Advocates Call on Indiana Governor Pence and Legislature to Expand Syringe Exchange; Federal Funding Ban on Syringe Services Continues to Hamper Local Efforts to Address Heroin Use and Reduce HIV/AIDS and Hepatitis C
NEW YORK—(ENEWSPF)—April 22, 2015. In recent months HIV/AIDS infection rates have skyrocketed in rural Indiana, in large part because of the sharing of syringes used for the injection of the prescription painkiller Opana, heroin, and other drugs. In response Indiana Republican Governor Mike Pence allowed one county to implement a 30-day syringe exchange program to reduce infection rates.
Governor Pence extended the program another 30 days this week, but advocates have pointed out that a temporary program in just one county is not enough to stop an epidemic. The legislature is considering legislation to make sterile syringes available on a broader and permanent basis.
“One program operating in one county for one month is not going to stop an epidemic,” said Bill Piper, director of the office of national affairs with the Drug Policy Alliance. “Indiana’s weak response to rising HIV/AIDS transmission rates threatens every Hoosier, as well as people across the Midwest and around the country.”
Decades of research in the U.S and from around the world has concluded that syringe access programs reduce the spread of infectious diseases without increasing drug use. By preventing people from contracting infectious diseases that can be expensive to treat, syringe exchange also saves money by reducing healthcare expenditures. A sterile syringe can cost as little as a nickel; treating someone with HIV/AIDS can cost taxpayers more than one million dollars.
In the U.S., injection drug use has accounted for more than one-third (36 percent) of AIDS cases – more than 354,000 people, according to the Centers for Disease Control and Prevention (CDC). Yet the U.S. bans federal funding for sterile syringe access programs, even though the CDC has found that such programs lower incidence of HIV/AIDS among people who inject drugs by 80 percent.
This refusal to adopt an evidence-based prevention strategy has cost the U.S. hundreds of thousands of lives and billions of dollars.
In countries where addiction is treated as a health issue, the fight against HIV/AIDS is being won. New HIV infections in countries such as Australia, Germany and Switzerland have been virtually eliminated among people who use drugs, just as mother-to-child HIV transmission has been eliminated in countries that make medicines for pregnant women accessible.
Last year, more than 140 local, national and international organizations released a letter calling on Congress to end the archaic federal funding ban on syringe service programs. The ban was put in place in 1988, repealed in 2009, and reinstated by Congress in 2011. The signatories include over 80 prominent organizations from 26 states, as well as Puerto Rico and the District of Columbia, in addition to dozens of national and international organizations.
Advocates say Governor Pence should work with his former Republican colleagues in Congress to repeal the syringe-funding ban. He should also support efforts in the Indiana legislature to allow every local jurisdiction to establish syringe exchange programs. Kentucky Governor Steve Beshear recently did this, signing legislation that creates syringe exchange programs in local jurisdictions that formally approve them. Hoosier families also deserve an effective syringe exchange policy.
“As a native Hoosier whose uncle died of Hepatitis C – which he likely contracted from injection drug use – I take syringe access very personally,” Piper said. “If the Governor’s serious about mitigating this disaster, he should expand Indiana’s program statewide and work with Congress to make sterile syringes widely available.”
Related Material:
New York Times
H.I.V. Cases Lead Indiana to Extend Needle Exchanges, By ABBY GOODNOUGH, APRIL 20, 2015 – http://www.nytimes.com/2015/04/21/us/hiv-cases-lead-indiana-to-extend-needle-exchanges.html
WASHINGTON — Gov. Mike Pence of Indiana extended a needle exchange program for another 30 days on Monday as the number of H.I.V. cases linked to intravenous drug use in a rural county continued to grow, with new cases being reported almost daily.
Mr. Pence, a Republican who has long opposed needle exchanges, first authorized the program last month when he declared a 30-day public health emergency in Scott County, which has about 24,000 residents and is near the Kentucky border. At the time, about 80 people there had tested positive for H.I.V. since December. But the number of cases has grown since then to 128, and state health officials say they are still trying to find and test everyone who could have been exposed to the virus.
“While we’ve made progress in identifying and treating those affected by this heartbreaking epidemic, the public health emergency continues and so must our efforts to fight it,” Mr. Pence said in a statement.
With the help of a team from the federal Centers for Disease Control and Prevention, state and county health officials have been trying to track down everyone who might have been exposed to the virus, which has spread largely from injection of the prescription painkiller Opana.
This “contact tracing” has proved challenging because the list of potentially exposed individuals keeps growing, said Dr. Jerome M. Adams, the state health commissioner.
“Every day we’re uncovering more cases, literally several times a day,” Dr. Adams said. “Every person who we contact, they are giving us, on average, nine additional contacts that we have yet to trace.”
The needle exchange, which is limited to Scott County, started on April 4. As of Friday, 5,322 clean syringes had been provided to 86 participants, and about 1,400 used syringes had been returned. Few people sought out the exchange at first, Dr. Adams said, but the number rose last week after a mobile unit started offering clean needles. Until then, participants had to go to an outreach center in Austin, a small city that has been hit hard by the outbreak.
“We’re trying to do everything we can to reach people where they are,” Dr. Adams said.
He said he had advised Mr. Pence to extend the exchange because it was a way to identify additional H.I.V. cases and to connect addicts with treatment programs and other services. But he added that he believed exchanges were “not a panacea.”
“As far as drawbacks,” he said, “I think the biggest is that people are overstating the value of it, and people just want to say, ‘O.K., needles for everyone, everywhere.’ It’s only going to work if it allows us to connect people to the resources they need to get clean, to get off drugs and get their infectious diseases appropriately diagnosed and treated.”
Dr. Kevin Burke, the public health officer who oversees H.I.V. testing in southeastern Indiana, said that he had hoped Mr. Pence would extend the program for at least 60 more days, but that 30 was a good start.
Dr. Burke also said he disagreed with Dr. Adams’s statement that needle exchanges could be seen as successful only if they connected addicts to treatment.
“Some of these people are going to abuse IV drugs until they die,” he said. “But I don’t think there’s any question that you decrease the risk of infection by allowing them to use clean needles.”
Huffington Post
Indiana Families Deserve an Effective Syringe Exchange Policy, Bill Piper, 04/14/2015 – http://www.huffingtonpost.com/bill-piper/indiana-syringe-exchange_b_7065984.html
Indiana’s Republican Governor, Mike Pence, is implementing a 30-day syringe exchange program in Scott County to combat escalating HIV/AIDS infection rates. It is part of a public health emergency he declared to keep Hoosiers safe. This plan is welcome news but one program operating in one county for one month is not going to stop an epidemic. Some legislators want real reform and the governor should work with them. Thousands of lives are at stake.
Syringe exchange programs are not new. They operate in dozens of U.S. states and are the cornerstone of fighting HIV/AIDS, hepatitis C and other infectious diseases in many countries around the world. In addition to preventing the spread of infectious diseases these programs offer critical health services to people who inject drugs, and often are a bridge to drug treatment. The programs also help get contaminated syringes off the streets, keeping neighborhoods safe, while ensuring that when police officers search suspects they don’t accidentally prick themselves and contract a disease.
I was born and raised in Indiana. My uncle Tommy died from liver complications related to hepatitis C, which he most likely contracted from injection drug use earlier in his life. When he was diagnosed with liver failure he was living a sober life, rebuilding relationships with friends and family, and finally doing well in life. Unfortunately his past mistakes caught up with him, cutting his life short, and depriving our family of someone we cared deeply about. Had he had greater access to sterile syringes he might be still be with us, telling jokes and sketching portraits of family members which he liked to do.
Decades of research in the U.S and from around the world has concluded that making sterile syringes widely available through syringe exchanges and other means reduces the spread of infectious diseases without increasing drug use. (If I handed you a sterile syringe would you run out and suddenly start using heroin?) By preventing people from contracting infectious diseases that can be expensive to treat, syringe exchange also saves money by reducing healthcare expenditures. A sterile syringe can cost as little as a nickel; treating someone with HIV/AIDS can cost taxpayers more than one million dollars.
The Centers for Disease Control and Prevention (CDC) recently determined that HIV /AIDS infection rates have soared in Scott County on account of the sharing of syringes used for the injection of the prescription painkiller Opana, heroin and other drugs. This isn’t an issue limited to one county, or even one state. In the U.S., injection drug use has accounted for more than one-third (36 percent) of AIDS cases – more than 350,000 people. Hundreds of thousands more have contracted hepatitis C.
Yet the U.S. bans federal funding for syringe exchange programs, even though the CDC has found that such programs lower the spread of infectious diseases among people who inject drugs by up to 80 percent. This refusal to adopt an evidence-based prevention strategy has cost the U.S. hundreds of thousands of lives and millions of dollars. In countries where addiction is treated as a health issue, the fight against HIV/AIDS is being won. New HIV infections in countries such as Australia, Germany and Switzerland have been virtually eliminated among people who use drugs.
Last year, more than 140 local, national and international organizations released a letter calling on Congress to end the archaic federal funding ban on syringe service programs. The ban was put in place in 1988, repealed in 2009, and reinstated by Congress in 2011. Repealing the ban would not cost any money; it would just allow states to use their share of federal prevention dollars more effectively. Over the long run it would save taxpayer money by reducing healthcare expenditures.
Governor Pence should work with Republicans in congress to repeal the shameful and deadly syringe-funding ban. He should also support efforts in the Indiana legislature to allow local jurisdictions to establish syringe exchange programs. Kentucky Governor Steve Beshear recently signed legislation creating syringe exchange programs in local jurisdictions that formally approve them. Hoosier families also deserve an effective syringe exchange policy. No family should have to go through what my family went through.
Bill Piper is the director of national affairs for the Drug Policy Alliance.
Follow Bill Piper on Twitter: www.twitter.com/billjpiper
Source: www.drugpolicy.org
