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Feature: Yellow Journalism -- San Francisco Exchange Programs Scored Over Dirty Needles

A series of sensationalistic articles in the San Francisco Chronicle over the past two weeks highlighted the problem of discarded needles near one of the city's needle exchange programs. The series appears -- on the surface -- to have prodded city officials to act on the problem. More accurately, it informed the public of planning that had been going on behind the scenes, though without informing readers of that. While the articles posed as muckraking, civic-minded journalism, they smeared needle exchange workers -- they failed, most importantly, to ask the most basic questions needed to actually determine the programs' impact on needle discarding -- and unnecessarily contributed to public fears about the programs.

The Chronicle series began Sunday July 29 with "The Situation at Golden Gate Park; Sunday in the Park -- With Needles," where the paper reported that the park was "littered" with discarded syringes. The reporting made it seem as if the discarded syringes were the fault of needle exchange programs:

"They tell us he was steaming, but San Francisco Mayor Gavin Newsom shouldn't have been too surprised when The Chronicle reported that Golden Gate Park was littered with used drug syringes.

"After all, his own Public Health Department spent $800,000 last year to help hand out some 2 million syringes to drug users under the city's needle exchange program -- sometimes 20 at a time.

"Although Health Department officials say 2 million needles were returned, the fact is they don't count them and can only estimate how many are coming back.

"And from the looks of things, a lot of them aren't."

That same article was also shocked to report that drug users can actually buy needles without a prescription:

"Under legislation passed in 2005 by the same Board of Supervisors whose members now decry the needle problem, anyone over 18 can walk into a Walgreens or Rite Aid and buy as many as 10 needles -- no questions asked."

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syringes
Like needle exchanges, non-prescription syringe access is a harm reduction measure designed to save lives and improve the public health by reducing the spread of disease through making needle access easier. Its beneficial impact, however, is blunted by a California statute defining syringe possession as a violation of the paraphernalia law. Hence, users anxious to avoid trouble with law enforcement may be rendered more anxious to get rid of their needles once done with them, and less likely to save them long enough to take them back to a program.

In that article and a same-day companion piece, "Golden Gate Park sweep -- can city make it stick? 'March of junkies': Haight's residents fume over needles," the Chronicle described finding needles in Golden Gate Park and interviewed neighbors upset with finding discarded syringes in the area. It made for compelling reading, but left several critical questions unanswered:

  • How many needles were being discarded in the park before there were needle exchange programs?
  • How many of the needles found by the authors of the neighborhood residents they quoted came from the needle exchange program?
  • What is the risk of HIV or Hep C infection from being pricked with a discarded needle? What was it before there were needle exchange programs?
  • How many needles not returned to the program are actually being unsafely discarded?
  • Overall, how significant is the threat to public safety from discarded syringes, and how does it compare with the threat from pre-needle exchange days?

If advocates and researchers are right, the answers to those questions don't support the premise of the Chronicle stories. "Nobody wants dirty syringes lying around," said Hilary McQuie, Oakland-based Western Director for the Harm Reduction Coalition. "But there were syringes everywhere in San Francisco before we started needle exchanges here in 1988. There is no recognition [in the Chronicle story] that there was a problem with discarded syringes before needle exchange came around, or that needle exchanges help reduce the problem."

The Chronicle also seemed to go out of its way to paint one program, the Homeless Youth Alliance, and its director, Mary Howe, in an unflattering light:

"Finding the needle exchange in the Haight isn't easy. Walk west on Haight Street, take a right at Cole, and turn in the first doorway. There's no identification, just a blue sign that says, 'entrance.'

"Walk up the hall, which smells of urine, and then knock on the scratched and battered wooden door. After two or three tries, someone might open the door a crack to see what you want.

"Welcome to a city drug needle exchange and HIV prevention facility.

"When then-Mayor Frank Jordan signed legislation endorsing needle exchanges in 1992, it was a high-minded, civically progressive program to slow the spread of HIV and hepatitis C. Drug users would get a needle, use it, then return it for a clean one. That's still the idea -- and it is a good one -- but somewhere along the line the concept went low-rent.

"Today the Haight facility looks more like a hole in the wall. The neighbors, many of whom say they have never been told what's going on up the street, find syringes in their gardens. And the original idea -- a one-for-one exchange -- is largely ignored.

"The exchange is run by the Homeless Youth Alliance, which gets a yearly budget of $275,000 from the city Department of Public Health. As the alliance's program director, Mary Howe, admits, they make no more than a rough count of the incoming needles. If someone says he returned 40, they hand over 40 new ones. And, if he doesn't have any, they give him 20 as a startup stash.

"'The point for a needle exchange is not to get every needle back,' says Howe. 'The majority of users dispose of needles in a respectful manner.'

"And those who don't?

"'That's not my responsibility,' Howe said. 'I can't hold everyone's hand and make everyone put them in a bio bucket. If someone has a liquor store, and they sell liquor to someone who gets into an accident, is it the store's fault?'"

"The Chronicle totally attacked Mary Howe," McQuie complained. "She's one of the few people who has a good relationship with the homeless users in Golden Gate Park, and the Chronicle didn't mention that her staff does regular clean-ups [collections of discarded syringes] there."

"That's right, said Peter Davidson, board chairman for the Homeless Youth Alliance. "We go out there monthly and clean up dirty needles," he said. "It's a large park, though, and I have to wonder why we are blamed for every needle in it. Picking on a small, poorly-funded needle exchange program doesn't seem particularly productive," he said.

"We're a little bit frustrated with the Chronicle coverage," said Davidson, "but we hope this whole kerfluffle will cause some movement."

Of course, no one wants people getting stuck with discarded needles, but some research can help to put that problem in perspective too. Infections from needle sticks are quite rare outside medical facilities, according to Dr. Robert Heimer, a professor in the Division of Epidemiology of Microbial Diseases at Yale University and an expert on HIV survival in syringes. "While HIV will survive for weeks inside a syringe, needle sticks are not likely to transmit the virus since virus on the surface of the needle, which would be introduced into the body of the person being pricked, loses viability quickly upon drying. Supporting this are the data from hospital needle stick transmission, which were strongly associated with fresh blood," he said.

A 1998 review of the literature on needle stick infections agreed. It found no HIV infections contracted via needle sticks among garbage disposal workers in one study reviewed. Other studies found low numbers (less than 15) cases of hepatitis infections contracted through needle sticks.

In the third article (so far) in the series, "Needles talk of town; SF officials promise system of drop boxes," the Chronicle patted itself on the back for prompting the city to act with its "exposé" of the dirty needle problem:

"City officials and nonprofit agency leaders, responding to an outcry over used syringes littering parks, promise to reform San Francisco's needle-exchange program -- including locked, 24-hour syringe drop boxes and technologically advanced syringes."

Indeed, both city officials and needle exchange program heads were quoted as saying they would be acting soon to install drop boxes where dirty needles could be dropped off. San Francisco currently doesn't have any, which probably goes a long way toward explaining why the city's return rate is only around 70% instead of the 90% reported in some cities that do have drop boxes. But it is not that the city and the exchanges suddenly woke up because of the Chronicle's reporting. According to insiders, planning for drop boxes has been ongoing, and the first ones will appear shortly. What the Chronicle's reporting really did was goose city hall and the exchanges to let the public know what was already underway.

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popular needle exchange logo
"Mary has been meeting with the public health department, the AIDS Foundation, and the police on disposal boxes for the last year and a half," said Davidson. "Everyone agrees it's a good idea. She's been shopping a written proposal around, but when it came to needles in Golden Gate Park, Parks and Recreation didn't want to get involved."

"We've been talking with the city public health department for awhile about disposal boxes, and I think this series and all the uproar it has aroused will make it happen," said McQuie. "That would be a good public relations move, but people don't want to carry their syringes around because of our paraphernalia law here in California." In the face of the assault on the NEPs in San Francisco, McQuie went on the offensive. "What we really need is to change the needle law so people don't feel like they have to get rid of them. We need syringe exchange machines like soda machines, where you put one in and take one out. And we need safe injection sites," she said.

Heimer also had some observations and suggestions about reducing the number of dirty needles strewn about in public. "Our studies comparing Springfield, Massachusetts, where there is no legal access to syringes, to New Haven and Hartford, where there is, found far more unsafe discarding in Springfield (44%) than in Connecticut cities (13.5%)," he pointed out. His unspoken conclusion was obvious: remove restrictions to needle access if you want to lower rates of unsafe discarding.

"We need publicly accessible drop boxes," Heimer suggested, "along with training injectors to use proper containers, training police to not harass people who carry syringes (then people won't have to chuck their rigs when approached by police), and expanding syringe exchange hours and, counter-intuitively, liberalizing exchange policies," he said. "We found that syringe return rates in three US cities -- Oakland, Chicago, and Hartford -- were highest (nearly 90%) in the city with the most liberal policy (Chicago) and lowest (only 50%) in the city with the most restrictive policy (Hartford).

But such fine points apparently did not interest the self-styled crusaders at the Chronicle. While the newspaper may have done a public service by reporting on the discarded needle problem, the way it did so was a disservice to the hard-working, dedicated people who run these programs for the public health. One would think the citizens of San Francisco deserve better than shabby, sensationalized reporting when it comes to critical public health issues. We only hope that the Chronicle's botched job leads to advances, not setbacks, for harm reduction and needle access in California.

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.)

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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.)
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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.

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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.

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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.

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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."

Drug War Issues

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