In recent months HIV/AIDS infection rates have skyrocketed in rural Indiana, in large part because of the sharing of syringes used for the injection of the prescription painkiller Opana, heroin, and other drugs. In response Indiana Republican Governor Mike Pence allowed one county to implement a 30-day syringe exchange program to reduce infection rates.
Governor Pence extended the program another 30 days this week, but advocates have pointed out that a temporary program in just one county is not enough to stop an epidemic. The legislature is considering legislation to make sterile syringes available on a broader and permanent basis.
“One program operating in one county for one month is not going to stop an epidemic,” said Bill Piper, director of the office of national affairs with the Drug Policy Alliance. “Indiana’s weak response to rising HIV/AIDS transmission rates threatensevery Hoosier, as well as people across the Midwest and around the country.”
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Decades of research in the U.S and from around the world has concluded that syringe access programs reduce the spread of infectious diseases without increasing drug use. By preventing people from contracting infectious diseases that can be expensive to treat, syringe exchange also saves money by reducing healthcare expenditures. A sterile syringe can cost as little as a nickel; treating someone with HIV/AIDS can cost taxpayers more than one million dollars.
In the US, injection drug use has accounted for more than one-third (36 percent) of AIDS cases – more than 354,000 people, according to the Centers for Disease Control and Prevention (CDC). Yet the US bans federal funding for sterile syringe access programs, even though the CDC has found that such programs lower incidence of HIV/AIDS among people who inject drugs by 80 percent.
This refusal to adopt an evidence-based prevention strategy has cost the US hundreds of thousands of lives and billions of dollars.
In countries where addiction is treated as a health issue, the fight against HIV/AIDS is being won. New HIV infections in countries such as Australia, Germany and Switzerland have been virtually eliminated among people who use drugs, just as mother-to-child HIV transmission has been eliminated in countries that make medicines for pregnant women accessible.
Last year, more than 140 local, national and international organizations released a letter calling on Congress to end the archaic federal funding ban on syringe service programs. The ban was put in place in 1988, repealed in 2009, and reinstated by Congress in 2011. The signatories include over 80 prominent organizations from 26 states, as well as Puerto Rico and the District of Columbia, in addition to dozens of national and international organizations.
Advocates say Governor Pence should work with his former Republican colleagues in Congress to repeal the syringe-funding ban. He should also support efforts in the Indiana legislature to allow every local jurisdiction to establish syringe exchange programs. Kentucky Governor Steve Beshear recently did this, signing legislation that creates syringe exchange programs in local jurisdictions that formally approve them. Hoosier families also deserve an effective syringe exchange policy.
“As a native Hoosier whose uncle died of Hepatitis C – which he likely contracted from injection drug use – I take syringe access very personally,” Piper said. “If the Governor’s serious about mitigating this disaster, he should expand Indiana’s program statewide and work with Congress to make sterile syringes widely available.”