This week on Capitol Hill, supporters of syringe exchange programs (SEP) for HIV prevention celebrated a victory. Last year, Rep. José Serrano (D-N.Y.) led successful efforts in the House of Representatives to allow the District of Columbia to spend its own funds on syringe exchange after a nine-year ban. D.C. has the highest HIV infection rate in the country, and Congress' ban on local funding (interference not faced by the states) severely hampered prevention efforts. President Bush's 2009 budget proposal calls for reinstating the local funding ban in D.C., but that will likely be ignored by congressional Democrats.
A campaign is now underway to overturn the older nationwide ban on federal funds, dating to 1988. We came close ten years ago.
In 1998, President Clinton's Secretary of Health and Human Services, Donna Shalala, was ready to call a press conference to confirm scientific findings that SEP helped decrease HIV infections without increasing drug abuse, and to announce that federal funds could be used for the purpose. At the last minute, Clinton bowed to pressure from his drug czar, General Barry McCaffrey, who claimed syringe exchange sent the wrong message to children. In the end, Shalala had to defend continuation of the federal funding ban despite confirming the effectiveness of syringe exchange.
POZ magazine founder Sean Strub urged Secretary Shalala to resign in protest. He wrote, "Let's hope that Clinton's modestly supportive (albeit failed) initiatives on gay issues are never confused with his record on AIDS, which is one of cowardice, opportunism, callous disregard and cynical dismissal." Scott Hitt, head of Clinton's AIDS advisory panel, said, "At best this is hypocrisy. At worst, it's a lie. And no matter what, it's immoral."
For two decades, the federal government, in the name of its ill-conceived "war on drugs," has blocked funding for a program proven to save lives. The irrationality of the "Just Say No" mindset, whether pertaining to drugs or sex, has been amply criticized. What is more disturbing is the silence and even complicity of people who know better. Clinton caved so many times on so many issues that one wonders what he thought the Oval Office was for. Oh, never mind.
What about the Clinton now running for president? Sen. Hillary Clinton answered a question last April from AIDS activist Charles King about SEP by saying, "I want to look at the evidence on it." Reminded that Secretary Shalala had affirmed the effectiveness of syringe exchange but that President Clinton had refused to end the federal funding ban, Sen. Clinton cited political realities. King pointed out that she had said we need a president with spine, and she replied, "We'll have as much spine as we possibly can, under the circumstances." By contrast, Sen. Barack Obama supports lifting the federal funding ban. John McCain's Senate office did not respond to an Associated Press query, but he voted on the Senate floor against D.C. funding of SEP in 2001.
It is not only the feds who have allowed ideology to trump the evidence on this issue. For example, in 2006, after Massachusetts lawmakers finally passed a bill permitting the sale of hypodermic syringes without a prescription, it was vetoed by then-Gov. Mitt Romney. Fortunately, the veto was overridden. On the other hand, life-saving needle exchange programs have been limited to four Massachusetts cities (Boston, Cambridge, Northampton and Provincetown) due to local opposition. This underscores the need for federal leadership.
For now, with D.C. finally able to fund syringe exchange, there are many who deserve recognition for their leadership: Congresswoman Eleanor Holmes Norton (D-D.C.); D.C. Council member Jack Evans (D-Ward 2); PreventionWorks!, which in addition to operating an SEP without public funds, had to overcome police interference and community mistrust; AIDS Action; amfAR; DC Appleseed; Human Rights Campaign; The AIDS Institute and Director of Federal Affairs Carl Schmid; Washington AIDS Partnership and Executive Director Channing Wickham; and Whitman Walker Clinic and Associate Executive Director Dr. Patricia Hawkins.
On Feb. 7, National Black HIV/AIDS Awareness Day, the Harm Reduction Coalition launched a campaign with the NAACP, the National Urban League and other groups to lift the federal funding ban. African Americans are disproportionately affected by HIV, and intravenous drug use is a vector for new HIV infections. It is past time to put lives and science first; but experience shows that this requires more than a change of political party. It requires political will.
36 Comments for “Syringes and Spine”
posted by Ashpenaz on
Interesting article–what does it have to do with being gay?
posted by North Dallas Thirty on
Yes, now DC can experience what San Francisco already knows.
posted by Brenda on
Interesting article, NDT. By linking to it, should I draw the inference that you support the main idea of the story: that SEPs are good and necessary programs, but if not administered carefully may result in some negative externalities?
I found it impressive that the citizens who were finding needles on their private property were still in support of SEPs, with one stating, “Like my neighbors, we believe in the concept of needle exchange. What we take issue with is location, transparency and oversight.”
Hopefully D.C. can learn from S.F. in implementing their SEP and reap similar benefits while minimizing any downsides.
posted by Brian Miller on
Of course, going a step further by ending the insane War on Drugs altogether would be opposed by most of the people lauding the needle exchange, as well as Republican shills like “ND-30.”
After all, we need to feel superior to these drug users we’re “helping” by compassionately allowing them to shoot up with clean needles. And most of the special interests who profit from continued state and federal spending on the war on drugs would lose a big fat paycheck if the whole thing was recognized as the profound failure it is.
posted by Ashpenaz on
Still not seeing the gay connection–am I missing something?
posted by North Dallas Thirty on
By linking to it, should I draw the inference that you support the main idea of the story: that SEPs are good and necessary programs, but if not administered carefully may result in some negative externalities?
Not particularly.
What you should draw is the fact that SEPs are a means of spending an inordinate amount of time and expense on cleaning up after people who have demonstrated their irresponsibility by leaving dirty needles on peoples’ property and on children’s playground equipment — all because you don’t want to confront them about what they’re doing.
Personally, I find it highly amusing that both Washington, DC and San Francisco can pass highly restrictive bans and extensive punitive measures on the use of tobacco and alcohol to stop people from using either with nary a tear shed, but seem utterly incapable of doing anywhere near the same thing for injectable drug use.
Of course, going a step further by ending the insane War on Drugs altogether would be opposed by most of the people lauding the needle exchange, as well as Republican shills like “ND-30.”
Mr. Miller, believe me, I would like nothing more than to leave you to the consequences of whatever drug you choose to use and not have to get involved myself.
But the simple fact of the matter is that your using injectable drugs like heroin or other ones like methamphetamine is incompatible with your driving on public streets, your interaction with the public, your receiving any form of public assistance or benefit, and your having any sort of employment protection.
If you want to withdraw to the center of Nevada without a car, miles away from any other human being, and shoot yourself full of heroin, it would be a waste of effort and resources in my opinion to come out and arrest you. But as long as you are living in a city of 750,000 people and a metropolitan area of over 2 million, forget it.
posted by Richard J. Rosendall on
Ashpenaz asks what SEP has to do with being gay. The chances are about zero that Ash doesn’t know the answer to that question. Gay people have been taking a leading role in the fight against HIV/AIDS for more than a quarter century, and a collective decision was made a long time ago that we would fight on behalf of all the victims and high-risk populations, and not only ourselves.
ND30, unsurprisingly, writes as if people who favor SEP do so because they themselves are injection drug users. He surely knows this is nonsense, but he cannot resist ad hominem attacks. He also refers to “highly restrictive bans and extensive punitive measures on the use of tobacco and alcohol.” What “highly restrictive” ban on alcohol is he talking about? We have a liquor control law like everybody else, and you have to be 21 to buy liquor, but not a ban. As to DC’s ban on smoking in restaurants, smokers are not just injecting harmful smoke into themselves but into the commonly breathed air. You can dispute the science on secondhand smoke if you like, but (A) there is a consensus in the scientific community that secondhand smoke is harmful, and (B) it can hardly be disputed that it is more difficult to breathe smoke-filled air.
One can have differing tastes and views regarding the regulation of businesses and where to draw the line, but you can hardly claim that some form of regulation is illegitimate unless you are such a doctrinaire libertarian that you also consider the regulation of (for example) the meat-packing industry to be illegitimate. I myself have mixed feelings about the Smokefree Workplace law, but my question has to do with where we draw the line of public policy, not whether there should be a line at all.
As to syringe exchange programs, there is no doubt at all in the scientific community concerning their effectiveness. The key thing is the word “exchange.” These programs are not increasing the net quantity of needles in circulation, they are CLEANING that supply. Which is merely dealing with the reality of injection drug abuse and the fact that it is a significant contributing factor in the spread of HIV. No one is saying that SEP is or should be the only tool in the toolbox for fighting against HIV, but it is one tool that has been proven to be effective.
posted by Ashpenaz on
I thought Bono was leading the fight against AIDS. Is he gay? I would have no way of knowing the sexual orientation of those helping AIDS victims worldwide any more than I would know the sexual orientation of those fighting hunger or poverty–except that a lot of them are Christians.
I’m still not sure why dirty needles would be of concern to gays. Gays, as far as I can tell from the answers here, are all in monogamous relationships, living in the suburbs, raising families, and adopting highways and working at food banks in their spare time. I can’t imagine a group less likely to affected by AIDS or dirty needles than the gays described by those on this board who know so much more about the gay community than I do.
So, why did dirty needles and sexually transmitted diseases become a concern for gays?
posted by Craig2 on
Possibly because harm minimisation and risk reduction have everything to do with safety? And incidentally, not all IV drug users conform to the stereotyped “addict” model.
Down here, we’ve had a national needle exchange programme for the last twenty years, and as a result, there hasn’t been that much of an epidemic amongst IV drug user social networks.
Personally, I’d support the idea of subsidised shooting galleries to provide certainty of clean needles, as well as point of service rehab counsellors in case they want to go “clean.”
Insofar as the War on Drugs goes, I think attention should be concentrated on the really hard stuff, like crystal meth,
which *should* remain prohibited
(while I also support decriminalising pot).
Craig2
Wellington, NZ
posted by Richard J. Rosendall on
Ash pretends to be participating in a conversation, but pays no more attention than the characters in Pinter’s play “The Collection.”
Ash’s comment about Bono appears to be the result of some syllogism he constructed out of a bizarre distortion he has made in his effort to divert us and the discussion.
Ash writes, “Gays, as far as I can tell from the answers here, are all in monogamous relationships, living in the suburbs, raising families, and adopting highways and working at food banks in their spare time.”
Who among us made any such claim? What I did say was that, contrary to your tendentious generalization, gay people are not all city dwellers who hang out in bars. Since I also pointed out that I live two blocks from Dupont Circle, I obviously was not claiming that no gays live in the city. I am afraid that if you responded honestly just once to someone else’s argument you would instantly be Raptured.
posted by Pat on
Still not seeing the gay connection–am I missing something?
Yes. I think the authors are allowed to post on issues that you may not think are gay related.
posted by North Dallas Thirty on
ND30, unsurprisingly, writes as if people who favor SEP do so because they themselves are injection drug users.
Perhaps some are, Richard, but what I think more likely is that they’re people who, for whatever reason, are willing to spend enormous amounts of money and have drug addicts leaving dirty needles in peoples’ yards and on children’s playground equipment rather than to have to confront those selfsame addicts about their unacceptable behavior.
What makes it really funny is that these same people are adamantly against secondhand smoke and fully in favor of zoning laws prohibiting liquor stores and bars, but seemingly have no issue with facilitating people strung out on heroin and meth doing things like driving, staggering through the parks, leaving dirty needles on peoples’ property and on children’s playground equipment, stuck on welfare because their addiction makes it impossible to hold jobs, committing petty and greater crimes to feed their habits, and regularly being rushed to emergency rooms at taxpayer expense because of their overdoses.
I prefer to take the far more effective tack of eliminating what makes them use needles in the first place.
posted by Richard J. Rosendall on
ND30 writes, “they’re people who, for whatever reason, are willing to spend enormous amounts of money and have drug addicts leaving dirty needles in peoples’ yards and on children’s playground equipment”
Actually, as I pointed out already, these programs are not just handing out needles, they are EXCHANGING them. Which means they are NOT increasing the net supply of needles, they are cleaning them. Dealing with an unpleasant reality does not mean that you want it to be that way, quite the contrary. A better question would be why you don’t mock the so-called war on drugs, which HAS NOT WORKED.
“rather than to have to confront those selfsame addicts about their unacceptable behavior.”
Actually, getting injection drug users to participate in SEP is an entry point for treatment and counseling.
“What makes it really funny…”
What is pathetic is your smug avoidance of the reality that syringe exchange programs did not create drug abuse, but are a response to it. That response has been proven to decrease HIV transmissions without increasing drug abuse.
“I prefer to take the far more effective tack of eliminating what makes them use needles in the first place.”
Talk is cheap. Evidence, please.
posted by ColoradoPatriot on
ND30: “I prefer to take the far more effective tack of eliminating what makes them use needles in the first place.”
How many drug-users have you saved through your internet trolling expeditions?
posted by Ashpenaz on
Perhaps the gays should leave this alone and let those groups who have a problem with drug addiction and dirty needles and the spread of AIDS deal with this issue. Why should we be involved in an issue we know nothing about? If gays want to be helpful, there are lots of highways to be adopted and old people in rest homes to be visited and undocumented workers to be given sanctuary. The unselfish compassion of the gay mainstream could be better used for those kinds of issues, right?
posted by ColoradoPatriot on
James: “The unselfish compassion of the gay mainstream could be better used for those kinds of issues, right?”
Those issues and countless others (including drug-rehab and needle exchanges), thank God that your miserable self isn’t the arbiter of all compassion. Go take care of your own mother and any illegals you find on the way to the rest-home…give the internet trolling a break for awhile.
posted by North Dallas Thirty on
Actually, as I pointed out already, these programs are not just handing out needles, they are EXCHANGING them. Which means they are NOT increasing the net supply of needles, they are cleaning them. Dealing with an unpleasant reality does not mean that you want it to be that way, quite the contrary.
Actually, Richard, did you bother reading the article I provided (all emphasis mine)?
Today the Haight facility looks more like a hole in the wall. The neighbors, many of whom say they have never been told what’s going on up the street, find syringes in their gardens. And the original idea – a one-for-one exchange – is largely ignored.
The exchange is run by the Homeless Youth Alliance, which gets a yearly budget of $275,000 from the city Department of Public Health. As the alliance’s program director, Mary Howe, admits, they make no more than a rough count of the incoming needles. If someone says he returned 40, they hand over 40 new ones. And, if he doesn’t have any, they give him 20 as a startup stash.
“The point for a needle exchange is not to get every needle back,” says Howe. “The majority of users dispose of needles in a respectful manner.”
And those who don’t?
“That’s not my responsibility,” Howe said. “I can’t hold everyone’s hand and make everyone put them in a bio bucket. If someone has a liquor store, and they sell liquor to someone who gets into an accident, is it the store’s fault?”……
Howe, a true believer who is a recovering addict herself, feels the debris is an unfortunate byproduct of a necessary initiative. To her, the single, most-important issue is stopping the spread of infectious disease. If that means giving out a double-handful of needles to someone who might leave them scattered in Golden Gate Park, so be it.
And where do those needles end up? Nursery school playgrounds.
posted by Richard J. Rosendall on
ND30’s selective citations of alleged horror stories notwithstanding, the evidence for the effectiveness of SEP is overwhelming. Following his logic, you should abolish emergency-response programs if you can find one that is incompetently run.
Ash writes, “Why should we be involved in an issue we know nothing about?”
Ash, (1) speak for yourself, and (2) kindly stop writing as if all gay people are identical. There are gay people who know all about all sorts of things, including SEP, of which you are utterly ignorant. Why do you find it necessary to tell other gay people what to do? Different people have different interests and talents.
“The unselfish compassion of the gay mainstream could be better used for those kinds of issues, right?”
Wrong. You go your way, and let others go theirs.
posted by North Dallas Thirty on
ND30’s selective citations of alleged horror stories notwithstanding
And here comes the usual liberal tactic when confronted with facts; call everything that disagrees with your postulate a lie.
Do you need another dose of reality, Richard?
They tell us he was steaming, but San Francisco Mayor Gavin Newsom shouldn’t have been too surprised when The Chronicle reported that Golden Gate Park was littered with used drug syringes.
After all, his own Public Health Department spent $800,000 last year to help hand out some 2 million syringes to drug users under the city’s needle exchange program — sometimes 20 at a time.
Although Health Department officials say 2 million needles were returned, the fact is they don’t count them and can only estimate how many are coming back.
And from the looks of things, a lot of them aren’t.
Mary Howe, director of the Homeless Youth Alliance, which operates a needle exchange program near the park with the help of city money, said her group gets back only about 70 percent of the needles it distributes.
So let’s see, 30% not returned times 2 million leaves a total of 600,000 dirty needles left in parks, in peoples’ yards, and on children’s playground equipment.
The supreme irony, Richard, is that SEP programs exist because liberals have aneurysms about how horrible it is that drug addicts might stick themselves with dirty needles and get sick.
But oddly enough, when it comes to over a half-million dirty needles being left around to stick people who DON’T use drugs and make them sick, that ISN’T a concern.
Please explain to us why liberals like yourself think that law-abiding taxpayers and their children should not only be endangered by, but be forced to pay for, the irresponsible, dangerous, and self-destructive behavior of people who made the decision to use injection drugs.
posted by Richard J. Rosendall on
ND30 continues to skew the truth about SEP. I have not denied facts as he claims. He is the one who writes as if SEP is entirely and everywhere a disaster, and blames such programs for all the problems associated with the drug abuse that SEP neither created nor worsened. Indeed, given the fact that SEP is an entry point for care and counseling, abolishing such programs would not only mean that drug needles would be dirtier, but also that drug abusers would be less likely to receive any intervention.
As to your demagogic question about taxpayers (which implies that individual taxpayers should be able to veto any program they don’t like), the fact that syringe exchange has been proved to decrease HIV infections saves costs in the long run. Prevention is cheaper. I would suggest, ND30 that you google it, but it is fairly clear that you only look things up to mine them for ammunition rather than to learn anything that doesn’t match your prior conclusions.
BTW, being snide and patronizing adds no more weight to your argument than throwing labels at me.
Syringe exchange is strongly supported by the elected officials here in D.C. It is not those city officials who have imposed their will on an unwilling electorate, but the U.S. Congress which has done so by blocking D.C. for nine years from spending its own funds on such programs despite the fact that they have operated successfully in many cities and that the science shows that they decrease HIV infections without increasing drug abuse.
posted by Ashpenaz on
I hope you’re not suggesting that the gay community has anything to do with drugs like meth or spreads STDs! You better watch out, because you’ll get a slew of angry responses telling you that any tales of drug use or multiple partners is just a homophobic myth. Gays are all in lifelong, monogamous relationships, raising families, and volunteering at homeless shelters. If you suggest otherwise, you’ll be called a self-loathing closeted queen so fast it will make your Gwen Stefani wig spin!
Just wait–here come the angry posts denouncing you for spreading the myth that gays use drugs and have multiple partners.
Here they come.
Just wait.
Any second now.
posted by North Dallas Thirty on
As to your demagogic question about taxpayers (which implies that individual taxpayers should be able to veto any program they don’t like), the fact that syringe exchange has been proved to decrease HIV infections saves costs in the long run. Prevention is cheaper.
Than what, Richard?
Getting people to stop using injectable drugs, which not only reduces the risk of them contracting HIV, but also avoids all the health consequences of using drugs?
Or how about this?
Consider the case of Ken Stevens, a lifelong resident of the city. Three years ago he took his 5-year-old son, Michael, to the playground at Corona Heights – a park we visited earlier this week.
Michael climbed up on the play structure, then turned to his dad and said, “Ouch.” He’d been poked by a needle left on the slide.
“You talk about a parent’s worst nightmare,” Stevens says today. “I think I went out of my mind for a couple of hours.”
Michael turned out to be fine, but it took three months of blood panels to establish that.
Yes, quite the cost savings there; let’s make the taxpayers not only foot the bill for the needles for the drug users and their medical care as they continue to destroy their bodies through drug abuse, but let’s make them also pay the costs for their children when they get stuck by those very same needles.
This is what comes of ideological myopia, Richard. Your only concern is reducing HIV among people who make the choice to use IV drugs; however, in the process, you increase the danger of contracting HIV from dirty needle sticks to everyone else.
What, exactly, is the preventative benefit when you reduce the danger to a tiny subpopulation by endangering the public at large?
posted by Karen on
Hey, I’ve got a question.
Can anyone here admit that there is NO easy answer here? That no “side” of this argument has THE answer?
Or are we doomed to have every subject used for people to take absolute, uncompromisible positions on and then throw grenades at each other from their separate corners?
Helloooo people – drug abuse and its disease-vector consequences are complicated problems to solve. SEPs will not fix everything, but neither will getting rid of SEPs.
posted by Karen on
ND30, you mistake a person’s support for SEPs in general with a person’s support for one poorly-implemented example of an SEP. “Starter kits” and not guaranteeing a 1-1 exchange are not ideas that are inherent in SEPs.
You’re also embarking upon one of your infamous “listen to my favorite anecdote and then jump to conclusions” adventures. I seriously doubt that the costs of accidental needle-sticks resulting from sharps lying around due to SEP-enabled litterbug junkies outweigh the costs of HIV treatment for the cases SEPs prevent. And the other medical problems that go along with drug use are irrelevant to the discussion until you can show that SEPs have any impact on the amount and scope of drug use.
People who support SEPs, you have to acknowledge that the potentials for abuse and mismanagement are enormous. A NIMBY problem also presents itself. And while I disagree that having SEPs sends any kind of mixed message to non-junkies about the acceptability of being a junkie, you must see the hypocrisy of completely outlawing a dangerous and destructive activity on one day, and then trying to make that activity safer with federal funds the next. Is it illegal? Or isn’t it?
posted by Richard J. Rosendall on
Karen, thank you for your thoughtful comments. Yes, SEP is a messy and hazardous business, which is why it requires careful protocols and oversight.
posted by Karen on
For instance, can you see the government funding research into ways to allow a drunk driver to drive more safely? Or funding programs that allow unlicenced plastic surgeons to access training and equipment that gives better and safer results? Maybe giving lessons on safe robbery tactics in order to reduce casualties during stick-ups?
Maybe drugs shouldn’t be illegal, maybe they should. Preventing HIV transmission and reducing drug use are both laudable aims, but is having a schizophrenic, hodgepodge official government policy that attempts to have the best of both worlds the best way to deal with this? I don’t know… maybe it is.
posted by Karen on
Thanks, Richard. I agree, if it is to be implemented at all… and I think the benefits probably do outweigh the negatives… it must be carefully done and closely watched.
But it still leaves questions in my mind… any increased risk to innocent bystanders is a bad bad thing, and potentially a dealbreaker. Money aside, how many addicts need to avoid the bug to outweigh the potential infection of an innocent child? But what about the innocent children of addicts who avoided mother-child transmission because of an SEP – where do they factor into this arithmetic? How much do SEPs cost? Would the money be better spent elsewhere? How far does the federal government’s public safety mandate go?
This is one of those issues that, if I think about it too much, will progress into doubting the whole structure of our government, the ability of humans to govern ourselves at all, and will inevitably end up with me in a puddle of doubt and misanthropy on the floor.
posted by Ashpenaz on
Honestly, I’m sure there will someone soon who will denounce the horrible homophobic myth that gays have anything to do with drugs or multiple partners. They were here a minute ago, I swear!
Just you wait.
They’ll be here.
Any minute now.
posted by Karen on
Ash, can it. Gays don’t own the needle vector. Really, they don’t. It’s not ours like lesbians don’t own the anal-sex vector. We all are still trying to find ways to fight it, every which way it gets transmitted.
Go have your hissy fits elsewhere.
posted by North Dallas Thirty on
And the other medical problems that go along with drug use are irrelevant to the discussion until you can show that SEPs have any impact on the amount and scope of drug use.
Since the damage caused by injectable drugs increases over time, why should the federal government be doing anything that facilitates people staying on drugs longer?
And furthermore, Karen, why on earth do you want to do something that facilitates in perpetuity a person getting high on heroin, and then going for a drive on the same public streets that your daughter crosses on her way to school every day?
Committing people to treatment eliminates both the problem of people continuing to use, peoples’ use continuing to endanger others, and people getting HIV from needle sticks — because if you aren’t sticking, you aren’t getting. Add to that the strong correlation that exists between promiscuous sex practices and use of drugs, and you choke off yet another pathway.
But that requires an entire generation of gays and lesbians who are still in denial about their own drug use to confront it in others. We have a schizophrenic national policy because we have a group — the baby boomers — who have spent the majority of their lives trying to rationalize their use of drugs.
posted by Karen on
I thought I made my ambivalence clear, ND30. I don’t “want” to do SEPs. But since I make of habit of arguing with you, I’ll take the side of pro-SEP.
You’re fooling yourself if you think that drug users, especially addicts, that don’t have access to clean needles won’t use a dirty one instead. That’s the entire reason for the existence of an SEP. I have no reason to believe that the existence or non-existence of an SEP has a significant effect on the rate of drug use and addiction. Can you show me that it does? Can you walk me through your thinking in assuming that it will?
In most cases, I bet that an SEP location also serves as a convenient place to reach out to addicts with help and support for getting clean. Incarceration certainly isn’t particularly effective for that. Ignoring them isn’t, either. So I don’t buy your “enabling perpetual/longer use/addiction” argument, either. What is a better option than education to prevent use/addiction, combined with SEPs to mitigate the dirty-needle vector and AA/NA style get-clean programs?
I’m not in denial about my drug use. It was restricted to pot and the occasional psychoactive in my wild teenage years. I’ve never used IV drugs at all. In fact, the only people I know who have are straight. So I’m not sure what your point about gays and IV drugs is…
posted by Karen on
By the way, nice appeal to emotion about my daughter. I don’t support closing bars and liquor stores, even though they are far more directly enabling something FAR more likely – that she could be mowed down by an alcoholic driving hammered at 3:00 on a Tuesday.
posted by North Dallas Thirty on
You’re fooling yourself if you think that drug users, especially addicts, that don’t have access to clean needles won’t use a dirty one instead.
Of course they will. Also, if they don’t have access to pure and pharmaceutical-grade drugs, they will inject other things that can be horribly detrimental to their bodies — so why don’t we just buy the drugs for them, too?
In most cases, I bet that an SEP location also serves as a convenient place to reach out to addicts with help and support for getting clean. Incarceration certainly isn’t particularly effective for that.
No, but court-ordered rehabilitation and confinement is — and it also takes advantage of the fact that intervention works best when the person is in crisis, i.e. right after being arrested.
Otherwise, you’re just facilitating the addict’s denial that there is a problem.
I don’t support closing bars and liquor stores, even though they are far more directly enabling something FAR more likely – that she could be mowed down by an alcoholic driving hammered at 3:00 on a Tuesday.
Um, no.
The better comparison would be if she was mowed down from a drunk driver leaving a government-sponsored bar, where the theory is that it needs to prevent disease by providing heavy drinkers with the cleanest glassware and liquor possible and giving them free medical checkups.
But oddly enough in this country, we penalize places that enable alcohol abuse, we tax the living daylights out of alcohol, we outright ban bars and places that serve it from opening in certain areas, and we force drunken drivers or habitual intoxicants into court-ordered treatment programs.
posted by Karen on
1) Buy their drugs? No. Drugs are illegal.
2) I support court-ordered rehabilitation and confinement. That doesn’t mean that SEPs aren’t useful for preventing HIV transmission through dirty needles.
3) Your analogy fails dramatically. Are the alcoholics catching HIV from the dirty glasses? Is it hard to get glasses? Is the “government bar” actually a place where no liquor is sold, but you can exchange dirty glasses for clean?
All I was saying with my example is that just because a risk exists doesn’t mean we have to run screaming. Liquor and IV drugs are two very different things, obviously. But if the risk of a heroin DUI – that is NOT actually caused by the clean needles provided by the government but rather by the illegal drugs that the junkie would be arrested if caught buying – is enough to outweigh the benefits of an SEP, wouldn’t the much greater risk of an alcohol DUI be enough to *outlaw the actual cause of the DUI*?
posted by North Dallas Thirty on
Where we can agree, Karen, is on court-ordered rehabilitation and confinement. And I will simply state that, rather than SEPs, we need to spend the money on getting the people out of the street, into this rehabilitation and confinement, and ultimately off drugs.
posted by Karen on
I respect that opinion, that the money would be better spent elsewhere. It may very well be the case. That’s not really a good enough reason to *ban* federal funds from being used, but it could be a reason to simply not fund SEPs in the first place.
But I’d point out that SEPs are not inherently about drug use, but rather HIV prevention. If I have x dollars set aside with which to prevent drug use, I’d probably spend a lot of them on confinement/rehab. But if my x dollars are set aside to prevent HIV transmission, spending them on confinement/rehab would be a very roundabout and inefficient way of reaching that goal. And I believe that both of those goals are reasonable uses of public health funds.
SEPs might not be first on the list of effective and reasonable ways to prevent HIV transmission, but rehabbing drug addicts is way lower, no matter how high it is on the list of effective and reasonable ways to prevent drug use.