Harm Reduction in Washington, DC
An article in last week’s New York Times describes the bureaucratic pressures that threaten the existence of Washington, DC’s needle exchange prgroams:
Since Washington is not part of a state, Congress controls the city’s local system of government, and for nearly a decade members of the House, citing concerns about worsening drug abuse, have inserted language into the bill approving the city’s budget to prohibit financing such programs.
That may soon change.
“This city’s situation is totally improper,” said Representative José E. Serrano, Democrat of New York and chairman of the subcommittee responsible for the District of Columbia appropriations bill. “It’s politically obscene to have Congress tell the District of Columbia that it can’t use local funds for something like needle exchange programs, which have been proven to have a major effect on fighting a deadly disease.”
The politics that surround Washington, DC’s funding issues are unique to that city, but the resistance on the part of politicians and bureaucrats isn’t. Needle exchange programs have been shown, time and again, to reduce the spread of infectious disease, but those who would support needle exchange run up frequently against the “war on drugs” mentality that has long viewed drug use as a moral blight, and drug users as criminals. An excellent review of the barriers to implementing needle exchange programs is found at here (pdf).
Do you have needle exchange programs in your region? What has been your experience with them?
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Across The Nation | House Subcommittee To Hear Washington, D.C., Appropriations Bill That Restricts City Funding for Needle-Exchange Programs
[Jun 05, 2007]
The House Appropriations Subcommittee on Financial Services and General Government on Tuesday will consider a Washington, D.C., appropriations bill that includes language preventing the city from financing needle-exchange programs, the Washington Post reports. According to the Post, some health advocates are hopeful that the language will be removed from the bill because of the “changed balance of power on Capitol Hill” (Levine, Washington Post, 6/5). The ban was first imposed under a federal law signed by former President Clinton in 1998 that prohibits the district government from using local tax money to fund any organization that operates a needle-exchange program (Kaiser Daily HIV/AIDS Report, 5/29). According to the Post, the House has added the ban each year to the district’s appropriations bill (Washington Post, 6/5).
Rep. Jose Serrano (D-N.Y.), chair of the subcommittee, recently said he will make it a priority to push for the removal of the language. District Mayor Adrian Fenty has said that he will provide funds for needle-exchange programs as soon as Congress removes the language.
Injection drug use is the second most common mode of HIV transmission among men in the district and the most common mode among women in the city. Prevention Works!, the district’s only needle-exchange program, is financed through private donations and reaches about one-third of the estimated 9,700 injection drug users in the city (Kaiser Daily HIV/AIDS Report, 5/29). Walter Smith, executive director of the DC Appleseed Center for Law and Justice, said that there is a connection between the high number of HIV/AIDS cases in the district and lack of a city-funded needle-exchange program, adding that it’s “time to uncouple” the connection.
Serrano said that although it is unclear whether the ban will be lifted, he is ready to push the issue. Del. Eleanor Holmes Norton (D-D.C.) called the ban “abuse of the city,” adding that “countless deaths have occurred” because the city lacks a government-funded needle-exchange program. More than two dozen medical, public health, social service and philanthropic organizations last month sent a letter to Sen. Richard Durbin (D-Ill.), chair of the subcommittee that initially handles the district’s budget, urging that the restriction be lifted, the Post reports. Chuck Knapp — a spokesperson for Rep. Todd Tiahrt (R-Kan.), the original author of the ban — said that Tiahrt likely will try to continue the ban but added that “it’s a different political environment” than when it originally passed (Washington Post, 6/5).