Needle Exchange

US House and Senate negotiators in conference committee approved the finishing touches on the Fiscal Year 2010 budget Tuesday night, and they included a number of early Christmas presents for different drug reform constituencies. But it isn’t quite a done deal yet--this negotiated version of the FY 2010 Consolidated Appropriations Act must now win final approved in up-or-down, no-amendments-allowed floor votes in the House and the Senate. What the conference committee approved: * Ending the ban on federal funding for needle exchange programs--without previous language that would have banned them from operating within 1,000 feet of schools, parks, and similar facilities. * Ending the ban on the use of federal funds for needle exchanges in the District of Columbia. * Allowing the District of Columbia to implement the medical marijuana initiative passed by voters in 1998 and blocked by congressional diktat ever since. * Cutting funding for the Office of National Drug Control Policy’s National Youth Anti-Drug Media Campaign from $70 million this year to $45 million next year. In a news release after agreement was reached, this is how the committee described the language on needle exchange:

Modifies a prohibition on the use of funds in the Act for needle exchange programs; the revised provision prohibits the use of funds in this Act for needle exchange programs in any location that local public health or law enforcement agencies determine to be inappropriate

Its description of the DC appropriations language:

Removing Special Restrictions on the District of Columbia:...Also allows the District to implement a referendum on use of marijuana for medical purposes as has been done in other states, allows use of Federal funds for needle exchange programs except in locations considered inappropriate by District authorities.

And its language on the youth media campaign:

National Youth Anti-Drug Media Campaign: $45 million, $25 million below 2009 and the budget request, for a national ad campaign providing anti-drug messages directed at youth. Reductions were made in this program because of evaluations questioning its effectiveness. Part of the savings was redirected to other ONDCP drug-abuse-reduction programs.

Citing both reforms in the states--from medical marijuana to sentencing reform--as well as the conference committee’s actions, Drug Policy Alliance Executive Director Ethan Nadelmann stopped just short of declaring victory Wednesday. “It’s too soon to say that America’s long national nightmare – the war on drugs – is really over,” said Nadelmann. “But yesterday’s action on Capitol Hill provides unprecedented evidence that Congress is at last coming to its senses when it comes to national drug control policy.” But, as noted above, there are still two votes to go, and DPA is applying the pressure until it is a done deal. “Hundreds of thousands of Americans will get HIV/AIDS or hepatitis C if Congress does not repeal the federal syringe funding ban,” said Bill Piper, DPA national affairs director. “The science is overwhelming that syringe exchange programs reduce the spread of infectious diseases without increasing drug use. We will make sure the American people know which members of Congress stand in the way of repealing the ban and saving lives.” Washington, DC, residents got a two-fer from the committee when it approved ending the ban on the District funding needle exchanges and undoing the Barr Amendment, the work of erstwhile drug warrior turned reformer former Rep. Bob Barr (R-GA), which forbade the District from implementing the 1998 medical marijuana initiative, which won with 69% of the vote. “Congress is close to making good on President Obama’s promise to stop the federal government from undermining local efforts to provide relief to cancer, HIV/AIDS and other patients who need medical marijuana,” said Naomi Long, the DC Metro director of the Drug Policy Alliance. “DC voters overwhelmingly voted to legalize marijuana for medical use and Congress should have never stood in the way of implementing the will of the people.” "The end of the Barr amendment is now in sight,” said Aaron Houston, director of government relations for the Marijuana Policy Project. “This represents a huge victory not just for medical marijuana patients, but for all city residents who have every right to set their own policies in their own District without congressional meddling. DC residents overwhelmingly made the sensible, compassionate decision to pass a medical marijuana law, and now, more than 10 years later, suffering Washingtonians may finally be allowed to focus on treating their pain without fearing arrest." Medical marijuana in the shadow of the Capitol? Federal dollars being spent on proven harm reduction techniques? Congress not micromanaging DC affairs? What is the world, or at least Washington, coming to?

One of the articles we are finalizing for publication in Drug War Chronicle tonight deals with needle exchange, and the state of legislation in Congress to end the ban on use by states of federal AIDS funds to support needle exchange programs. A bill has passed the House of Representatives -- good news -- but it includes a provision that would render it nearly useless. This provision would require that needle exchange programs receiving federal funds not operate "within 1,000 feet of a public or private day care center, elementary school, vocational school, secondary school, college, junior college, or university, or any public swimming pool, park, playground, video arcade, or youth center, or an event sponsored by any such entity." I'm not sure how any program could track where all the different such entities decide to hold events. More importantly, the rule would basically prevent needle exchanges from operating at all, because the area encompassed is pretty much everywhere inside any city. Dr. Russell Barbour, at Yale School of Medicine's Center for Interdisciplinary Research on AIDS, has produced several charts that advocates are using now on the Hill, illustrating the impact the provision would have on AIDS prevention efforts in Chicago and San Francisco. He graciously provided them to us. Check them out here: (more below the fold)

Another video from the Hungarian Civil Liberties Union, this time in partnership with the Swedish Drug Users Union. Sweden's government is one of the world's most prohibitionist, but nevertheless has moved toward harm reduction in recent years by expanding needle exchange into a national policy. Previously needle exchange was happening only in two cities in the nation's south. Well, there's still no needle exchange in Stockholm, according to HCLU, it's even hard to get into a methadone maintenance program, and those who do often face negative attitudes from the program's staff. Check out the video below, or here.

As I noted here two weeks ago, legislation to repeal the ban on use of federal AIDS funds for needle exchange programs was included in a House subcommittee's health budget bill. The language survived an attempt on the House floor to repeal it, and so has made it through the full House of Representatives. Satisfyingly, the Congressman who tried to delete the language was Mark Souder, who also lost a committee vote on Tuesday to significantly gut his anti-student aid drug law. Souder's pro-AIDS amendment lost 211-218. The flip side is that 49% percent of Congress voted to continue spreading HIV and Hepatitis throughout our communities.

The Central Asian Republic of Kyrgyzstan sits along a drug trafficking route, and has an estimated 80,000-100,000 drug users, more than half of whom inject drugs. Unlike some countries in the region, Kyrgyzstan has embraced harm reduction strategies such as needle exchange and methadone maintenance. Even prisoners in Kyrgyzstan have access to these programs. By going this route, they have been able to curb the country's HIV epidemic. A new video from the Hungarian Civil Liberties Union -- in Russian, with English subtitles -- tells the story. Check it out: