AIDS

An Old New Way To Stop AIDS

When invited to trade filthy used needles for sterile new ones, drug users often take the safer route.

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By signing a religious freedom bill that provoked a hail of criticism, Indiana Gov. Mike Pence did a brilliant job of diverting attention from something deserving of commendation. That same day, he took a wise step to contain an outbreak of HIV infections in southern Scott County.

Since December, more than 80 new cases have been identified in the county. That's up from five in a normal year and the worst epidemic the state has ever seen.

Pence was advised by the federal Centers for Disease Control and Prevention that stopping the epidemic would require opening a needle exchange—which would encourage intravenous drug users to turn in used syringes for new ones instead of lending the contaminated equipment to their friends.

The advice could not have been welcome in the governor's office. Indiana law prohibits needle exchanges, a ban Pence still supports. What's more, federal laws forbid the use of federal funds to pay for them—a policy repealed by the Democrat-controlled Congress in 2009 but restored after Republicans gained control in 2011. Pence was part of that GOP House majority.

But last week, taking a brief respite from antagonizing gays and everyone else, he declared an emergency and approved needle exchange in Scott County. The area abounds in people who abuse a prescription opioid painkiller called Opana. Many have been infected with HIV, and when they share syringes with other Opana users, they have a very high probability of spreading the virus.

Drug addicts may not be famously fastidious, but they don't use dirty syringes because they like to. They do it because it's cheaper than buying new ones—which in Indiana also requires signing a register.

But when invited to trade filthy used needles for sterile new ones, we have learned in other places, drug users often take the safer route. Some of them also pursue treatment and other services offered by the programs.

Indiana is not alone in the problem.

Kentucky Gov. Steve Beshear last week signed a bill legalizing needle-exchange programs in response to an epidemic of hepatitis C, a deadly disease that also spreads through the reuse of contaminated syringes. Addressing addicts, he said, "We're coming to help you. Work with us and help us to help you get on the road to recovery."

Part of the motive is fiscal: Treating a patient with this illness can cost the government upward of $1,000 a day. A new syringe costs the government upward of a nickel. There's also something to be said for sparing people from illness and death.

Pence is deferring to harsh necessity, but grudgingly. He authorized the Scott needle exchange for just 30 days, and he has threatened to veto any measure allowing this remedy elsewhere.

The opposition to clean-syringe outreach efforts stems from the fear that they will have all sorts of unsavory side effects, like promoting more drug addiction, fostering crime and leaving more syringes on the street. A wealth of research indicates the fears are unwarranted.

The CDC reports that needle exchanges "do not encourage drug use" or "the recruitment of first-time drug users." Evidence from Baltimore found no increase in the number of arrests after the program began. The very nature of exchanges gives addicts a good reason not to litter the sidewalk with used hypodermics.

What clean-syringe handouts do is encourage more responsible behavior on the part of drug users, which curbs the transmission of HIV and hepatitis C to them, their sexual partners and their children.

A National Institutes of Health committee said, "An impressive body of evidence suggests powerful effects from needle-exchange programs," including "reduction in risk behavior as high as 80 percent, with estimates of a 30 percent or greater reduction of HIV" among injecting drug users.

Some critics bridle at the idea of spending taxpayer dollars to protect drug users from their own behavior. But banning support for needle exchange, notes Bill Piper of the Drug Policy Alliance, doesn't save the federal treasury any money—it just diverts the funds to other prevention projects. Since many of the addicts who contract HIV or hepatitis C end up on Medicaid or Medicare, stinginess on needle exchange is the ultimate false economy.

Three decades after the first experiments in needle exchange were mounted in response to HIV and AIDS, you'd think policymakers everywhere would see their value. In Indiana, they're learning the hard way, but they're learning.

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  1. But last week, taking a brief respite from antagonizing gays and everyone else

    Thinking is hard isn’t it, Chapman?

    1. How would he know?

    2. thinking isnt hard. maintaining a sense of humor in the midst of all this culture war … that seems to give ppl some trouble

  2. Some critics bridle at the idea of spending taxpayer dollars to protect drug users from their own behavior.

    However, subsidizing the behavior of other people is just peachy.

  3. Pence was advised by the federal Centers for Disease Control and Prevention that stopping the epidemic would require opening a needle exchange?which would encourage intravenous drug users to turn in used syringes for new ones instead of lending the contaminated equipment to their friends.

    The advice could not have been welcome in the governor’s office. Indiana law prohibits needle exchanges, a ban Pence still supports. What’s more, federal laws forbid the use of federal funds to pay for them?a policy repealed by the Democrat-controlled Congress in 2009 but restored after Republicans gained control in 2011. Pence was part of that GOP House majority.

    So we’re endorsing gov. subsidies now?

    1. Just cut spending please, all spending and let the markets work.

      1. I think OM has it below, but there isn’t a way to easily get clean needles if you are a drug user because the govt has made it illegal to sell them.

        I know that years and years ago you could buy a syringe to inject air into a night crawler for fishing. Then you couldn’t buy them anymore.

        So the subsidy isn’t as important as just making them available without the cops busting you.

        1. “to inject air into a night crawler for fishing”

          Wait…what? Enlighten me, plz. With my fishing record, I can use all the help I can get.

          1. It allows the worms to float, allegedly. More likely to be spotted by the fish?

            1. Exactly. The thinking was you could get them to drift along a foot or two above the lake bed and get more bites.

              https://youtu.be/tNDR6Hsgp-4?t=53

          2. Aren’t you living in Europe?

            Forget about night crawlers, all you have to go after is carp. Right?

            All you need then is a bunch of corn and maybe a nice dough ball if you are feeling extra ambitious.

            By the way, nothing wrong with carp. One of my sons lives for fishing them. He and his buddies go down to the river and spend the day fucking off and catching “the queen of the river”. I agree that a 3 lb carp is 100 times more fun to catch than a 3lb walleye.

        2. I had no idea you couldn’t buy syringes. Do you need a prescription or something?

          What the hell is going on in this country?

        3. AFAIK, beginning like 15-20 yrs. ago, states quickly began repealing their prescription-only laws on syringes. IIRC, NJ was the last to repeal. So what’s the reason for needle exchange programs now?

          1. i clarified this below. pharamacies continue to refuse to sell without a prescriptuon or diabetic card in states where it is legal – almost certainly this is due to regulatory and law enforcement pressure.

            try it. go into a pharmacy in NJ and ask for syringes and see what happens.

            1. You can walk into any vet supply or country equipment store and buy the exact same syringes used on people. Ranchers, horse owners/breeders, and small animal breeders do almost all of their own vaccinations. Not to mention the endless number of places you can buy them online and have them shipped to your front door within 2 to 3 days.

  4. Kentucky Gov. Steve Beshear last week signed a bill legalizing needle-exchange programs in response to an epidemic of hepatitis C

    You can go to ANY pharmacy in Mexico – anywhere in the country – and buy cheap disposable syringes by the GROSS if you want to, never mind needles.

    “Land of the free” my ass. Fucking gringos. You are so stoopid.

    1. More evidence of the failure of Mexico. Any self-respecting country bans the sale of icky needles.

    2. at least we know how to spell stupid, stupid…frigging wetbacks

    3. So go back to Mexico! You un-american something or other.
      (That’ll teach that old mexican)

    4. To be fair, Mexicans are at least as stupid. Maybe in slightly different ways.

      I can go to a store down the street right now and buy a large caliber handgun, for example.

      1. Can and should.

      2. Stop bragging.

  5. Needges and syringes should be freely purchaseable because government has no business regulating that. But goddam it justifying spending government money to subsidize people’s lifestyle choices so we don’t spend more money later treating the results of their lifestyle choices is not particularly libertarian. It directly please into the entire concept of controlling people’s lifestyle choices because those choices will cost us money later. How about we just let people alone to go to hell in their own way.

    1. The response should be to allow me to give syringes to my fellow Hoosiers out of the kindness in my heart. But as long as Indiana is going to take a shit-of my money anyway; might as well be to help keep people from the HIV.

    2. Government should spend the taxpayer’s money to alleviate an artificial shortage the government created specifically to prevent the product being used in the way the government is spending taxpayer’s money to facilitate.

      Of course that makes perfect sense.

      1. It is an amazing Mobius Strip of government policy.

        1. It is crazy right? We can see that in this instance the best way to stop the spread of AIDS is to get people new needles. We won’t allow a private organization to to the distribution because that would mean that we were wrong. Furthermore, this is only okay for this small part of the state d/t it being a REALLY big outbreak there. The remainder of the state is still at baseline which we can live with.

          My point is that if the state will be too obtuse to do the best thing, the fifth best thing is better than the worst thing, nothing. For what I paid in taxes last year and where a lot of my money goes this is not as upsetting.

          1. yes. the best thing would be to remove the massive government intervention against drug addicts. as much as we talk about the long term jail sentences, when it comes to opiate dependent people government intervention results in deaths by the thousands.

            the problem is that real reform is politically untenable. pot legalization is barely in the majority now … opiates? even propot ppl cheer when junkies die. in the meantime the drugwar has contributed to a massive public health crisis with AIDS (iv drug users have always been the highest risk group, then haitians, then gays). nonjunkies screw junkies, and AIDS is back in the god-fearing sober community.

            long story short, this huge spending loop is crazy. but its better to have needle exchange witb a drug war than no needle exchange and a drug war. and unlike nearly all government spending it has proven immediate and long term public benefits.

    3. No, it’s not libertarian. It’s still better than not letting them get clean needles at all, I think.

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    1. How do we give this mother fucker AIDS?

      1. If he’s making $58 for fifteen minutes of “work,” he’s probably at risk already.

  7. This piece made me go and check the latest CDC HIV Surveillance Report. Sure enough, things are still the same as they were 20-30 years ago as to who might get this little bug:

    http://www.cdc.gov/hiv/library…..veillance/

    Of course, in polite society, we’re frowned upon if we point out the obvious.

    1. Was there any doubt? I’ve never really heard anyone try to deny that most HIV infections are among IV drug users and men who do each other in the butt.

  8. “An Old New Way To Stop AIDS”

    Not clickbait-y enough. “Doctors don’t want this 50 year old woman to find out about this one weird trick for preventing AIDS while sharing filthy needles”

    Here’s a clickbait headline generator for more inspiration
    http://community.usvsth3m.com/…..-generator

    “39 cat related novelty dances that can be solved by capitalism”

  9. drug addicts dont fail to purchase needles over price. they do so because pharamcies refuse to sell to them, even where legal. every pharmacy in the US demands a diabetic card for syringe purchase. Addicts outside of needle exchange need to lie, steal or otherwise divert them.

    Syringe handling in this country is the most perverse and homicidal drug war tactic, and kills far more than the cops ever could.

    1. I can walk into the local animal feed store and purchase as many needles as I wish with no questions asked. I can also order them from a vet supply online. Either pharmacies are doing this themselves or there is specific legislation banning pharmacies from selling. In 25 years and in over 20 states I have never once been asked for anything other than payment when purchasing syringes and needles. (By the thousands at a time in most cases) I just last year ordered and received 100 needles and syringes from an online vet supply for giving my dogs shots. They shipped them to my front door no questions asked.

      Pharmacies have every right to set policies on their sales
      Government shouldn’t be telling pharmacies they can’t sell needles
      Government also shouldn’t be using my money to hand out needles
      Of course it goes without saying the government shouldn’t be telling people what they can inject into their own bodies.

      But we no longer live in a free society and we are less free every day.

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