Pubdate: Tue, 14 Jul 2009
Source: Boston Globe (MA)
Copyright: 2009 Globe Newspaper Company
Contact: http://bostonglobe.com/news/opeds/letter.aspx?id=6340
Website: http://www.boston.com/globe/
Details: http://www.mapinc.org/media/52
Author: Derrick Z. Jackson
Referenced: The CDC review 
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5644a4.htm
Bookmark: http://www.mapinc.org/find?137 (Needle Exchange)

COMMON SENSE ON NEEDLE EXCHANGE

TWO DECADES of paranoia on needle exchange took a welcome hit last 
week when a House subcommittee omitted the federal ban on needle exchange.

Since 1988, needle exchange programs have been prohibited from 
receiving federal funding. However, such programs have long been 
proven to dramatically reduce the spread of HIV/AIDS by allowing 
intravenous drug users more access to clean needles. The proof, 
domestically and globally, has been around for so long that in 1998, 
Health and Human Services Secretary Donna Shalala and Surgeon General 
David Satcher said it was time to lift the ban. "One of the worst 
things that can happen in this country is for us to say, if the 
science doesn't agree with our perspective, then we want to suppress 
the science," Satcher said.

But that's exactly what President Clinton did back then, a Democrat 
cowed by Republican moralizing about aiding and abetting drug users 
despite the science showing otherwise. No push to repeal the ban 
would come under Republican President Bush, of course.

Then came Obama, who said during the campaign, "We have to look at 
the drastic measures potentially, like needle exchange, in order to 
assure that drug users are not transmitting the disease to each 
other." Obama has surrounded himself with appointees who support 
needle exchange, such as drug policy director and former Seattle 
police chief Gil Kerlikowske, Food and Drug Administration 
Commissioner Margaret Hamburg, and Centers for Disease Control and 
Prevention Director Thomas Frieden.

But as for Obama himself, his FY 2010 budget contained the sentence 
banning needle exchange: "No funds appropriated in this Act shall be 
used to carry out any program of distributing sterile needles or 
syringes for the hypodermic injection of any illegal drug."

In milquetoast responses to press inquiries, White House spokesmen 
said Obama needs time to "build support" with Congress and the public 
to get rid of the ban.

Instead, it is Congress, or rather, courageous members of Congress, 
who are in the position of building support with Obama. The heavy 
lifting was left to David Obey, the Democrat from Wisconsin who 
chairs both the House Appropriations Committee and the Subcommittee 
on Labor, Education, Health and Human Services, which cut out the 
ban. Having decided that ideology has far too long ruled the day as 
US intravenous drug users have 11 times the HIV infection rate of 
such drug users in Australia, which has long had needle exchange, 
Obey made sure he highlighted the repeal in his public statement on 
the appropriations bill.

"Scientific studies have documented that needle exchange programs, 
when implemented as part of a comprehensive prevention strategy, are 
an effective public health intervention for reducing AIDS/HIV 
infections and do not promote drug use. The judgment we make in this 
bill is that it is time to lift this ban and let State and local 
jurisdictions determine if they want to pursue this approach."

Aides to the Appropriations Committee said that some of the science 
that Obey relied on was a 2007 CDC review of 185 needle exchange 
programs in 36 states, the District of Columbia, and Puerto Rico. The 
review concluded that with just state and local funding, the programs 
"are helping protect IDUs [injection drug users] and their 
communities from the spread of bloodborne pathogens and are providing 
access to health services for a population at high risk."

This is of little interest to some Republicans, such as Todd Tiahrt 
of Kansas, the ranking Republican of the House subcommittee, who said 
he was "very concerned" about the elimination of the ban. He still 
clings to the disproved notion that clean needles promote drug use. 
It is time, with the House having taken the lead, for Obama to get 
out front and say once and for all that science takes the front seat 
to ideology. Some issues are too critical to the very lives of 
Americans to wait to "build support." 
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MAP posted-by: Richard Lake