New at Reason

June 18, 2007

Steve Chapman wonders whether the federal government's rage at drug users has wrecked its policies on needle exchange.

Comments

NP|6.18.07 @ 6:38AM|#

Call Chapman's articles lightweight if you will, but his breezy style is always a hoot.

|6.18.07 @ 8:02AM|#

Am I the only one questioning Chapman's advocacy on an allegedly libertarian website of a brand new federal entitlement program to hand out free needles to addicts? Or his math, which assumes that every 25 cent needle handed out prevents a case of AIDS? Seems like the only libertarian approach here is to legalize the sale of needles, without any government subsidies.

|6.18.07 @ 8:09AM|#

The federal government should be handing out free needles, filled with free doses of the narcotic of your choice, since our society's failure to provide adequate free social services -- and regulate commercials on TV to ensure only wholesome choices are presented to children == are the direct causes of addition. After all, didn't the social contract you agreed to by remaining in this country include the government making sure you are protected from the consequences of the evil corporate ad execs pushing sugared cereals upon impressionable children, leading to harder drugs later on? It's society fault == won't someone pleeeeze think of the children?

NP|6.18.07 @ 8:16AM|#

jh,

As far as I can tell Chapman's article doesn't support such an entitlement program per se. And I think Chapman would agree with you that he's not a textbook libertarian; he would probably describe himself as libertarianish, like Jonathan Rauch.

c|6.18.07 @ 8:23AM|#

@jh
Yes, his math stuck in my craw too.

@preemtive
Certainly easier to argue with people if you put the words in their mouths, huh?

NP|6.18.07 @ 8:34AM|#

jh and c,

You really thought Chapman meant the math to be taken at face value?

c|6.18.07 @ 8:41AM|#

@NP

no, of course not. But I couldn't shake the sense that he was someone willing to fudge the numbers to make a cheap rhetorical point. Especially since making a best-guess attempt at plausible numbers (1000 needles over a lifetime) would still have come out in his favor ($250 for $600,000).

|6.18.07 @ 8:42AM|#

Grmpph. Needle exchange programs are a wonderful charitable idea.

Forcing people opposed to drug use to pay for them is as immoral as forcing a person who does not believe in creationism to pay for intelligent design classes.

Of course, we could decriminalize heroin ownership, and allow people to buy it at CVS, prepackaged in disposable syringes... but no, that would give children the wrong message; that they live in a free country.

NP|6.18.07 @ 8:55AM|#

c,

I think Chapman was talking about the overall costs of caring for the infected after the fact.

|6.18.07 @ 9:02AM|#

NP says: "As far as I can tell Chapman's article doesn't support such an entitlement program per se."

The article reads: "The federal government spends some $15 billion a year on health care and financial assistance for AIDS patients. But it refuses to lay out one thin dime for this type of prevention. By law, no federal money may be spent on programs furnishing clean injecting equipment to drug addicts. "

Seems like Chapman is clearly advocating spending federal money on such a program -- and I'm assuming far more than just "one thin dime".

thoreau|6.18.07 @ 9:03AM|#

Needle exchange programs are definitely a far lesser evil, and hence a good idea for practical purposes.

|6.18.07 @ 9:09AM|#

Wow - this is the most non-libertarian piece I've ever read at Reason.

Did Chapman just suggest that a theoretical government policy might produce good results? What editor let this through?

NP|6.18.07 @ 9:11AM|#

jh,

Yeah, I read the part too. And you may be right that Chapment does support the program, but on the other hand he might have just wanted to point out the inefficacy of the government's providing medical assistance for an infection that can be prevented, especially the same government adopts the precautionary principle in so many other cases.

NP|6.18.07 @ 9:12AM|#

Make that especially when.

c|6.18.07 @ 9:16AM|#

The real libertarian beef with this article should be it's based on the implicit fact that, once someone is infected and destitute, we the taxpayers are on the hook for the cost of treatment. A real libertarian wouldn't be whinging over the cost of clean needles -- a real libertarian would be telling HIV positive addicts to go die in an alley.

@NP -- Not to prolong this trivial point, but the cost of caring for someone after infection is the 600K. I have no problem with that, I have no idea if that's right. But I do know for sure that the cost of prevention with clean needles is not the cost of one single clean needle. It's the cost of all the needles the guy uses before infection. (Technically, you could save some $ by not giving clean needles to the already-infected.)

|6.18.07 @ 9:17AM|#

c says: "But I couldn't shake the sense that he was someone willing to fudge the numbers to make a cheap rhetorical point. Especially since making a best-guess attempt at plausible numbers (1000 needles over a lifetime) would still have come out in his favor ($250 for $600,000)."

Plausible numbers would have to include far money than the actual cost of needles on a free market. The feds would probably manage to overpay for the needles -- say, buy them from Halliburton. They;d likely hand out needles to people who aren't actually drug addicts, who'd then resell them. They'd pay government employee union wages to the people handing out the needles -- and the bureaucrats supervising the employees handing out the needles -- and all sorts of other creative uses of our taxes. And don't forget the unrelated pork that would get attached to the appropriations bill to buy support from reluctant or avarious congressscums for this controversial program. Anyone who's spent time watching legislation get slapped together should know that the cost per addict could get really high (sorry about the bad pun.)

As opposed to simply letting free market drug stores sell the drugs and the needles.

|6.18.07 @ 9:23AM|#

They;d = they'd

avarious = avaricious (greedy?)

Gotta screen my posts a bit more before hitting "send", yeah?

|6.18.07 @ 9:24AM|#

Find someone who will give you $600,000 if you give them 25 cents.

Taking the debate on the numbers as a given the big risk I see to the value of the program is the assumption that people will avail of the needle exchange even when it is free. I would also suspect that intravenous drug users have other risk factors for AIDS mitigating the savings. I want drugs legalized but I also want costs borne by the users. I want the government out of the business of funding healthcare and financial assistance regardless of the trendiness of the disease.

|6.18.07 @ 9:26AM|#

The real libertarian beef with this article should be it's based on the implicit fact that, once someone is infected and destitute, we the taxpayers are on the hook for the cost of treatment. A real libertarian wouldn't be whinging over the cost of clean needles -- a real libertarian would be telling HIV positive addicts to go die in an alley.

True, except they need to also tell the addicts to make sure it's a privately owned alley and not a public street.

Of course, a Reason libertarian would simply assume that private charities will take care of all addicts, if only we cut taxes.

|6.18.07 @ 9:27AM|#

jh -
you're on to something there. Imagine the political fallout surrounding the replacement of care for the already infected with a needle exchange. If anything you'd end up paying for both programs.

This reeks of the abstinence only education issue, whose proponents say that we, as a society, can't possibly help kids who are already going to have sex be safe about it because it's socially undesirable. Similarly, we can't help drug addicts be safe about it because it's socially unacceptable.

I'm not advocating the government supply needles, but they should be legalized.

NP|6.18.07 @ 9:32AM|#

c,

Point taken. Still, I think both of us would agree that the costs of prevention, at least in this case, are far lower than the costs of treatment, and in that sense I think Chapman's rhetorical cost comparison was valid.

One more thing: "a real libertarian would be telling HIV positive addicts to go die in an alley." Now that's not really fair. The real libertarian position would be that decriminalization of needles or relevant drugs is likely to prevent the infections in the first place. And surely you don't think most libertarians would just ignore anyone on the verge of death if they met one on the street?

|6.18.07 @ 9:33AM|#

"a real libertarian would be telling HIV positive addicts to go die in an alley."

A real libertarian would be telling HIV positive addicts to go die on their own private property, not the privately owned alleys resulting from the government selling all the roadways.

Seriously, most libertarians would tell them to go seek private charity -- though they would support the First Amendment right of the Ayn Randian "selfishness is virtue" crowd to be bastards about it.

c|6.18.07 @ 9:41AM|#

ok, fair. consider it retracted, and revised to "a real libertarian government would be telling HIV positive addicts to go die in an alley."

A real libertarian individual might to any damn thing, including perhaps offering to foot the bill of treatment him- or herself.

|6.18.07 @ 9:48AM|#

Dan Troll said: "True, except they need to also tell the addicts to make sure it's a privately owned alley and not a public street.

Of course, a Reason libertarian would simply assume that private charities will take care of all addicts, if only we cut taxes."

A real libertarian doesn't use "the P-word", Dan ("public"), any more than a theocon uses "the P-word" ("pubic").

And a real libertarian would only extend charity to addicts who showed some gratitude and appreciation -- statist addicts who demanded help because they're entitled to it, dammit, would have to apply for help from other statists.

|6.18.07 @ 9:50AM|#

c -

"libertarian government" is an oxymoron.

NP|6.18.07 @ 9:54AM|#

c,

I knew you were gonna say that! (No snark, btw.) So let me rephrase: the position of a libertarian government would be that decriminalization of needles or relevant drugs is likely to prevent the infections in the first place.

Now as for the already infected, I think most practical libertarians (call 'em consequentialists, if you wiil) wouldn't probably propose to abolish the national health care system altogether. They'd probably say what chicks often coyly say about the art of makeup: less (funding) is more (liberty).

|6.18.07 @ 9:55AM|#

"libertarian government" is an oxymoron.

Not entirely. But the comment that the libertarian government would say something (especially to go die in an alley) to someone HIV positive is ridiculous. Who would say it to them exactly? The Bureau of AIDS? I don't think so..

|6.18.07 @ 9:57AM|#

A 2004 report by the World Health Organization found "no convincing evidence of major unintended negative consequences."

And perhaps no major intended consequences either (nice link, BTW).

It's easier for a junkie to sterilize a needle than to exchange it, but most can't be bothered to do so.

Most junkies are actual criminals (about 80% are burglars and such), and about half of all burglaries are committed by junkies. Legalizing drugs would likely decrease those numbers considerably, but needle exchange programs won't help at all - if the exchange programs actually worked (do they?), the number of burglaries would just increase because there'd be fewer dead junkies. Next to prohibition itself, wasting taxpayer money to keep these scumbags alive is the real crime.

NP|6.18.07 @ 10:00AM|#

jh,

"libertarian government" is an oxymoron.

I'm tempted to agree, but by that definition I doubt even the Reason staffers (with the possible exception of Brian Doherty) would qualify as a libertarian.

|6.18.07 @ 10:03AM|#

"libertarian government" is an oxymoron.

I'm tempted to agree, but by that definition I doubt even the Reason staffers (with the possible exception of Brian Doherty) would qualify as a libertarian.

Perhaps you're both confusing "libertarian" with "anarchist"

|6.18.07 @ 10:07AM|#

The hyperbole of the number is pretty weak. I'm sure the needle program does work but there have to be some users who would use the provided clean needles most of the time, but dirty needles at other times.

If the needles (and the distribution???) are so inexpensive, why not have private charities provide them. Thats a pretty clear libertarian idea, eh?

NP|6.18.07 @ 10:15AM|#

Reinmoose,

Perhaps you're both confusing "libertarian" with "anarchist"

I thought that was exactly what jh was trying to argue. Many would agree that anyone who's not an anarchist cannot call oneself a libertarian.

|6.18.07 @ 10:21AM|#

A libertarian does believe in government, since they are in favor of using taxes and force to keep the poor from taking stuff from the rich. Just not vice versa.

|6.18.07 @ 10:29AM|#

This party is really boring with all the serious talk about issues and philosophy and such! Thank God I'm here to drop turds in the punchbowl!

|6.18.07 @ 10:34AM|#

Umm, I was trying to be funny with the "libertarian government is an oxymoron" comment. There are anarcho-capitalists who do in fact believe that, but most libertarians are minarchists who concede some limited role for government, and I suspect the vast majority of people who call themselves libertarians only hold a few really libertarian beliefs, or are really Republicans who found it's easier to get dates if they use the cooler title "libertarian". Though as a former Republican turned into a borderline anarcho-capitalist, I suspect if you start calling yourself a libertarian even if you aren't except on a very few topics, you might start reading stuff that changes your mind and makes you into one for real.

Personally, I'm agnostic about the anarcho vs. minarchist thing. We'd have to trim waaaaay back on government before we'd hit anything that either camp would disagree about eliminating.

Sorry if I came across as pedantic. If so, I apologize.

NP|6.18.07 @ 10:43AM|#

jh,

No need to apologize at all. Ridding H&R of all its pedantic posts would be like downsizing Rosie into Nicole Richie. I don't know about you, but I actually prefer the former. (Er, figuratively speaking, of course.)

|6.18.07 @ 10:45AM|#

jh -
I know your comment wasn't entirely serious, but there are some out there (who I needn't even name) who will take that comment as an invitation to apply that opinion to all libertarians. It will come up in a later thread. They'll be all like "Don't libertarians believe in eliminating government altogether? You're all hypocrites!"

That's all I was trying to protect against :)

David Ross|6.18.07 @ 10:47AM|#

Excuse me, was I supposed to feel sorry for intravenous recreational drug users?

NP|6.18.07 @ 10:58AM|#

DR,

Chapman's article explicitly mentions the danger of intravenous drug users infecting nonparticipants. I'm not sure if the latter group will appreciate the charge of "intravenous recreational drug users" thrown at them, especially if they've already been infected.

|6.18.07 @ 11:03AM|#

"No need to apologize at all. Ridding H&R of all its pedantic posts would be like downsizing Rosie into Nicole Richie. I don't know about you, but I actually prefer the former. (Er, figuratively speaking, of course.)"

You prefer fat mouthy statist lesbians to skinny mouthy deranged socialites? Or were you talking about plump v. skinny only? I have a pretty wide tolerance on the latter, being (in economic jargon) indifferent between anorexic and obese, with a revealed preference for "plump with astonishingly large breasts".

Ooops. Did I just threadjack this bad puppy?

|6.18.07 @ 11:11AM|#

If truth in advertising laws were applicable to the government, The War on Drugs would have to be renamed to The War On Sanity.

|6.18.07 @ 11:19AM|#

Excuse me, was I supposed to feel sorry for intravenous recreational drug users?

No, you are supposed to feel sorry for all of the productive members of society who will watch their payroll taxes increase, their age of retirement increase, their Medicare benefit decrease and their benefits being means-tested (in short the erosion of their quality of life) just because the government is running out of money that it has obligated itself to pay to Medicare and Medicaid recipients, all the while ignoring a simple opportunity to save the programs billions of dollars because some flaming right-winger will have his sense of morality outraged that someone is getting high with an assist from Uncle Sam.

|6.18.07 @ 11:24AM|#

Put another tick in the 'Steve Chapman has to go' column. Even when I agree with his main thesis, I find his reasoning dismal. The 600k/0.25 has already been discussed. This analogy also wouldn't pass muster with Mrs. Fry (9th grade Creative Writing teacher).

You can find studies that fail to vindicate needle distribution, just as you can find Sundays when the Detroit Lions win.

Pro football teams play most of their games on Sunday (although Detroit plays at least one Thursday game every year). But there's no reason providing needle exchange should cause studies to "fail to vindicate" it. So it would seem that what he's saying is that studies typically fail to vindicate needle exchange, which he then contradicts in the next sentence. I'm afraid I care too much to find Steve's sloppy style 'a breezy hoot'.

|6.18.07 @ 12:06PM|#

well put, swilfredo pareto.

I waver a bit on this issue and tend to fall to the side of "addicts did it to themselves, let them suffer the consquences" except for the fact that drug addiction and its sphere of collateral damages to innocents is not such a cut and dry issue.

I would support spending the money it takes to fund a needle-exchange program only if I knew it would save the projected billions of dollars down the road.

My guess is, given many addicts' inability or unwillingness to practice basic self-care (let alone pick up new needles to inhibit the spread of HIV) we would be funding both needle-exchange and HIV care for the same population.

|6.18.07 @ 12:23PM|#

Thanks for reminding me that my Lions suck out loud and always will. What a great way to start your Monday.

|6.18.07 @ 1:41PM|#

Several of our largest cities up here, north of the border, have had needle give-away and exchange programs for decades. The best evidence to date shows that, while the rate of AIDS and hepatitis infection may be reduced slightly as a result of these programs, the overall incidence of addiction increases where those programs are in place.

In other words, a slightly lower rate of infection combined with an increased population of drug-users results in more infections and a higher rate of disease.

I would suggest that people who adopt a lifestyle choice that leads inexorably to an early death, should be allowed to suffer the consequences of their actions. (On a personal note, as a recovering alcoholic living in a country with universal "free" health care, I do not expect society to cure me of liver cirrhosis if my bad choices should lead to that potential result.)

A compassionate society should ensure that any of its citizens who suffer illness through no fault of their own are cared for, regardless of personal wealth or social status. Those who simply make bad choices should face the consequences of their actions.

NP|6.18.07 @ 4:51PM|#

jh,

I was thinking more in terms of "an avalanche of fatuous remarks vs. little of any substance."

|6.18.07 @ 6:32PM|#

NP - I agree that trying to pick the lesser of those two evils is effing hard. I have a tiny preference for "little of any substance", because even hardcore statists have a hard time taking whorish socialites seriously, while some unfortunate folks might actually form their notion of proper governance -- and foist those choices upon the rest of us -- based on Rosie's fatuous remarks.

Can we have a third option -- MSM completing ignoring everything those two say? Sorry, dreaming.

NP|6.18.07 @ 7:37PM|#

jh,

Alright, fair enough. Though you gotta admit, Rosie's definitely more amusing to watch.

|6.18.07 @ 8:46PM|#

"It's easier for a junkie to sterilize a needle than to exchange it, but most can't be bothered to do so.

Most junkies are actual criminals (about 80% are burglars and such), and about half of all burglaries are committed by junkies. Legalizing drugs would likely decrease those numbers considerably, but needle exchange programs won't help at all - if the exchange programs actually worked (do they?), the number of burglaries would just increase because there'd be fewer dead junkies. Next to prohibition itself, wasting taxpayer money to keep these scumbags alive is the real crime."

The vast, vast majority of heroin addicts aren't burglars or thieves. I think you pulled that number out of your ass. I sold drugs, including heroin, for a few years (go free market!). Most of my customers had jobs, some with advanced degrees. An addiction doesn't turn you into a piece of shit, it's just that if you happen to be a piece of shit it's hard to hide when you're a junky. While I was addicted, I never stole or took advantage of people, and most of the people I know didn't either.

Also, just so everyone knows, the 25 cent figure was an over statement. In bulk, syringes cost about 2 cents a piece.

|6.19.07 @ 1:09AM|#

wow...so let me get this right....there are no social costs or wealth transfers thrown on us from illegal immigration ...nothing going on there....but god forbid if anything, even a lack of state provided needles, interfers with "social" freedom....... to the barricades!!....reason is getting more
pathetic everyday

|6.19.07 @ 5:06AM|#

This is exactly the sort of problem of the common good that can be addressed in a collective manner in a possibly more effective way than private means could achieve. How might one address this privately short of full legalization (which, like it or not, ain't gonna happen)?

While generally sympathetic to Libertarian ideas, I don't see why some communitarian ideas are anathema if they are shown to be effective. Are all libertarians totally opposed to pragmatism on every level?

Still, it is suprising to see advocacy of this idea in this publication.


SJ- Dallas

|6.19.07 @ 9:06AM|#

C said : "And surely you don't think most libertarians would just ignore anyone on the verge of death if they met one on the street?"

So tell me "C" , what would Libertarians do upon meeting someone with AIDS on the street on the verge of death?

LeeH|6.19.07 @ 3:41PM|#

Just for the record, the label "Libertarian" was originally used by the Anarchists, or Libertarian-Socialists, and was later borrowed by the Libertarian-Capitalists.

Also, I wonder how much money Rep. Todd Tiahrt is currently receiving from the the pharmacuetical industry, which has a vested interest in making sure there is a steady supply of AIDS patients lining up for their costly meds.