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Harm Reduction: San Antonio Needle Exchange Program Not To Be, Texas Attorney General Says Would Violate State Law

A state-sanctioned needle exchange program envisioned for Bexar County (greater San Antonio) under legislation passed last year will not happen -- at least not this year. Texas Attorney General Greg Abbott Monday issued an opinion saying that state drug laws blocked the program from moving forward.
popular syringe exchange logo
The needle exchange program was envisioned to help slow the spread of HIV/AIDS and Hepatitis C among injection drugs users and would have been the first official program in Texas, which is the only state in the nation without one. The law was scheduled to take effect last September, but was put on hold after Bexar County District Attorney Susan Reed raised objections in August, saying that it would be illegal to conduct such a program because, in her opinion, the law was defective. That sparked State Senator Jeff Wentworth's request for an attorney general's opinion.

In addition to blocking the needle exchange program, the attorney general's opinion also opens the way to the vindictive prosecution of Bill Day, a 73-year-old AIDS sufferer who was ticketed along with two other people earlier this year for passing out clean needles. District Attorney Reed, a Republican who has warned she would arrest anyone trying to hand out needles, stayed Day's case pending Abbott's opinion, but is now likely to move forward with it.

While Day faces up to a year in jail if convicted of violating Texas drug paraphernalia laws, that's unlikely, First Assistant District Attorney Cliff Herberg told the Dallas Morning News. "Nobody expects that Mr. Day will go to jail," said Herberg. "If people think that he's well-intentioned, that's a punishment issue, not a guilt or innocence issue."

In his opinion, Abbott wrote the law passed last year was not written clearly enough to protect needle exchange participants from prosecution because it said only that the county health department "may" set up a needle exchange, not that it "will" set one up. While the legislature may have intended to set up a program, it needs to redraft the law to fix the language, he said.

Rep. Ruth Jones McClendon (D-San Antonio), the legislation's main sponsor, vowed to make fixing it one of her top priorities next year. "Obviously, I am terribly disappointed," she told the Morning News. "The outcome [with the needle exchange] would have been much more effective in saving thousands of lives and saving millions of taxpayer dollars at the same time."

Southwest Asia: In Harm Reduction Move, Iran to Provide Condoms, Syringes in Vending Machines

Officials of the Iranian government announced last week that they are embarking on a pilot program to provide syringes and condoms to drug users in an effort to prevent the spread of AIDS and hepatitis. The items will cost the equivalent of a nickel.

Situated next door to Afghanistan, home of 90% of the world's opium and heroin production, Iran now suffers one of the world's highest opiate addiction rates. Iranian officials generally estimate that 2 million of the country's 71 million people are addicted to opiates, now mainly heroin.

"Five of these machines which have been made will be installed in five of Tehran city's welfare shelters for addicts," the deputy head of Iran's anti-narcotics organization, Mohammad Reza Jahani, said in remarks reported by Agence France-Presse. "Condoms, syringes, bandages and plasters will be easily accessible just by inserting a coin. This protects addicts from acquiring AIDS and hepatitis."

Look for more syringe and condom vending machines, said Jahani. "The machines will be used for a three month trial period and if the scheme is successful then we will upgrade them and increase their distribution to other shelters," he said.

The harm reduction measure is the latest in a series of moves in the Islamic Republic's approach to drug use and addiction. While it still hangs traffickers and guns down smugglers, it now tries to treat users as "people who need help," or at least is starting to, rather than throwing them into already overcrowded jails.

Editorial: Yet More Unintended and Impossible-to-Predict Harm Caused by Drug Prohibition

David Borden, Executive Director
David Borden
Four years ago, I opined about an issue that had come up in California, one affecting the schools and with which the legislature was grappling. According to NPR affiliate station KQED in Los Angeles at the time, many school systems had stopped providing locker space to students, because some administrators see lockers as facilitating the problems of guns and drugs. Of course, drug selling is a principle reason for carrying a gun to school, although only because drugs are illegal.

Unfortunately for California schoolkids, as a result of the locker closures, some young people had developed posture problems, with resultant chronic pain, as a result of having to carry all of their books around all day. KQED interviewed once such student from North Hollywood. He typically carried about 30 pounds of books with him, which was 19% of his body weight, nearly twice the maximum recommended by the American Chiropractic Association. As a teenager he had become a regular user of Tylenol in order to manage the pain.

The reason I chose that story for my editorial that week was the unpredictable nature of it. There are a lot of things that are easy to predict about drug prohibition laws, based on historical experience. We know that prohibition causes crime, and builds up organized crime entities, by putting a lucrative industry with its hundreds of billions of dollars of annual revenues into a criminal underground. We know that prohibition causes preventable deaths, especially of the addicted, by ensuring that users of the banned drugs obtain them from that underground, which lacks the regulation and quality controls that legal industries have. We know that prohibition has a corrupting effect on youth, and others -- the guns and the drug trade in the schools issue that legitimately concerned California administrators is a frightening example -- by providing job opportunities for those who are attracted to the those moneymaking opportunities and the associated glamour.

But who would have guessed the drug war would lead to teen back pain? Lest any should dismiss that issue as unimportant by comparison with the harms of drugs, and of guns in the schools, remember that the guns and drugs didn't go away as a result of the lock closures. Did anyone really think they would, for that matter? Back pain is an issue that can deeply affect the life of a sufferer, young or old, and which for many can go uncorrected for a lifetime. Lockers are part of a school's infrastucture. When drug policy leads us to start dismantling infrastructure, that is a sign of a policy problem.

This week our blog reported on another unpredictable public health problem from the drug laws, a more dramatic and gruesome one. In Brazil, the drug war is exacerbating a deadly plague carried by mosquitoes. The problem is that one in four people in the city of Rio de Janeiro live in the poverty-stricken "favelas," or shantytowns, where pools of water are common during the rainy season, which attracts the mosquito population. But access for authorities to the favelas is hampered by Rio's raging drug war, hampering efforts to contain the disease. Of course, these drug wars are happening only because drugs are illegal, prompting the governor of the state of Rio de Janeiro to call for legalization last year.

After 14 years in drug policy, it's not so very often that I learn a new angle. Yet I have no doubt that there are many unintended consequences of prohibition which have yet to be brought to light, and many impossible-to-predict harms from prohibition that we have yet to see.

Harm Reduction: New Jersey's First Legal Needle Exchange Is Open

The needle exchange program bill passed nearly a year ago by the New Jersey state legislature has borne its first fruit. A needle exchange program operated by the South Jersey AIDS Alliance in Atlantic City began operations Tuesday.
popular syringe exchange logo
Under the New Jersey law, up to a half-dozen municipalities can apply to operate needle exchange programs. Atlantic City has long clamored for such a program and is the first off the mark, but preparations for similar programs are underway in Camden, Newark, and Paterson.

Needle exchange programs are a proven means of reducing the spread of blood-borne diseases, such as HIV/AIDS and Hepatitis C.

According to a report from the Drug Policy Alliance's New Jersey head Roseanne Scotti, who was instrumental in guiding the legislation to passage, 20 people registered for the Atlantic City program on its first day of operation. The program runs out of the South Jersey AIDS Alliance drop-in center and is currently limited to four hours a day on Tuesdays, Wednesdays, and Thursdays. The city plans to take the exchange program mobile, but it still working on gathering the money to pay for a van.

Harm Reduction: Anti-Safe Injection Site Amendment Killed in Conference Committee

An amendment to the Labor-HHS-Education appropriations bill that would have barred the dispersal of federal funds from those departments to any city that opened a safe injection site for drug users was killed in conference committee this week. The measure was deleted "without prejudice," meaning committee members did not have to go on record as opposed to the amendment.
drug war bad guy Jim DeMint
Officially, it was deleted because it was not in the House version of the bill. But drug reform activists say it was because committee Democrats got lots of calls from constituents urging them to oppose it.

"This is a victory for harm reduction and the drug policy reform movement," said Bill Piper, director of national affairs for the Drug Policy Alliance, which led the effort to kill the amendment. "Congress came close to adopting something that would have the same sort of impact as the federal ban on funding needle exchanges. It's good to see that in this case, at least, Congress didn't let politics trump science."

The amendment was sponsored by Sen. Jim DeMint (R-SC) in reaction to talk in San Francisco about opening a safe injection site there. Although the sites have been proven to reduce needle-sharing and the spread of infectious blood-borne diseases such as HIV and Hepatitis C and are open in eight European countries, Australia, and Canada, no such sites are operating in the US.

Two weeks ago, DeMint was crowing about his victory. "The Senate sent a clear message to cities that it's beyond ridiculous to ask Americans to pay for drug addicts to inject themselves with heroin and cocaine," he said. "The officials in San Francisco that gave credibility to this absurd idea should be embarrassed. This would undermine federal law and promote illegal behavior. These safe havens for drug users would only encourage more addiction and support the illegal drug market."

DeMint is eating those words now.

Southeast Asia: Drug Crackdowns Spread HIV/AIDS, Experts Say

Repressive law enforcement responses to injection drug users in Southeast Asia are undermining the effort to slow the spread of HIV/AIDS in the region, analysts meeting in Bangkok said last week. Needle sharing among injection drug users could account for up to 50% of all new infections, they said.
Thai embassy protest in Washington (DRCNet's David Guard in foreground)
Harassment and arrests of clients at needle exchange programs means many avoid them, while heavy-handed police crackdowns in places like Thailand have driven users deep underground, away from needle exchange programs and treatment services.

In Thailand, where a government "war on drugs" killed a reported 2,500 people over three months in 2003, police often blur the line between dealers and users, hindering efforts to treat addicts, said Precha Knokwan of the Thai Drug Users' Network. "The drug users themselves are afraid that they might be a victim of the police," he said.

It's a similar situation in Indonesia, where prisons are full of HIV-positive drug users who have no access to services, said Aditya Anugrah of the Indonesian Drug Users' Association. "Drug policies in Indonesia do not separate users from dealers," he said. That leads to needle-sharing and the spread of HIV, he said. "Our policies are focusing on sending people to jail and treating them as criminals rather than as health problems."

What is needed is harm reduction, but that requires the cooperation of governments and law enforcement, said Daniel Wolfe of the Open Society Institute. "Harm reduction measures can only work if law enforcement understands them and helps to enforce them," he said.

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.

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.

United States

Medical marijuana question passes (Bedford Minuteman, MA)

United States

Judge rejects San Diego challenge to medical marijuana law (The Mercury News, CA)

United States

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