Pubdate: Sun, 17 Jun 2007
Source: Chicago Tribune (IL)
Copyright: 2007 Chicago Tribune Company
Contact:  http://www.chicagotribune.com/
Details: http://www.mapinc.org/media/82
Author: Steve Chapman
Note: Steve Chapman is a member of the Tribune's editorial board.
Bookmark: http://www.mapinc.org/find?137 (Needle Exchange)

MAKING THE WRONG TRADE ON AIDS

Being a journalist, I'm no expert on making money. But you don't have
to be Warren Buffett to recognize one way to get rich: Find someone
who will give you $600,000 if you give him 25 cents. A few swaps like
that, and you're a permanent resident of Easy Street.

You might assume that no such deal exists and that if it did, no one
would pass it up. You would be wrong. This advantageous exchange is
available any time our leaders in Washington want to take it. But so
far, they've refused.

The reason for their reluctance is that the trade involves something
unsavory: illegal drug use. More than 1 million people in this country
regularly inject themselves with heroin, cocaine and other prohibited
pharmaceuticals. Many of them also reuse and share their hypodermic
syringes.

All it takes is one instance of sharing with someone carrying HIV to
create another AIDS victim -- and possibly several, since those
infected can transmit the virus to their spouses, sexual partners and
even children. About 22 percent of all AIDS infections are
attributable to intravenous drug use.

This is an incurable and lethal disease, and an expensive one. Caring
for someone infected with the virus costs about $25,000 a year, or
$600,000 over the typical patient's life. What would it take to
prevent it? A sterile new syringe, which sells for about a quarter.

The federal government spends some $15 billion a year on health care
and financial assistance for AIDS patients. But it refuses to lay out
one thin dime for this type of prevention. By law, no federal money
may be spent on programs furnishing clean injecting equipment to drug
addicts. To top it off, Congress bars the District of Columbia --
which has one of the biggest HIV problems in the country -- from using
its own locally generated revenues for that purpose.

This last policy, however, may be on the way out. The House of
Representatives is expected to vote this week on a bill to let D.C.
decide for itself whether to spend its own dollars to hand out
syringes. It will encounter opposition from members who have
previously supported the ban. Among them is Rep. Todd Tiahrt (R-Kan.),
who recently told The Washington Post that needle exchange has "been
proven in many studies to be ineffective and a threat to the
surrounding community."

You can find studies that fail to vindicate needle distribution, just
as you can find Sundays when the Detroit Lions win. But they are rare
and unrepresentative. Among experts, the strong consensus is that
these efforts have proven their value beyond dispute.

In 2000, the surgeon general concluded that they reduce HIV
transmission and "do not increase the use of illegal drugs among
participants." The federal Institute of Medicine said in 1997 that
needle exchange is "an effective component of a comprehensive strategy
to prevent infectious disease."

A 2004 report by the World Health Organization found "no convincing
evidence of major unintended negative consequences." The National
Institutes of Health says, "There is no longer doubt that these
programs work." The Centers for Disease Control and Prevention ...
well, you get the idea.

When I contacted Tiahrt's office, an aide said he thinks that
regardless of what the studies show, "It is a horrible message to send
children that it must be OK to do drugs." But that's like saying that
when the government pays for lung cancer treatment, it encourages kids
to smoke. The existing policy sends a worse message: If drug users
can't conquer their addiction, they deserve to die -- and so do their
innocent spouses and children.

The funding bans are not the only impediment. Scott Burris, a law
professor at Temple University, says 23 states have laws that forbid
or deter pharmacies from over-the-counter sale of syringes -- which
would allow drug users to forgo exchanges and buy their own. Local
AIDS activists say the District of Columbia is guilty of the same
mistake. While it's asking for help from Congress on needle exchange,
it could help itself by deregulating needles.

Restrictions on the sale and possession of injecting equipment, like
the funding bans, make it harder for drug users to take basic
self-preservation measures. If you like throwing away money,
preventing addicts from getting access to sterile syringes is an
excellent strategy. If you like squandering lives, it's even better.