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Congress Votes to Restore Needle Exchange Funding Ban

Two years ago this week, after years of advocacy by public health and harm reduction advocates, the long-standing ban on federal funding for needle exchanges was repealed. On Saturday, it was restored as the Senate took the final votes to approve the 2012 federal omnibus spending bill.

It was a Democratic-controlled House and Senate that rescinded the ban two years ago, and it was House Republicans who were responsible for reinstating it this year. Three separate appropriations bills contained language banning the use of federal funds, and House negotiators managed to get two of them into the omnibus bill passed Saturday.

A Labor-Health and Human Services appropriations bill including the ban on domestic use of federal funds for needle exchanges and a State Department bill including a ban on funding for needle exchange access in international programs both made it into the omnibus bill.

The Centers for Disease Control and Prevention (CDC), American Medical Association, National Academy of Sciences, American Public Health Association, and numerous other scientific bodies have found that syringe exchange programs are highly effective at preventing the spread of HIV/AIDS and other infectious diseases. Eight federal reports have found that increasing access to sterile syringes saves lives without increasing drug use.

Needle exchange supporters said restoring the ban will result in thousands of Americans contracting HIV/AIDS, hepatitis C or other infectious diseases next year alone.

"The federal syringe funding ban was costly in both human and fiscal terms -- it is outrageous that Congress is restoring it given how overwhelming and clear the science is in support of making sterile syringes widely available," said Bill Piper, director of national affairs for the Drug Policy Alliance. "Make no mistake about it -- members of Congress who supported this ban have put the lives of their constituents in jeopardy."

They should pay a political price, Piper said. "We may have lost this battle, but we have just begun to fight," said Piper. "The Republicans who insisted on restoring the ban, and the Democrats who didn’t fight hard enough to oppose it, will be responsible for thousands of Americans contracting HIV/AIDS or hepatitis C. We will make sure Americans know which members of Congress care about their health and well-being and which do not."

Washington, DC
United States

Email from Rep. Jose Serrano on Reinstatement of Federal Syringe Exchange Funding Ban

(The following statement from Rep. José Serrano (D-NY), sponsor of 2009 legislation that repealed the ban on federal funding of syringe exchange, was distributed on email lists that we monitor. It expresses his thoughts regarding the ban's reinstatement in Congressional legislation this week.)

Dear friends and allies:

We had a large setback on our goal of allowing life-saving syringe exchange programs to operate freely and with full funding from all levels of government without restrictions. The FY2012 funding package that was passed today contained multiple policy riders that expressly prohibit federal funding for syringe exchange programs. We were able to preserve DC’s right to carry out syringe exchange with their local funding, which is very important and would have been a tremendous blow to have lost. But the overall picture remains bleak with regard to federal funding.

We had so much success in recent years as we first removed the ban on DC conducting syringe exchange, and then the full federal ban. As I said at those moments, we were only able to achieve these long-overdue policy changes because of the years of advocacy, education, organizing and hard work that you all carried out. Now we’ve taken a step backwards, and will have to begin some of that work all over again.

Like you, I feel frustrated at moving backwards. But also like you, I know that we have the power of facts, science and experience on our side in this debate. We will have to begin to re-engage and re-start our push to educate those who don’t understand the lifesaving power of syringe exchange programs.

I look forward to continuing to work with you on this vital issue. We cannot rest it seems until we’ve ended all prohibitions on syringe exchange and also ended the debate on it for good. Too many lives are at stake: We must continue this fight.

Sincerely,


José E. Serrano

Breaking: Congress Votes to Kill People

Earlier this week we alerted our email subscribers and web site readers that Republicans in Congress were pushing to reinstate the only recently repealed syringe exchange funding ban. Lifted two years ago as part of the FY 2010 budget bill, the ban had prevented states from making their own decisions as to whether to use federal AIDS grant funding to support needle exchange programs. As most if not all aspects of the drug issue demonstrate, when Republicans talk about state and local control, they don't sincerely mean it, at least not as a group. (The libertarian-minded Ron Paul initially supported the ban, but changed his view and helped repeal it years later.)

Not that the ban's reinstatement can be blamed solely on Republicans, certainly not in the Democratically-controlled Senate. It happened in part because Democrats did not make it a priority to keep it from happening.

Congress's action this week means misery and death for large numbers of people. As the eight federal reviews of the research on this issue demonstrate, needle exchange programs reduce the spread of HIV without increasing the use of drugs. According to the Harm Reduction Coalition, needle sharing by injection drug users accounts for 8,000 new cases of HIV and 15,000 new cases of Hepatitis C each year. Of course the diseases spread from them to other people on occasion, including people who have no involvement in illegal drug use. As HRC points out, New York City has seen a 75% reduction in new HIV cases as a result of instituting such programs, according to a 2005 study.

So let's be clear; the evidence is overwhelming. In fact, even the studies cited by opponents of needle exchange actually support needle exchange, if you take the time to read them. Reinstituting the federal ban will have the effect of defunding many programs, and the science is clear that this means more infections and more needless of life. It won't save the federal government any money, because it doesn't affect the total amount of funding in the Ryan White program. All it does is make the program less effective at accomplishing its goals. And of course, health care costs will only grow because expensive AIDS and Hepatitis treatments will be needed for more people. Sadly, expressing the drug war ideology through deadly legislating seems to be more important for certain members of Congress than any of that. On the bright side, at least they didn't reinstate the old ban on the District of Columbia spending its own funds on needle exchange programs.

Don't give up and don't think that it's over. The ban got repealed once, and it will get repealed again. In the meanwhile, here are a few of the statements about the event that have come to my attention since yesterday. (Feel free to link more in the comments section.)

Congress to Restore Federal Syringe Exchange Funding Ban as Part of 2012 Spending Package

Drug Policy Alliance

www.drugpolicy.org

For Immediate Release: December 16, 2011
Contact: Tony Newman or Bill Piper

Congress to Restore Federal Syringe Exchange Funding Ban as Part of 2012 Spending Package

Ban on Allowing States to Use HIV Prevention Money on Life-Saving Syringe Programs was Overturned in 2009 After 20-Year Struggle

Reinstatement of Ban will Lead to Thousands of New HIV/AIDS, Hepatitis C Cases Annually

As part of the 2012 spending package being voted on today, Congress is restoring a ban on using federal funding for syringe exchange programs that reduce the spread of HIV/AIDS, hepatitis C, and other infectious diseases. The ban, enacted in the 1980s and repealed in 2009, was largely responsible for hundreds of thousands of Americans contracting HIV/AIDS directly or indirectly from the sharing of used syringes. Advocates warn that restoring the ban will result in thousands of Americans contracting HIV/AIDS, hepatitis C or other infectious diseases next year alone.

“The federal syringe funding ban was costly in both human and fiscal terms – it is outrageous that Congress is restoring it given how overwhelming and clear the science is in support of making sterile syringes widely available,” said Bill Piper, director of national affairs for the Drug Policy Alliance. “Make no mistake about it – members of Congress who supported this ban have put the lives of their constituents in jeopardy.”

House Republicans passed restrictive language in three separate appropriations bills, and succeeded in getting two of three bans in the current House-Senate compromise omnibus for Fiscal Year 2012 being voted on today. In addition to the overarching ban on domestic use of federal funds contained in the Labor-HHS spending bill, House republicans also succeeded in imposing a ban on use of State Department funds for syringe access in international programs. In large parts of the world the HIV/AIDS epidemic is being driven by injection drug use. The international syringe funding ban will mean the global HIV/AIDS epidemic will continue to grow.

The existing federal syringe exchange policy, signed into law by President Obama in December of 2009, allows states and local public health officials to use federal funds for syringe access, in consultation and with the consent of  local law enforcement. The policy change is widely credited with having prevented thousands of new cases of HIV and Hepatitis C, thereby saving many lives and improving public health and safety.  

The Centers for Disease Control and Prevention (CDC), American Medical Association, National Academy of Sciences, American Public Health Association, and numerous other scientific bodies have found that syringe exchange programs are highly effective at preventing the spread of HIV/AIDS and other infectious diseases. Increasing the availability of sterile syringes through exchange programs, pharmacies and other outlets also helps injection drug users obtain drug education and treatment. Eight federal reports have found that increasing access to sterile syringes saves lives without increasing drug use.

“We may have lost this battle, but we have just begun to fight,” said Piper. “The Republicans who insisted on restoring the ban, and the Democrats who didn’t fight hard enough to oppose it, will be responsible for thousands of Americans contracting HIV/AIDS or hepatitis C. We will make sure Americans know which members of Congress care about their health and well-being and which do not.”

###

ALERT: Don't Let Congress Backslide on Needle Exchange

Dear drug policy reformer:

One of the most important actions taken by Congress in recent years was the lifting of a ban on the use of federal AIDS grants to support needle exchange programs. We have just learned that as part of the end-of-year Congressional spending package, Republicans are pushing hard to reinstate the ban. If they succeed, it won't reduce federal spending -- this is entirely about the choices state and local officials get to make with the funds that they have -- but it will kill people by promoting syringe sharing by injection drug users and the resulting spread of deadly diseases like Hepatitis and HIV, in turn driving up health care costs related to those diseases.

Please call the White House to urge President Obama to stand firm on this issue and not allow the needle exchange funding ban to be reinstated. The White House comment line number is (202) 456-1414. Here is a sample script for your phone call: "My name is _______. I live in <CITY, STATE>. Thank you for your past support of syringe exchange. I support maintaining current language that allows local officials to make their own decisions to use federal and local Washington DC funds for Syringe Exchange. Please do not allow the Senate or House to change the current law in the Fiscal Year 2012 Appropriations negotiations. Thank you."

Please also make the following calls to Congress:

  1. Senate Majority Leader Harry Reid (D-NV): (202) 224-3542
  2. Senate Assistant Majority Leader Richard Durbin (D-IL): (202) 224-2152
  3. Charles Schumer, chair of Senate Democratic Policy Committee (D-NY): (202) 224-6542
  4. Your Own Two Senators: (202) 224-3121 for the Congressional Switchboard or look up your Senator's numbers at senate.gov

    Sample script for phone calls to the Senate: "My name is _______. I live in <CITY, STATE>. I support maintaining current language that allows local officials to make their own decisions to use federal and local Washington DC funds for Syringe Exchange. Please do not change the current law in the Fiscal Year 2012 Appropriations negotiations. Thank you."
  5. House Democratic leader Nancy Pelosi (D-CA): (202) 225-4965

    "Thank you for your past support of syringe exchange. "My name is _______. I live in <CITY, STATE>. I support maintaining current language that allows local officials to make their own decisions to use federal and local Washington DC funds for Syringe Exchange. Please do not change the current law in the Fiscal Year 2012 Appropriations negotiations. Thank you."

Please email us to let us know what phone calls you've made -- especially if the staffers who take your phone calls offer any indication as to what their bosses' intentions are. Thank you for your taking action.

California Gov. Brown Signs Needle Access Bills

California Gov. Jerry Brown (D) has signed into law a pair of bills that will expand access to clean needles and help prevent the spread of HIV and Hepatitis C infections in the state. The move is winning him kudos from drug reformers and public health advocates.

Badly needed needle exchanges could be coming to more CA counties under a bill just signed by Gov Brown. (wikimedia.org)
The first bill, Senate Bill 41, sponsored by Sen. Leland Yee (D-San Francisco), makes legal the sale of syringes at pharmacies without a prescription. An earlier pilot program allowing such sales had been in effect in some counties and has proven effective at reducing needle-sharing, but most counties did not participate. Now, once the bill goes into effect on January 1, people will be able to buy syringes without a prescription at pharmacies statewide.

The second bill, AB 604, sponsored by Assemblywoman Nancy Skinner (D-Berkeley), allows the California Department of Public Health to authorize new needle exchange programs after consultation with local public health and law enforcement. Currently, needle exchange programs are only authorized after county officials declare a public health emergency, and the political will to do that has been lacking in some counties. This bill allows public health officials to take the initiative instead of waiting for elected officials. It, too, will go into effect on January 1.

"I am directing the department to administer AB 604 in a constrained way, working closely not only with local health officers and police chiefs, but with neighborhood associations as well," said Gov. Brown in his signing statement. "I believe that AB 604 can reduce the spread of communicable diseases and the suffering they cause and, at the same time, respect public safety and local preference."

"This is a huge victory for public health and common sense," said Laura Thomas, Deputy Director of California for the Drug Policy Alliance. "Now all Californians will have the same access to proven, effective HIV and hepatitis C prevention. This gives drug users the tools that they need to protect their health and that of their partners, children, and communities, as well as protecting the California taxpayer from the cost of HIV and hepatitis C infections."

Sacramento, CA
United States

Scottish Needle Exchange Conference

Scottish Needle Exchange Conference

'Working Together'

Stirling Highland Hotel, Stirling, Scotland 

WEDNESDAY 9TH NOVEMBER

 

The conference is the inaugural Scottish Needle Exchange Conference held to support the implementation of the first national needle exchange contract.

The primary aim of the conference is to communicate on a Scottish wide basis, trends within the needle exchange arena, and to support best practice, working together.

Visit http://www.snxc.org for further information.

Date: 
Wed, 11/09/2011 - 8:30am - 5:00pm
Location: 
Stirling, STG
United Kingdom

Chronicle Book Review: Drugs and Drug Policy

Drugs and Drug Policy: What Everyone Needs to Know, by Mark Kleiman, Jonathan Caulkins, and Angela Hawken (2011, Oxford University Press, 234 pp., $16.95 PB)

http://stopthedrugwar.org/files/drugs_and_drug_policy.jpg
Mark Kleiman isn't real popular among the drug reform set. The UCLA professor of public policy is no legalizer, and even though he's too much of an evidence-minded academic to be a wild-eyed drug warrior, he still seems to have an unbecoming fondness for the coercive power of the state. Kleiman, who gets top-billing over coauthors Jonathan Caulkins of Carnegie Mellon and Angela Hawken at Pepperdine, also ruffles reformers' feathers with unnecessary snideness and snark.

But I watched Kleiman address Students for Sensible Drug Policy conventions a couple of times, and I thought it was a good thing, a very useful jolt to the group-think that can grip any gathering of congregants committed to a cause. I thought having the students have to hear the arguments of a leading academic thinker on drug policy who, while not "the enemy," was not especially saying what the average SSDPer wanted to hear, was salubrious for their critical thinking skills. I still think so.

In Drugs and Drug Policy, Kleiman and his coauthors continue with the occasional jibes aimed at the drug reform movement, at times reach conclusions at odds with my own, but also serve up a surprisingly chewy work of drug policy wonkery in delicious bite-size chunks. The innovative format, something like a series of FAQs organized within broader chapters -- "Why Have Drug Laws?" "How Does Drug Law Enforcement Work?" "What Treats Drug Abuse?" "Can Problem Drugs Be Dealt With at the Source?" -- allows us to unpack that all-encompassing monster called "drug policy" one subset at a time, and for that achievement alone, is worthy of praise. That it manages to cover so much ground in a paltry 234 pages is all the more laudable.

Overall, Drugs and Drug Policy is smart, reasonable, and thoughtful. It wants policies based on evidence and it advocates for some intelligent alternatives to current policies. It recognizes the utility of needle exchanges, safe injection sites, and opiate maintenance, even as it complains that "harm reduction" has been hijacked by legalizers. It explains that most people who use drugs -- even those diagnosable as suffering from substance abuse disorders -- will quit using drugs themselves without recourse to treatment. And it even allows that drug use can have beneficial effects, even if it doesn't do so until the seventh chapter.

But Kleiman et. al dismiss decriminalization as unlikely to have a big impact on the social fiscal burden of drug law enforcement because, even though it doesn't appear to have much impact on consumption, drug consumers are not, for the most part, filling our prisons -- drug dealers are. While they do concede that not criminalizing otherwise law-abiding citizens could have "significant benefits," they seem to underplay the negative, life-long impact of a criminal drug record on one's life prospects.

In fact, they seem all too comfortable with maintaining the pernicious role of the criminal justice system in drug policy even as they recognize that enforcing the drug laws is "unavoidably an ugly process," with its reliance on snitches, surveillance, and other "intrusive methods" of enforcement. To give them credit, they want smarter drug law enforcement -- concentrating police repression on violent drug dealers while turning a blind eye to discreet dealing, triaging coerced drug treatment spots so they are reserved for the people who could most benefit from them, giving up on interdiction and source country eradication as ineffective -- that might actually reduce the social and fiscal costs of both drug abuse and enforcement, and since drug prohibition isn't going away anytime soon, at least wasting less money on drug war tactics that don't work well should be on the table.

And they reject drug legalization as too scary to experiment with, but seem to imagine it as possible only within a corporate-controlled, heavily-advertised, low-priced scenario similar to that which has accreted around the alcohol industry. Yes, it's probably true that selling cocaine like Coors, would lead (at least initially) to a significant increase in use and problem use, but why does that have to be the only model? A government monopoly similar to the state liquor store model, with reasonable taxes and no corporate pressure to advertise could conceivably allow legalization without the increases in consumption that the authors predict, even though they concede they don't know how large they might be.

Still, when you get to what it is Kleiman et al. would do if they had their druthers, all but the most purist of legalization advocates will find a lot to like. They create three separate lists of recommendations -- a "consensus list" of reforms they think are politically doable now or in the near future, a "pragmatic list" of reforms that would appeal to dispassionate observers but could raise the hackles of moralists, and a "political bridge too far list" of reforms too radical for mainstream politicians to embrace.

The "consensus list" includes expanding opiate maintenance therapy, encouraging evidence-based treatment, early intervention by the health care system, encouraging people to quit on their own (as opposed to being "powerless"), relying less on interdiction, ending the charade that alternative development is drug control, and concentrating drug enforcement on reducing violence and disorder, as well as smarter, more effective coerced treatment in the legal system. If we saw the drug czar's office produce a National Drug Control Strategy with these recommendations, we would consider that a great victory. It ain't legalization, but its headed in a more intelligent, more humane direction.

The "pragmatic list" includes recommendations to lower the number of drug dealers behind bars, not reject harm reduction even if it's been "hijacked," stop punishing former dealers and addicts, reduce barriers to medical research on illegal substances, and be open-minded about less harmful forms of tobacco use.

The authors don't neglect alcohol and tobacco -- the two most widely-used drugs -- and that is really evident in their "political bridge too far" recommendations. The first three items there are aimed squarely at reducing alcohol consumption and its ill effects. They also argue for the legalization of individual or collective marijuana cultivation, a sort of legalization without the market, increased study of the non-medical benefits of drugs, and increasing cigarette taxes in low tax states.

I think Drugs and Drug Policy needs to be read by anyone seriously interested in drug policy reform. It hits almost all the bases, and it's well-informed, provocative, and challenging of dogmatic positions. You don't like the authors' conclusions? Refute them. It'll be good for you.

US Surgeon General Gives Okay for Needle Exchange Funding

Needle exchanges save lives -- ask the Surgeon General (Image via Wikimedia)
In a notice dated last Friday, but posted in the Federal Register Wednesday, US Surgeon General Regina Benjamin has determined that needle exchange programs constitute a form of drug treatment, which means that NEPS can qualify for funding under the Substance Abuse Prevention and Treatment block grant programs.

"[NEPs] are widely considered to be an effective way of reducing HIV transmission among individuals who inject illicit drugs and there is ample evidence that [NEPs] also promote entry and retention into treatment," Benjamin said in making the determination. "The Surgeon General of the United States Public Health Service has therefore determined that a demonstration syringe services program would be effective in reducing drug abuse and the risk that the public will become infected with the etiologic agent for AIDS."

The use of federal dollars to fund NEPS had been banned for 21 years until 2009, when a Democrat-controlled Congress undid it and President Obama signed the lifting of the ban into law. But moves are afoot in the Republican-controlled House of Representatives to put it back in place. The Surgeon General's notice will weaken that effort.

Washington, DC
United States

White House Moves to Fund Needle Exchanges As Drug Treatment

The Obama administration has designated needle exchanges as a drug treatment program, allowing federal money set aside to treat addictions to be used to distribute syringes to intravenous drug users. Two years ago President Obama lifted the 21-year ban on federally funded needle exchange programs as a necessary evil to reduce the spread of HIV among illicit drug users. The new position, determined by the surgeon general, is that the states can receive federal funding for programs that hand out the syringes as a treatment. A 11-year-old study in the Journal of Substance Abuse Treatment that found that addicts who participated in needle exchanges were five times more likely to enter drug treatment.
Publication/Source: 
Washington Examiner (DC)
URL: 
http://washingtonexaminer.com/local/crime-punishment/2011/02/white-house-moves-fund-needle-exchanges-drug-treatment

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