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Needle Exchange Moving Forward, Not A Moment Too Soon

Harold Pollack is a professor at the University of Chicago School of Social Service Administration and Special Correspondent for The Treatment.

Ryan Grim reports in the Huffington Post:

House Democrats have reversed a decision by President Obama and ?removed a ban on federal funding for needle-exchange programs that he ?included in the 2010 budget...

?I think this is more of a tactical disagreement than a real conflict between Congressional Democrats and the Administration. We’re winning. Only the timing is now at issue.

The public health community hoped we would win because of the overwhelming medical and scientific evidence. I hope this evidence helps, but the real political gains aren’t coming from any scientific panel or finding. We are prevailing for different reasons: seismic changes underfoot in American culture that make needle exchange yesterday’s culture-war battle. (Some of these changes are detailed in Ryan’s own book, This Is Your Country on Drugs: The Secret History of Getting High in America.)

America in 2009 is different from the America of two decades ago when Jesse Helms proposed his notorious amendment that curbed federal needle exchange funding. Our society includes millions of people who consume psychoactive medications for good or ill. We’ve elected several presidents with hinted or acknowledged past histories of substance use. We have not recently experienced a drug-related crime wave akin to the crack epidemic.

Other things have changed, too. Twenty years ago, needle exchange was politically radioactive in many African-American communities. Today, the Congressional Black Caucus is a major ally on HIV prevention. Add to that the general discredit of social conservatism. Who wants to defend anything called the “Helms Amendment” these days?

Social conservatives are still giving this the old college try. Grim reports that Republicans offered an amendment that bars funding for syringe distribution

...in the District of Columbia within a thousand feet of a public or private daycare center, elementary school, vocational school, secondary school, college, junior college or university or any public swimming pool, park, playground, video arcade or youth center or an event sponsored by any such entity.

Democrats accepted the amendment. Who wants to defend distributing needles across the street from a daycare center? Once again, federal politicians bully the District to make a cheap partisan point.

Despite such hiccups, we know where this is headed. The federal challenge now is to finance and rigorously compare different syringe distribution strategies not only to prevent HIV, but also to expand access and recruitment into treatment--and to more effectively address the needs of injection drug users.

The Helms Amendment and related measures wasted many lives. We don’t have much time to lose.

--Harold Pollack