumulative HIV/AIDS cases among women, the third highest rate of pediatric HIV/AIDS cases, the fifth highest rate of adult HIV/AIDS cases and a rate of injection-related HIV infection that is nearly twice the national average.

Still, it took years of activism and lobbying by local public health officials and the Drug Policy Alliance, whose Roseanne Scotti paced the halls of the state capitol, to win approval of needle exchange programs in New Jersey. And the battle isn't over yet. Seven other New Jersey cities that could be eligible to participate have so far failed to do so.

Job Opportunity: Harm Reduction Coalition, Oakland

The Syringe Exchange Program Specialist will be responsive to the technical assistance and training needs of California Syringe Exchange Programs and Local Health Jurisdictions. Candidates must possess organizational skills, training and technical assistance expertise and hands on experience with community-based syringe access. Experience with community organizing and familiarity with local service providers and communities is preferred. Ideal candidates are highly organized, independent thinkers with capacity to operationalize systems and streamline information through several projects. HRC values candidates with a strong work ethic, common sense, humor, and a commitment to human rights and social justice issues.

This position is based in Oakland, CA and the salary range is $43,000-46,000.

Responsibilities include coordinating activities related to syringe access, intake of training and technical requests, and individual level plans for syringe exchange program in need; responding to training and technical assistance requests within 48 hours; providing technical assistance on implementation strategies; developing regional, individual and group trainings; maintaining relationships with consultants and contract consultants on an "as needed" basis; attending staff and program meetings; working in tandem with HRC's other projects to organize and consolidate materials, publications, curricula, and fact sheets; and additional duties as required.

To apply, please fax your resume and cover letter to (510) 444-6977. No phone calls please. Deadline for applications is July 21, 2007, so please act quickly if you are interested in the position.

People of color, formerly incarcerated people, and people with histories of substance use are encouraged to apply. HRC is EOE and offers a competitive salary with decent health benefits.

The Harm Reduction Coalition (HRC) promotes the health and human rights of people who use drugs by advocating for effective policy responses to fight HIV, hepatitis C, overdose deaths, and drug addiction. Since its inception in 1994, HRC has grown from a small group of syringe exchange activists concerned about preventing HIV, into the leader of a rapidly growing grassroots movement, shaping current public health and drug policy toward practical, compassionate harm reduction interventions. HRC provides technical assistance, training, and capacity building to support existing syringe exchange programs, health departments and community-based organizations in California. The goal is to expand syringe access in rural and urban areas.

The Drug Debate: American Mayors Urge "A New Bottom Line" and a Public Health Approach for Drug Policy

Meeting at its annual convention in Los Angeles late last month, the US Conference of Mayors passed an historic resolution putting America's chief elected municipal officials on record urging a fundamental rethinking of the country's drug policies. The mayors called for a public health approach to drug use and abuse and "a new bottom line" in assessing how and whether drug policies reduce harms associated with drugs and society's effort to deal with them.

The US Conference of Mayors represents more than 1,100 mayors of cities with a population over 30,000. The non-partisan group plays a significant role in advocating for and setting national urban policies. Resolutions passed at its conventions become official policy.

The drug policy resolution, "A New Bottom Line in Reducing the Harms of Substance Abuse," was introduced by long-time drug reform advocate Mayor Rocky Anderson of Salt Lake City. It was adopted after debate at the convention.

After a long series of "whereases" in which the resolution recites a now-familiar litany of drug war failures and excesses -- the huge number of drug war prisoners, the lack of spending on drug treatment, the failure of expensive law enforcement programs to affect drug price and availability, differential racial impacts, the ineffectiveness of the drug czar's office, massive marijuana arrests in the face of rising violent crime -- the resolution gets down to business:

"The United States Conference of Mayors believes the war on drugs has failed and calls for a New Bottom Line in US drug policy, a public health approach that concentrates more fully on reducing the negative consequences associated with drug abuse, while ensuring that our policies do not exacerbate these problems or create new social problems of their own; establishes quantifiable, short- and long-term objectives for drug policy; saves taxpayer money; and holds state and federal agencies accountable," the mayors resolved. "US policy should not be measured solely on drug use levels or number of people imprisoned, but rather on the amount of drug-related harm reduced."

The mayors identified a number of specific policy objectives they supported, including:

  • Provide greater access to drug abuse treatment on demand, such as methadone and other maintenance therapies;
  • Eliminate the federal ban on funding sterile syringe access programs;
  • Establish local overdose prevention policies; and
  • Direct a greater percentage of drug-war funding toward evaluating the efficacy and accountability of current programs.

While the mayors did not explicitly call for an end to the drug prohibition regime or even for an end to imprisoning drug users, the resolution identified the large number of drug law offenders behind bars and the racial disparities created by drug law enforcement as examples of "drug-related harm."

"The mayors are clearly signaling the serious need for drug policy reform, an issue that ranks in importance among the most serious issues of the day," said Daniel Abrahamson, director of legal affairs for the Drug Policy Alliance.

The drug prohibition regime appears increasingly hollow and rotted from within. The resolution adopted last month by the US Conference of Mayors is one more indication that what once was fringe thought is now going mainstream.

Silly Scott

Scott was being silly last Friday night when he published his "D.C. Needle Exchange Ban Lifted: Let's Do Heroin!" blog post. In fact, Scott was being silly in multiple ways. First, the DC needle exchange ban is only a ban on the District using its own tax dollars to fund the program. The PreventionWorks needle exchange program has been operating now for almost nine years, legally, and before that its predecessor program at the Whitman-Walker AIDS Clinic operated the exchange. It has been making do with private funding. Lifting of this ban means that PreventionWorks will be able to expand its operations, and that more needle exchange programs will be able to open, all of them together reaching more of the people who need the help. But it's not a matter of whether Scott personally could have gotten clean needles. Second, the PreventionWorks office is only a 15 minute walk from our office, so if Scott had really wanted to use heroin all this time, he wouldn't even have had to travel far to get clean needles. (It's a pretty walk, too, and there's a nice coffee shop in the neighborhood.) Third, as I pointed out in my editorial this week, the risk created by infected used syringes, while a major one, is by no means the only risk. So long as heroin itself continues to be illegal, the user will continue to be "at risk of overdose from fluctuating purity or poisoning from adulteration," and the addict will continue to suffer "severe financial debilitation from the high street prices created by prohibition," some of them "driven to extreme measures to afford drugs that would cost pennies to produce in a legal market." I know for a fact that Scott understands this as well as I do, and I published that editorial less than 24 hours before Scott wrote his blog post, so it must have been fresh in his mind. (Fourth, Scott was simply being sarcastic, in case anyone didn't realize it. He and I both scoff at the idea that more needle exchange will lead to increased drug use -- and we have the evidence to back us up.) So, I'm afraid that Scott and I will be holding out for legalization before we start shooting smack. I recommend that you wait too. (I'm being sarcastic too -- we also reject the idea that legalization will lead to large numbers of people using intense drugs like heroin who don't already use them now -- I certainly have no interest in it.)
Location: 
United States

D.C. Needle Exchange Ban Lifted: Let's Do Heroin!

From The Washington Post:
The House yesterday lifted a nine-year-old ban on using D.C. tax dollars to provide clean needles to drug addicts, handing city leaders what they consider a crucial new weapon against a severe AIDS epidemic.
Well, I know what I'm doing tonight. Heroin. Because concerns about the availability of clean needles were the only thing stopping me.

Pro-AIDS activist Mark Souder is furious. He thinks this will cause a heroin epidemic or something. He's right, if you can call a bunch of heroin users that would otherwise be dead an epidemic.

Not to mention that all my friends are pawning their playstations in anticipation of getting super-wasted on uncut, AIDS-free H. I hear it's like having sex with a cloud.

Location: 
United States

DPA Press Release: Congress Votes to Lift Washington, DC Syringe Funding Ban; Change Will Save Thousands of Lives

For Immediate Release: June 28, 2007 For More Information: Naomi Long, T: (202) 669-6071, or Grant Smith, T: (202) 669-6573 Congress Votes to Lift Washington, DC Syringe Funding Ban Change Will Save Thousands of Lives Today the U.S. House of Representatives rejected an amendment that would have restored a ban that prohibits the nation’s capital from spending its own (non-federal) money on syringe exchange programs. The ban was eliminated weeks ago in committee. Congressman Rep. Mark Souder (R-IN) tried to reinstitute a modified ban on the floor that would have had a chilling effect on the existing needle exchange program in D.C. (which currently operates entirely on private funds), but the House rejected it 216 Nays to 208 Yeas. In 1998, the Republican-led Congress barred the District Government from spending its own local funds on syringe exchange programs. The ban has been reauthorized in the appropriations bill every year since. But with Democrats now in power, the push to lift the ban gained traction. The Drug Policy Alliance applauds Rep. Jose Serrano (D-NY), who chairs the Financial Services Subcommittee, for spearheading the effort to lift the ban, and recognizes the tireless efforts of D.C. Delegate Eleanor Holmes Norton. “This is a huge step in helping to reduce HIV and AIDS in Washington, DC,” said Naomi Long, director of the Washington Metro office for the Drug Policy Alliance. “We are pleased that Congress decided to stop playing politics with the lives of intravenous drug users in D.C. at a time when the District is suffering from a HIV/AIDS crisis.” It has been long established by the scientific community that needle exchange programs reduce the spread of HIV/AIDS amongst people who inject drugs without increasing drug use. In Washington, DC, injecting drugs is the second-most common means of contracting HIV among men – and the most common form among women. Approximately one-third of new AIDS cases annually are the result of intravenous drug use. Supporters of needle exchange include the American Medical Association, American Public Health Association, Centers for Disease Control and three former U.S. Surgeons General. A number of faith communities officially support needle exchange including The Presbyterian Church (USA), Episcopal Church and the United Church of Christ.
Location: 
Washington, DC
United States

Press Release: Governor Signs Texas' First Needle Exchange Bill into Law

press release from the ACLU of Texas:

AUSTIN -- Governor Perry signed a Medicaid reform bill (SB 10) into law this afternoon, which includes a provision authorizing the first legal needle exchange program in Texas. The new law brings Texas up to date with most other states in the nation by starting a safe, legal needle exchange pilot program in Bexar County this fall.

"The public health and safety of Texas requires that we offer public health programs that prevent the spread of infectious diseases. Fiscal responsibility also requires that preventive programs be made available, and this is just one way that we can begin to curb the spread of hepatitis and HIV in geometric proportions. I am pleased that we can begin this process with a pilot program in Bexar County," said Rep. Ruth Jones McClendon, who sponsored the provision and represents part of San Antonio and Bexar County.

This year, Sen. Robert Deuell and Rep. McClendon teamed up to sponsor SB308/HB 856, which was originally proposed to authorize needle exchange programs statewide. The bill passed through the Senate, but appeared to die in the House Public Health Committee when the Chair did not call for the committee's vote. Rep. McClendon resurrected the concept by attaching an amendment to the Medicaid bill. Her amendment allows the health authorities in Bexar County to design and operate the program, which is expected to reduce disease and improve outreach to injection drug users.

Disease prevention is the goal of most needle exchange programs, but they also provide an opportunity to connect addicts to treatment. After filing the bill, Sen. Deuell said, "The local health authorities who administer these programs may also provide drug counseling and treatment. This might be the only time we can get to these people and give them the opportunity to rehabilitate themselves. One study showed more than 1,000 drug users found their way into treatment through a needle exchange program."

San Antonio has a history of strong and outspoken support for needle exchange. Rep. McClendon said, "In particular, we especially appreciate the encouragement received from Judge Nelson Wolff, Sheriff Ralph Lopez, Dr. Fernando Guerra of San Antonio Metro Health, and other local foundations and healthcare organizations. This pilot program is bound to be successful."

Rep. Garnet F. Coleman, who sponsored needle exchange legislation in years past added, "After working on this issue for two sessions, now we have a state-sanctioned opportunity to save lives through needle exchange. Hopefully this pilot program will lead to legislation next session that sets up needle exchange programs statewide."

"Needle exchange has become a standard disease prevention practice around the country, and we commend Rep. McClendon, Sen. Deuell and the rest of the legislators who worked hard to bring this important public policy measure to Texas," said Tracey Hayes, Director of the Access Project at the ACLU of Texas.

Feature: Congress Moves to End Ban on DC Needle Exchange Funding

A nine-year-old measure barring the District of Colombia from spending its own funds on needle exchange programs (NEPs) instituted by conservative Republican lawmakers was removed from the DC appropriations bill Tuesday. Led by House Subcommittee of Financial Services and General Government chair Rep. Jose Serrano (D-NY), the subcommittee voted to excise the language from the bill, a key step in allowing the District to enact the proven harm reduction measure in an effort to reduce the spread of HIV/AIDS and other blood-borne infectious diseases.

http://www.stopthedrugwar.org/files/preventionworksatwork.jpg
Ron Daniels at PreventionWorks! van, Washington (screen shot of recent nytimes.com ''slide show'')
Although it has one of the highest HIV/AIDS infection rates in the country, with as much as a third of it linked to injection drug use, Washington, DC is the only city in the country expressly prohibited from spending money for NEPs. According to the North American Syringe Exchange Association, more than 200 NEPs are currently operating in 36 states.

"My basic principle in this bill is that the federal government should not dictate to the city how to manage its own affairs or spend its own money," said Serrano in a Tuesday statement. "Therefore, you will find that we have removed or changed riders that have been in past bills that closely prescribed to the city what it should or should not do."

"This is a huge step in helping to reduce HIV and AIDS in Washington, DC," said Naomi Long, director of the Washington Metro office for the Drug Policy Alliance. "We are pleased that Congress decided to stop playing politics with the lives of intravenous drug users in DC."

"This is extremely important," said Channing Wickham, director of the Washington AIDS Partnership. "About a third of AIDS cases here in the District are related to injection drug use. This is not a pro-drug move; it's a public health move," he told Drug War Chronicle. "There are numerous studies that show not only that giving drug users access to clean needles reduces the spread of HIV infections, but also that people in such programs get access to drug treatment and medical care. It's a win-win situation," he said.

"If they actually lift the ban, that'll be great," said Ron Daniels of Prevention Works!, a privately-funded NEP that arose in response to the 1998 federal ban on funding. "If they don't, our hands are tied. The people we are serving now are only the tip of the iceberg," he told the Chronicle from the mobile van the group uses to take clean needles to drug users. "We're only seeing about a third of the people we know are injection drug users. They have got to do something to stop this epidemic."

Even with the limitations imposed by having to seek out private funding, Prevention Works! managed to distribute more than 236,000 needles and had regular contact with some 2,000 injection drug users last year.

http://www.stopthedrugwar.org/files/needle-exchange-logo-small.gif
popular needle exchange logo
While the DC appropriations bill is still in the early stages, the subcommittee vote this week was a critical step, said Bill Piper, director of government relations for the Drug Policy Alliance. "This was the key vote," said Piper. "Committee chairs pick their battles carefully, and the fact that Serrano went ahead and did this suggests he thinks he can take this all the way. In the full committee, the Democrats will generally get behind whatever the subcommittee decided, and on the floor, the presumption will be against amending bills against the wishes of the committee."

That doesn't mean ideologically driven opponents will give up without a fight. Rep. Todd Tiahrt (R-KA), the man who inserted the ban in 1998, was still at it this week. Apparently ignorant of the mountain of scientific evidence establishing the effectiveness of NEPs in reducing the transmission of HIV/AIDS and other diseases, Tiahrt claimed that "needle exchange programs have been proven in many studies to be ineffective and a threat to the surrounding community, especially the children."

That prompted a Wednesday visit to Tiahrt's office by the Drug Policy Alliance, which hand-delivered numerous studies proving the effectiveness of NEPs. "Rep. Tiahrt's claims that syringe exchange programs don't work is similar to claiming the world is flat," said Piper. "We want him to have the information so he doesn't continue to embarrass himself and, more importantly, sabotage this life-saving measure."

With the subcommittee vote, DC is now closer than ever to being able to finance NEPs, and the measure will pass, Piper predicted. "I think this is one we will win," he said. "Not without a fight, of course, but the stars are aligned, everyone in DC wants this, and in the end, the DC syringe ban will be repealed."

DPA Press Release: Congressman Continues to Make Ignorant Statements About Needle Exchanges Programs; Advocates to Bring Him Evidence so He Can Stop Embarrassing Himself

For Immediate Release: June 6, 2007 For More Info: Bill Piper (202) 669-6430 or Naomi Long (202) 669-6071 Rep. Tiahrt (R-Kan.) Continues to Make Uninformed Statements That Discount the Proven Effectiveness of Needle Exchange Programs Advocates to Deliver Mountain of Evidence to Tiahrt’s Office Today So the Kansas Congressman Can Stop Embarrassing Himself Despite Washington, D.C. having one of the worst HIV infection rates in the country, Rep. Todd Tiahrt (R-Kan.) continues to ignore the mountain of scientific evidence that proves the effectiveness of syringe exchange programs at reducing the transmission of HIV/AIDS, hepatits C and other infectious disease. Tiahrt’s assertion that there are no proven studies that show the efficacy syringe exchange programs is a direct effort to sabotage a recent Congressional effort to remove the ban on funding syringe exchange programs in Washington, D.C. In a strong editorial in today’s Washington Post calling for D.C. to be allowed to fund needle exchange programs, Tiahrt is quoted claiming “…needle exchange programs have been proven in many studies to be ineffective and a threat to the surrounding community, especially the children.” In response, the Drug Policy Alliance will hand deliver numerous studies proving the effectiveness of needle exchange programs to Tiahrt’s office today. “Rep. Tiahrt’s claims that syringe exchange programs don’t work is similar to claiming the world is flat,” said Bill Piper, national affairs director of the Drug Policy Alliance. “We want him to have the information so he doesn’t continue to embarrass himself and, more importantly, sabotage this life-saving measure.” Every established medical, scientific, and legal body to study the issue concurs in the efficacy of improved access to sterile syringes to reduce the spread of infectious diseases: including the National Academy of Sciences, American Medical Association, American Public Health Association, Centers for Disease Control and Prevention, and President George H.W. Bush's and President Clinton's AIDS Advisory Commissions. Eight government reports concur that access to sterile syringes deceases the transmission of infectious diseases without increasing drug use. No reports contradict these findings. On Tuesday, June 5, Congress moved one step closer to lifting the funding ban on syringe exchange programs in Washington, D.C. The House Subcommittee on Financial Services and General Government removed the ban from an appropriations bill that includes the city’s spending plan. In 1998, Tiahrt and the Republican-led Congress barred the D.C. government from spending its own local funds on syringe exchange programs. The ban was reauthorized in the appropriations bill every year since. But with Democrats now in power, the push to lift the ban gained traction. Rep. Jose Serrano (D-NY), who chairs the committee, spearheaded the effort to lift the ban. It has been long established by the scientific community that needle exchange programs reduce the spread of HIV/AIDS amongst people who inject drugs without increasing drug use. In Washington, D.C., injecting drugs is the second-most common means of contracting HIV among men—and the most common form among women. Approximately one-third of new AIDS cases annually are the result of intravenous drug use. DC’s syringe exchange program is crucial to getting people with substance abuse problems into drug treatment. The program estimates it refers about 50 people a month to treatment. Needle exchange programs help public health professionals assess the medical needs of clients, gain trust in the community by meeting clients in their own surroundings, and provide educational materials and referrals.
Location: 
Washington, DC
United States

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