States Can Use Federal Dollars for Needle Swaps
With the new year comes new funding opportunities for controversial needle exchange programs targeting injection drug users and meant to combat the spread of diseases—mainly HIV/AIDS—passed through dirty needles.
Some states such as New York have hosted these needle swaps for years, praising their ability to stop the spread of HIV/AIDS and other blood-borne diseases by providing clean syringes to drug users and others at risk of using dirty needles. And although some states fund the programs and others don’t, no state has ever been able to use federal funding for the needle swaps … until now.
In early December, President Obama signed the Consolidated Appropriations Act of 2010, which lifted the 1989 ban on using federal dollars for needle exchange programs.
“This is an historic action in the fight against HIV/AIDS, one that has the potential to reduce HIV infections among people who inject drugs,” said Jonathan Mermin, director of HIV/AIDS Prevention for the U.S. Centers for Disease Control and Prevention. Mermin leads the CDC’s domestic HIV prevention activities.
“I think in the long run it bears well on syringe exchange. It helps support the intervention as a smart, cost-efficient public health tool,” said Pamela Lynch, trainer for The Institute at the Harm Reduction Coalition, a national training initiative that promotes the health and dignity of individuals and communities impacted by drug use. She’s also recently worked with pilot needle exchange programs in New Jersey. “The boost in funding will absolutely help fight the spread of blood-borne pathogens all over the country, but particularly in areas where there is a condensed urban injection drug using population with limited access to sterile syringes.”
That’s the state of affairs in places like Camden, Trenton and Newark, N.J., as well as Washington, D.C., etc, Lynch said.
Although lifting the ban is just the first step and new funding isn’t flowing to the states yet, the process is changing and supporters of needle exchange are happy that federal money is at least a possibility.
“There really isn’t a new flow of money into New York state. Some of this is still in the planning phases,” said Jeffrey Hammond, spokesman for the New York Department of Health, on federal funding for needle exchange programs. “But we’re very pleased the federal government is making these changes.”
Mermin from the CDC credits the syringe exchange programs with slowing the spread of the deadly disease among injection drug users. The number of new HIV infections among injection drug users declined by 80 percent since the late 1980s, according to Mermin.
But, people who use needles to inject drugs are still spreading HIV. Injection drug users account for an estimated 16 percent of new HIV infections, according to Mermin.
Supporters also say the needle exchange programs save money by preventing the spread of costly disease, often pointing out a syringe cost anywhere from 5 to 10 cents, while treating a new HIV case can cost $600,000.
But critics say needle exchange programs may send the message that drug use is OK as long as clean needles are used.
There are more than 211 syringe exchange programs in 36 states and territories, according to the latest figures from the North American Syringe Exchange Network. That’s up from the 186 programs the network was tracking in 2007. Typically, the programs stockpile clean syringes and allow people to come in and swap dirty, used needles for clean ones.
Programs like the Positive Health Project in New York City host wraparound services where injection drug users can come in and swap needles, but they also get pointers on minimizing their risk for contracting diseases and they can take advantage of a whole host of services including educational programs, outreach, case management, therapy, counseling and referrals.
Experts who work in these programs say that getting clean needles leads to other things.
That’s what makes programs like New York City’s Positive Health Project more than just a needle swap. The place not only offers syringe exchange to thousands of clients, it also provides services ranging from AIDS testing to acupuncture to help manage drug cravings, and from support groups to mental health services.
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