Health Fitness :: Health
Needling the Law by E. Jeanne Harnois
EDGE ContributorTuesday Nov 15, 2005 Laws and statutes banning the sale of hypodermic needles have long been a mainstay in the arsenal on the war on drugs. However, as the war on drugs has collided with the war on AIDS, many states have had to rethink this approach, although change has been slow.
Becoming enlightened to the health risks posed by sharing dirty (used) needles and weighing the public health threat of AIDS and Hepatitis-C against the threat of illegal drug use, most states have begun to enact legislation easing restrictions — for example, by limiting the number per purchase — or outright legalizing sales — which permits their sale in retail stores. By 2002, the number of illegal states was down to 11, and this number has been rapidly falling. Gov. Schwarzenegger of California signed clean-needle legislation that went into effect early this year leaving only three states in which a prescription is required to buy needles. This past Monday (November 14) one of those states, Massachusetts, passed a measure in the House of Representatives to legalize hypodermic needle sales. The bill still has to be voted on by the Senate and also faces the threat of a veto by Governor Mitt Romney who has publicly opposed any changes to the law because it contradicts his anti-drug agenda.
There are others, too, who are unwilling to embrace change. “It’s another move to keep [addicts] using drugs,” says Clare Waismann, the medical director of the Waismann Institute, a private medical detox center in Beverly Hills, Calif. She is hesitant to increase access to needles. “We, society, keep judging these people and giving them what they need to keep using. Then we they get in trouble we lock them away in rehab,” Ms. Waismann says. “That’s not helping.” However, she is quick to add that from an AIDS perspective, providing access to hypodermic needles may be a necessary concession.
The two most prevalent means of spreading AIDS are unprotected sex and intravenous drug use. While the safe-sex message has gotten out, behavior changes among drug users has been slower to take hold. Those on the front lines see how these drug policies play out in the lives of those either afflicted or at risk for AIDS and Hepatitis-C and are realizing that new approaches are needed, especially since restricting the sale of needles has not been particular effective in reducing drug use.
“The reality is that people are continuing to use injections and have been for several years,” says Amy Offenberg, Director of HIV and Methadone Services at RoxComp Health Center in Roxbury, Mass., “People will continue to do it whether they [needles] are legal or not. I don’t see the problem going away.”
Ms. Offenberg says she started her career thinking that abstinence — reducing the risk of AIDS and Hepatitis-C by getting users just to stop — was the answer. However, she discovered that it is not that easy. “No matter what I or legislators feel about drug use, it goes on. We need to use options — like clean needles — to keep our population healthy,” she says.
While sitting on a park bench on a sunny afternoon, Juan Lopez (not his real name) says that he has been using heroin for over 30 years, and is well aware of the dangers of sharing needles. “It’s complicated,” he says. He belongs to a needle exchange, but can’t always get a clean needle when he needs one. “I go around asking people. They don’t really care, they don’t say nothing if they are sick or not. I ask them, but is all you want to do is get off. It’s a powerful feeling — it takes control of your mind and your body.” Mr. Lopez was diagnosed with AIDS in 1986. If someone asks him to share a needle, he tells them his status, but says they will still take his needle. He says, “I feel guilty, but at least I let them know.”
Black market needles are somewhat available on the street, says Solomon (not his real name), from diabetics who sell their extra needles. If users can find these needles, they will buy and use them, however, if the need for the drug comes at a time when no such needles can be found, they will resort to using a dirty needle, regardless of the risk. “A lot of people are conscious of the spread of AIDS and Hep-C. It’s a gamble,” he says. “For the past month I have shared needles 70% of the time knowing that I could catch HIV. I already have Hep-C.”
The AIDS message is out there, but it’s not enough. “People are able to acknowledge they are putting themselves at risk. It is not difficult to get them to hear the message,” says Offenberg. “What is difficult is getting them to realize the message is greater than their addiction.”
While legislative change is happening, long-held beliefs die hard. Back in 1998, “Reconsider: Forum on Drug Policy” published a study proving that providing clean needles, through needle exchange programs and through legalizing sales, reduces infectious rates of HIV and Hepatitis-C.
Professor Scott Burris, from Temple University Law School in Philadelphia, has studied syringe access from a legal perspective. Along with Steffanie Strathdee and Jon Vernick, Burris published a paper entitled “Lethal Injections: the Law, Science, and Politics of Syringe Access for Injection Drug Users” in the Summer 2003 edition of the University of San Francisco Law Review.
One of the reasons for the slow change is that easing drug laws is perceived as being soft on drugs. But to public health professionals and researchers such as Burris, sales of hypodermic needles do not reflect an attitude of condoning drug use. “That’s a kind of almost religious belief,” says Burris. “It’s hard to think of in terms of empirical belief. The evidence doesn’t bear that out. If you think about it, it’s preposterous. We’ve made it as difficult as possible and still people use illegal drugs.”
“Those are human beings and their lives are in danger,” says Burris, “and to stand by and let them get infected when we can stop this is so inhumane it makes me sick.”
E. Jeanne Harnois, Boston-based freelance writer, can be reached at jeanne.harnois@gmail.com.
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