House Dems Reverse Obama, Remove Ban On Needle Exchange Funding

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House Dems Reverse Obama, Remove Ban On Needle Exchange Funding
Ryan Grim
Huffington Post
7/10/2009

House Democrats have reversed a decision by President Obama and removed a ban on federal funding for needle-exchange programs that he included in the 2010 budget. Including the ban broke a campaign pledge and the flip-flop set off outrage in the gay community and among HIV/AIDS activists. Twenty-six activists were arrested Thursday in the Capitol protesting the policy.

"For us this is a major positive development," said Allan Clear of the Harm Reduction Coalition. "We're optimistic it will stay out. We don't think Democrats would do this unless they thought they could keep it out."

"The fact that Democrats took it out in subcommittee means they're willing to take it all the way," said Bill Piper, director of national affairs for the Drug Policy Alliance.

Syringe exchange programs have been demonstrated to reduce the spread of HIV/AIDS but opponents charge that they encourage drug use.

The needle-exchange question goes to the heart of a seemingly never-ending debate in Washington: Should policy be made based on sound science or used to drive a wedge between the electorate? Obama has placed himself squarely in the sound science camp, which is why his decision touched off such anger.

It is also, quite literally, a life or death question. "Thirty-thousand people a year get HIV or Hepatitis C directly or indirectly from intravenous drug use," said Piper. "That's 300,000 people that could be saved over the next decade."

Appropriations Committee Chairman David Obey (D-Wisc.) highlighted the reversal Of Obama's decision when releasing the budget Friday. Obey is also the chairman of the subcommittee that removed the ban.

"One key exception that I want to mention concerns needle exchange programs. This bill deletes the prohibition on the use of funds for needle exchange programs," he said. "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."

At the time of Obama's reversal, spokesman Ben LaBolt said that the president left the ban in because he wanted Congress to take the lead and that the president didn't want to fight policy battles in the budget language.

"We have not removed the ban in our budget proposal because we want to work with Congress and the American public to build support for this change," he said. "We are committed to doing this as part of a National HIV/AIDS strategy and are confident that we can build support for these scientifically-based programs."

He added, "In recent years, Washington has used the budget process to litigate divisive issues and score political points. This practice, which both sides have engaged in, has limited our ability to tackle our major economic challenges. President Obama decided not to play politics as usual with this budget and while he remains committed to supporting the program he wants to address that through the normal legislative process."

That commitment, however, was called into question by the White House decision to remove its support of needle exchange programs from its website. See the before and after here.

House Speaker Nancy Pelosi (D-Calif.) represents San Francisco, which runs a non-federally funded and successful needle exchange program. She was elected to Congress in the midst of the AIDS crisis and has long been a supporter of ending the ban on federal funding of syringe exchange.

"The CDC, NIH, WHO and former Surgeon General David Satcher have all confirmed the scientific evidence in support of needle exchange, which clearly shows these programs are an effective public health intervention that reduces the number of new HIV infections without increasing the use of illegal drugs," said Pelosi in a statement reacting to the removal of the ban. "By lifting the ban on federal funding for needle exchange, the language in the Labor-HHS-Education appropriations bill reflects this sound science. As this bill moves forward, we must ensure science comes first in our public health policy."

In 2000, Pelosi called for a scientific review of the effectiveness of needle exchange. Surgeon General Satcher produced a report that concluded: "The senior scientists of the Department and I have unanimously agreed that there is conclusive scientific evidence that syringe exchange programs, as part of a comprehensive HIV prevention strategy, are an effective public health intervention that reduces transmission of HIV and does not encourage the illegal use of drugs."

On Thursday, AIDS activists chained themselves inside the Capitol to protest Obama's inclusion of the ban in the budget. An Obama spokesman didn't immediately respond to a request for comment.
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LINK
 
Although I support making clean needles readily and easily available to anybody who chooses to IV their drugs, I don't think that government should be using tax payer money to buy and supply them to people. If somebody wants to buy needles, they should be able to. But I think it's entirely inappropriate for government to be purchasing needles and distributing them. If you can justify government funding for clean needles, then I want government to also provide me with clean ecstasy pills containing only MDMA and no adulterants.
 
Finally people are starting to see addiction as a medical issue not a criminal one, this can only help reduce transmission of diseases, and hopefully it will help educate newer users tosafer using practices.
 
Wow - our government doing something that makes sense? Wow.

What's next - re-allocating the DEA to Homeland Security and stopping terrorist attacks on the USA rather than spending $60,000 a year to lock up non-violent drug offenders? Where will it end??
 
AfterGlow, it is for the greater good for the Government to fund needle exchanges. In theory I see what you are saying but the fact is a lot of junkies can barely afford their DOC and more often than not can't afford to go buy syringes aswell.

These people are going to have to resort to reusing needles, sharing needles, etc. and it reduces the cost on the health system to supply these people with clean syringes than to let blood borne virus spread further and foot the bill for mass treatment of these diseases.

Not to mention that needle exchanges take used syringes and dispose of them ethically, if an IV user has to go back to the needle exchange to get more needles they will probably have the decency to bring all their used rigs. If they have no reason to go to these facilities then more IV users would dispose of their rigs unethically.

Basically by providing clean syringes to junkies and giving them a place to dispose of their used ones, the cost of doing so is totally negated by what is saved on a reduced burden on the healthcare system.
 
AfterGlow said:
Although I support making clean needles readily and easily available to anybody who chooses to IV their drugs, I don't think that government should be using tax payer money to buy and supply them to people. If somebody wants to buy needles, they should be able to. But I think it's entirely inappropriate for government to be purchasing needles and distributing them. If you can justify government funding for clean needles, then I want government to also provide me with clean ecstasy pills containing only MDMA and no adulterants.
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You make a lot of sense in your argument but perhaps you should consider it from another perspective. Below are some excerpts from a paper I wrote a few years ago on harm reduction for a criminology class. The last paragraph directly address the points that you made-

The idea of Needle Exchange Programs (NEPs) is still a controversial aspect of harm reduction philosophy explaining the disparity between necessity and availability. According to the Center for AIDS Prevention Studies at the University of California, San Francisco, (CAPS) it is estimated that 50% of all new HIV infections occur in injection drug users and for women, 61% of cases of HIV are due to either their own injection drug use or their partners'. Most tragically of all is that more than half of the children born with HIV are due to injection drug use and most or all of these cases could have been prevented if sterile needles had been used.

....

Most states criminalize the possession and distribution of syringes under paraphernalia laws and 10 states require prescriptions for needles and syringes to be purchased. Many injection drug users fear arrest or they simply can not afford their own syringes so they do not carry or possess them even where they are available and they resort to sharing equipment. (CAPS)

A study by the Journal of the American Medical Association on the transmission of HIV looked at 5 cities internationally where rates of HIV remained low among injection drug users and found that they all shared certain components. These components included prevention activities when levels of HIV were still low in the area, sterile equipment was available or provided through NEPs and community outreach was provided to injection drug users. (Des Jarlais, 1995) Further demonstrating how quintessentially important NEPs are in disease prevention:

A study of 81 cities around the world compared HIV infection rates among IDUs in cities that had NEPs with cities that did not have NEPs. In the 52 cities without NEPs, HIV infection rates increased by 5.9% per year on average. In the 29 cities with NEPs, HIV infection rates decreased by 5.8% per year. The study concluded that NEPs appear to lead to lower levels of HIV infection among IDUs. (CAPS)

....

Congress passed a law banning federal funding to NEPs unless two criteria could be met: 1.) It must be demonstrated that they decrease the spread of HIV and 2.) It must also be demonstrated that they do not encourage drug use in that community or the society as a whole. Hundreds of studies were conducted that were summarized in eight federally funded reports and universally they confirmed the two criteria were met however instead of lifting the ban on federally funding NEP's to discourage the spread of HIV, they changed the law to ban funding despite the criteria having been met.

The last question of whether needle exchange programs are worthy of federal dollars to fight disease is if they are cost effective. Currently the cost-burden of treating many HIV-infected individuals falls on the tax-payers so if it would save money to prevent the spread of disease then arguably it is a worthwhile program. Mathematical models demonstrate that the cost of each averted HIV infection due to NEPs is $9,400 compared to the lifelong cost of treating an HIV-infected person at over $195,000. (CAPS)
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I just know I don't want to explain to a rape victim or kid with HIV why as a society we would rather spend 20x as much money treating their HIV instead of setting up NEP's so addicts can have free clean needles.
 
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I don't believe government funding of a needle exchange program is justified under the guise that it is more cost effective to buy IV drug users clean needles than it is to treat their health problems if they decide not to buy their own. You're probably right about the dollars and cents. But that's only because government is trying to take care of people instead of simply providing a system of law and order. I would much rather be given more liberty and more responsibility for myself than to relinquish my freedom to make decisions for myself and be taxed so that the government can take care of me. I believe that responsible drug use should be legal. But I do not believe that government and my taxes should subsidize it. I guess we just have a difference in philosophy.
 
AfterGlow said:
I don't believe government funding of a needle exchange program is justified under the guise that it is more cost effective to buy IV drug users clean needles than it is to treat their health problems if they decide not to buy their own. You're probably right about the dollars and cents. But that's only because government is trying to take care of people instead of simply providing a system of law and order. I would much rather be given more liberty and more responsibility for myself than to relinquish my freedom to make decisions for myself and be taxed so that the government can take care of me. I believe that responsible drug use should be legal. But I do not believe that government and my taxes should subsidize it. I guess we just have a difference in philosophy.
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As long as the users are free to not use the exchange programs, I do not see a problem with it.

US Constitution said:
The Congress shall have power To lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defence and general Welfare of the United States
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I think non-coercive disease prevention programs fall under promoting the general Welfare (and kinda the common Defence, if disease is considered an attacker).
 
a thing said:
As long as the users are free to not use the exchange programs, I do not see a problem with it.

Originally Posted by US Constitution, Article 1, Section 8
The Congress shall have power To lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defence and general Welfare of the United States
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I think non-coercive disease prevention programs fall under promoting the general Welfare (and kinda the common Defence, if disease is considered an attacker).
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As long as the needle exchange program is not funded by public tax money, I do not see a problem with it either.

This is not the general welfare of the united states. This is the specific welfare of those IV drug users who choose to share needles instead of buying new ones.

I have compassion and understanding for the issue of clean needles. I just think that IV drug users should take fiscal responsibility for buying their own needles legally.
 
AfterGlow said:
As long as the needle exchange program is not funded by public tax money, I do not see a problem with it either.

This is not the general welfare of the united states. This is the specific welfare of those IV drug users who choose to share needles instead of buying new ones.

I have compassion and understanding for the issue of clean needles. I just think that IV drug users should take fiscal responsibility for buying their own needles legally.
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It is the general welfare of the United States. IV drug users who have HIV and hepatitis C have sex with others and the disease spreads.
 
In my opinion... government should only be doing for us what we cannot do for ourselves as individuals. If I can afford a drug habit, I should be responsible enough to buy my own clean needles. There is no need for a government funded program to provide them for free. If you're going to argue that, then you might as well argue for government provided free drugs too.
 
AfterGlow said:
I don't believe government funding of a needle exchange program is justified under the guise that it is more cost effective to buy IV drug users clean needles than it is to treat their health problems if they decide not to buy their own. You're probably right about the dollars and cents. But that's only because government is trying to take care of people instead of simply providing a system of law and order. I would much rather be given more liberty and more responsibility for myself than to relinquish my freedom to make decisions for myself and be taxed so that the government can take care of me. I believe that responsible drug use should be legal. But I do not believe that government and my taxes should subsidize it. I guess we just have a difference in philosophy.
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I am a very strong supporter of NEPs but you make an excellent point. Unfortunately there are a lot of people who think they know what's best for someone else better than they know for themselves, as well as those who won't have the responsibility to deserve that freedom. It's a shame that states' rights and personal accountability are dead in American politics today.
 
As posted in another thread people are being arrested and charged and having their mug shot published in the news for possessing a syringe in New York state of all places, so now we will have federal funding encouraging criminal activity?

Is it too much to ask to have our legislature agree on what the hell they are doing?

This is like passing a law to legalize gay marriage while people are still being arrested and charged with being homosexual, priorities!
 
AfterGlow said:
In my opinion... government should only be doing for us what we cannot do for ourselves as individuals. If I can afford a drug habit, I should be responsible enough to buy my own clean needles. There is no need for a government funded program to provide them for free. If you're going to argue that, then you might as well argue for government provided free drugs too.
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like methadone and heroin and suboxone clinics?

and some individuals CANNOT afford habits/needles/FOOD because of, simply, where they were born. capitalism necessitates this
 
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