What the 1,000 Foot Ban Means for Needle Exchange

This is not a needle exchange program center
(from here)

I've written before about the needle exchange legislation which is very good...in an imaginary world lacking parks, schools, and other places where children congregate. From Maine, we find out what this legislation really means:

Such a position could conceivably pave the way for additional federal money for needle exchange -- with one catch. Bill McColl is the political director at AIDS Action in Washington D.C., who's been following the needle exchange debate in Congress. "They did accept an amendment that would ban the use of federal funding within 1,000 feet of schools, universities, parks, day care centers, video arcades -- I like that one because it's right out of 1980s -- and unfortunately what that means is that, in effect, it would restore the ban," McColl says.

That's because even in states as rural as Maine, all four of the needle exchange programs fall within those limits. Patsy Murphy of the Eastern Maine AIDS Network says her office in a small strip mall adjacent to a park and within walking distance of downtown Bangor has been in its location since 2002 and, for many reasons, she'd prefer not to move. "This is a local issue. We know our community best and we are in the best position to protect our neighborhoods and our children."

I think there's this image that needle exchange centers are like opium dens, when the reality is very different (italics mine):

At the Eastern Maine AIDS Network in Bangor, Executive Director Patsy Murphy and her staff keep track of about 380 clients. About 100 are HIV/AIDS patients who get assistance with medical, legal and mental health needs. The rest are people who regularly use the needle exchange program where they can swap out dirty needles for clean ones as a way to reduce the transmission of HIV/AIDS and Hepatitis C.

"J.J.," who is HIV positive, declined to give his last name. He says he and his friends come here regularly and he says they've learned not to mix up their works....

Clients are regularly tested for HIV. If they're interested in substance abuse treatment or other counseling services, they are referred to outside agencies. Many of them are homeless or couch surfing, so the program also offers personal care products and access to a food pantry. But using drugs on the premises is prohibited.

As an extra precaution, Murphy says exchangers are not even permitted to use the bathroom. "They could use our facilities to shoot drugs. That's not what we're about," she says.

When Murphy first took over three years ago, she says the program was only handing out about 300 clean needles a month. Now she hands out about 4,000. She says the average exchanger is male, between the ages of 25 and 29 and either unemployed or on disability. "Many of the folks were receiving prescription drugs from physicians who prescribed painkillers either through a workers' comp injury or some type of car accident and now they can't get a prescription for it and they purchase drugs on the street."

There's also this dose of unreality by a Republican opponent of needle exchange:

For some members of Congress, the idea of providing clean needles to drug users runs counter to the anti-drug message, "Just Say No." Indiana Rep. Mark Souder, for example, supports the ban. He could not be reached for comment for this story, but he told a congressional hearing on drug policy four years ago that, instead of providing addicts with clean needles, "We should break the bonds of their addiction once and for all."

Yes, because opiate addiction is really easy to break. We're talking about really hardcore addicts: this isn't like smoking. Daily, they are dealing with criminals in order to maintain their habit (and that's the most pleasant part). I don't see Republicans like Souder trying to fund comprehensive anti-addiction programs that provide treatment, a new environment, and the means to a sustainable livelihood (in fairness, I don't see many Democrats trying to do this either). So, as is the case with the oral cholera vaccine, we make do with second best: let them come to a place that could help them start to break their habit ("If they're interested in substance abuse treatment or other counseling services, they are referred to outside agencies"), while preventing them from becoming HIV or hepatitis C positive:

Bill McColl of AIDS Action says that's a misguided position. He points out that the cost of syringe exchange to prevent one HIV infection is about $8,800. The lifetime cost of treating one HIV positive person for life is $730,000.

I would add that we can't treat dead people for drug addiction either.