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Needle Exchange Alert from the Drug Policy Foundation

from the Drug Policy Foundation
Washington, D.C. * New York

To our online friends and supporters:

Below is the full text of a new DPF "Alert" sent to all 20,000 members as well as the media and other key contacts. We encourage you to become informed and get active in reaction to this "Alert" also. For your convenience, the sections are as follows:

Dave Fratello/Rob Stewart


Dear Friend:

Needle exchange programs have been controversial for years. But now, scientific evidence weighs solidly in favor of needle exchanges as a method for reducing the spread of HIV/AIDS and other needle-borne diseases. Moreover, the data do not indicate that the programs increase drug use.

The development of solid science supporting needle exchanges coincides with an increased need for the programs. New HIV/AIDS data show that needle-sharing is becoming the most significant route for the epidemic's spread, including the spread of HIV, the virus that causes AIDS, among the general population.

Taken together, these facts lead to an important conclusion: It is time for science to reign in the debate on needle exchange programs. The programs must be expanded dramatically to curtail the spread of HIV/AIDS. Federal leadership on this issue is needed, including direct funding of existing needle exchange programs and seed money for new programs.

It won't be easy to make that happen. But DPF is taking on the challenge. The issue here is saving lives. The face of the HIV/AIDS epidemic has changed dramatically in the last year. Drug users, their sexual partners and their children have replaced homosexual men as the majority of new HIV/AIDS cases. Research by the Centers for Disease Control concludes that 30,000 of the 40,000 new HIV infections last year in the United States were related to drug use. More than 20,000 of those infections were traceable to the sharing of infected needles.

Though the demographics of HIV/AIDS have changed, federal policy has not. Each year since 1988, Congress has banned the use of federal funds for needle exchanges, unless the Surgeon General formally finds them to be effective. The Surgeon General must conclude that needle exchanges:
1) reduce the spread of HIV and
2) do not increase drug use.

The Clinton administration has the evidence it needs to begin saving lives by funding needle exchanges, but it refuses to act. Congress stands ready to attack, rather than welcome, efforts to check the HIV/AIDS epidemic with needle exchanges, even though the disease threatens every American.

The current silence on this issue has deadly consequences in the real world. Yet it's no secret why the government seems paralyzed on needle exchanges. Politicians do not want to appear "soft" on drug use. That political concern seems to prevent leaders from taking a step that science says will save lives. It's a classic case of bad policy flowing from the perverse politics of drugs in America.

These days in Washington, all sorts of programs are being cut, and the proper role of the federal government in local affairs is being debated. Still, the case for funding needle exchanges remains strong in this political climate, for two reasons. First, this is a matter of national public health requiring urgent action. Second, needle exchanges are a fiscally conservative way to attack the HIV/AIDS epidemic -- each infection prevented saves over $100,000 in health care costs. Just this year's 20,000 new needle-borne HIV infections will cost at least $2 billion!

Diseases like HIV/AIDS do not care which party controls Congress. They continue their deadly spread regardless. A non-partisan, rational response to the problem is needed, not more bickering.

The good news is that the public is smarter than most elected officials might think: In a 1994 public opinion poll by Peter Hart Research Associates, 55 percent of respondents said they favored using needle exchanges to reduce the spread of HIV/AIDS. That's one of the clearest indications yet that it is time for the bi-partisan stalling to end.

In last fall's Alert on our new government affairs program, we promised you that DPF would act on this issue, as well as several others. The reason is that needle exchange programs are a cornerstone of harm reduction policies. As you will see from the news enclosed, DPF has already been working hard. Our talented staff deserves a lot of credit. We intend to keep up the pressure, and for that we need your participation and your support.

Get involved today! Write to the officials listed on the back. Talk about this issue in your community. And please support DPF with a contribution to keep us moving forward.


David C. Condliffe              Arnold S. Trebach 

Executive Director              President



On December 10, 1993, the Centers for Disease Control and Prevention -- and other federal health agencies - recommended federal funding of needle exchange programs. The basis: A comprehensive report submitted three months earlier by researchers from the University of California's San Francisco and Berkeley campuses, conducted with CDC funds. But the CDC's recommendation was never acted upon; it wasn't even made public. A congressional committee requested the health agencies' reviews of the UC research in the summer of 1994, but only got copies six months later, after promising not to release the information. A Freedom of Information Act request for the reviews by the San Francisco Chronicle was denied in late 1994.

The information blackout ended March 7, 1995, when the Drug Policy Foundation made the reviews public. (They had been leaked to DPF.) National news stories featured the documents' release, including stories on the Associated Press national wire, National Public Radio and the CBS Morning News. The Foundation also made the documents available to needle exchange program directors, advocates, and health departments of state and local governments. For a copy of the 48-page document, along with press clips, for $5 to cover copying and postage (address below).


After releasing the Clinton administration's reviews of the needle exchange issue, DPF brought top researchers to Washington to explain the case for federal funding of the programs. The March 10 event in the Rayburn House Office Building was the third DPF congressional forum on needle exchanges.

One of the featured experts was Dr. Peter Lurie of the University of California at San Francisco, who directed the UC study of needle exchanges around the world. Dr. Lurie presented his report's key findings and noted that the research meets a two-point test set up by Congress to permit funding of needle exchange programs. The Clinton administration's claims that the research is insufficient to lift the ban, Dr. Lurie said, represent "a legalistic fig leaf" used to justify inaction.

The forum also featured Prof. Edward Kaplan of Yale University, who designed ground-breaking research of the New Haven needle exchange. DPF advisory board member Ernest Drucker, from New York's Montefiore Medical Center, put the needle exchange issue into the broader context of drug policy. Among those attending the forum were congressional staffers, AIDS workers, needle exchange coordinators and members of the media.

Also featured at the forum was the premiere of a new video, "Fire in Our House," produced by Rory Kennedy and Vanessa Vadim of MayDay Media. This gripping, 10-minute film shows the promise of needle exchanges for combating HIV/AIDS among injecting drug users, their sexual partners and, especially, their children. (For a copy, call MayDay Media at (202) 338- 1094.)




Sec. 506 of the FY 1995 appropriations bill for the Dept. of Health and Human Services (PL 103-333) reads in part: "no funds appropriated under this act shall be used to carry out any program of distributing sterile needles for the hypodermic injection of any illegal drug unless the Surgeon General of the United States determines that such programs are effective in preventing the spread of HIV and do not encourage the use of illegal drugs."


In September 1993, University of California re-searchers published the most comprehensive survey of needle exchange research to date, entitled "The Public Health Impact of Needle Exchange Programs in the United States and Abroad." The study was conducted with funding from the Centers for Disease Control and Prevention. Among the findings:


The Clinton administration's health agencies reviewed the UC research in late 1993. The consensus was that the study was thorough and sound. Based on that fact, and the UC study's own recommendations, the CDC said:

These CDC recommendations were kept from public view by the Clinton administration, which has failed to act on the health agency's words. Federal money could go to needle exchanges if the administration officially found that the programs reduce HIV's spread and do not encourage drug use.


You can make a difference by writing to the decision-makers in this controversy. Dr. Philip Lee is the top health official in the administration with responsibility to act. But you should also write to your representatives in Congress, along with your state and local governments, about the need for executive branch action on this issue.

Key points for your letters:



The U.S. government can't handle debate on drug policy. Silence is preferred whenever possible. Hence the State Department's demand in February that the Colombian government justify a scheduled speaking engagement by Gustavo de Greiff, formerly the nation's prosecutor general and now Colombia's ambassador to Mexico. De Greiff planned to speak in Florence, Italy, to the Sixth International Conference on the Reduction of Drug-Related Harm March 27.

It wasn't to be. After all, De Greiff is an outspoken advocate of changing the drug laws. In 1993, he came out and said of the drug war, "The profits are so large that it is a delusion to think that killing or jailing major traffickers" would make a dent in the drug trade. "In the end," De Greiff said, "the only solution is legalization, with regulations to control the market."

De Greiff continued to speak out, and in 1994 DPF congratulated him with its top annual award. But his Florence speech fell victim to anti-drug politics between Colombia and the United States. The U.S. government says Colombia hasn't been fighting hard enough, and in March it took a special exception from President Clinton to prevent sanctions against the Colombians. In the middle of that fight, the State Department suggested that having De Greiff speak out in Florence would make Colombia look bad. And, of course, there was the implied threat of serious consequences if De Greiff spread his dangerous ideas. Ultimately, De Greiff agreed to stay home, to spare his country retribution from American prohibitionists.

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