Needle Exchange

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.)

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.

Back during our jury civil disobedience in 2004, David Guard and I did our community service time at the needle exchange program here in Washington and got to know the people there. They've been doing a lot for the community, all of it with privately-raised funds, but more is needed to be able to reach all the people who are at risk from contracting diseases like AIDS or Hepatitis C through needle sharing. The District of Columbia government would almost certainly fund needle exchange work, but Congress gets to control what our budget looks like if they want to, and in their infinite wisdom (sarcasm) they decided to forbid DC from spending even its own taxpayer dollars on needle exchange. Rep. Jose Serrano (D-NY), who chairs the Subcommittee on Financial Services and General Government, which has jurisdiction over this area of the US Code, has said he wants to undo the restriction. Today the New York Times ran a strongly supportive editorial:

Washington, D.C., is one of America’s AIDS hot spots. A significant proportion of infections can be traced back to intravenous drug users who shared contaminated needles and then passed on the infection to spouses, lovers or unborn children. This public health disaster is partly the fault of Congress. It has wrongly and disastrously used its power over the District of Columbia’s budget to bar the city from spending even locally raised tax dollars on programs that have slowed the spread of disease by giving drug addicts access to clean needles.

The Times titled the editorial "Congress Hobbles the AIDS Fight." The activist paraphrase of that, which is how the editorial was first presented to me, would be "Congress has blood on its hands." Last week the Times also ran a news feature about DC's needle exchange, and an online "slide show" featuring the program's Ron Daniels. The larger legislation in which the DC funding ban could get repealed is expected to move quickly, with markups scheduled for Serrano's subcommittee tomorrow and the Appropriations Committee of which it is a part next week -- you never know how quickly something will really move in Congress, but that's how it looks right now. Stay tuned.

EDITOR'S NOTE: I tried to post this Friday morning from the Hilton in Salt Lake City, but due to some mysterious problem with the internets, it didn't get through. The 2nd National Conference on Methamphetamine, HIV, and Hepatitis is now in its second day. The Hilton Hotel in downtown Salt Lake City is doing an admirable job of dealing with the influx of treatment providers, social service workers, needle exchangers, speed freaks, drug company representatives, academics, researchers, and politicos who have flooded into the hotel for three days of plenaries, panels, workshops, and breakout sessions on various aspects of the methamphetamine phenomenon. For me, a lot of the sessions and presentations are of limited interest, which is not to say they have no value, only that they are directed at people who are doing the hands-on work in the field. As someone interested in drug policy reform and, frankly, legalizing meth and everything else, the differences in behavior or susceptibility to treatment between gay urban speed freaks and rural hetero speed freaks is not really that important to me. Ditto for comparisons of different treatment modalities. Again, I'm not saying this stuff is unimportant, only that it's not what I'm about. I'm much more interested in the politics of meth, the methods of blunting repressive, reactionary responses from the state, and the ways of means of crafting more enlightened policies. For all the progress we have made in the drug reform arena in the past decade or so, it seems like all someone has to do is shout "Meth!" and we are once again in the realm of harsh sentencing, repressive new legislation, and drug war mania reminiscent of the crack days of the 1980s. That's why it's so heartening to see political figures like Salt Lake Mayor Rocky Anderson stand front and center for enlightened responses to meth use and abuse. Of course, it isn't just Rocky. Here in the Salt Lake Valley, state and local officials from the governor on down are attempting a progressive response, whether it's the governor lobbying for more money for treatment or local prosecutors practicing restorative justice. And it's not just Utah. Cut across the Four Corners into New Mexico, and you find another state where officials are rejecting harsh, repressive measures and instead seeking to educate youth and adults alike with evidence-based curricula. As one measure of the changing status quo, the Drug Policy Alliance is getting involved in the Land of Enchantment. It has been selected by the state government to administer a $500,000 grant to develop prevention and education curricula. I find it just a little bit ironic that I'm sitting in Salt Lake at this major meth conference just as SAMSHA puts out an analysis of national survey data showing that meth use is declining after about a decade a stable usage patterns. There was a significant drop in the number of new meth users between 2004 and 2005 and a steady decline in past year meth users since 2002. Despite all the hoopla, meth users now account for only 8% of all drug treatment admissions. Meth crisis? While there is no denying the social and personal problems that can and do result from excessive resort to the stimulant, it seems like there is less to it than meets the eye. Still, it has the politicians and funding agencies riled up enough to cough up money for programs and conferences and the like. I guess we'll take what we can get.

A few weeks we reported in Drug War Chronicle that New Jersey had become the only state in the nation not allowing needle exchange programs in some form or at least syringe purchase without a prescription -- the second to last state, Delaware, passed a needle exchange law last month.