Texas legislature adjourns without hearing syringe exchange bill

The 82nd Texas legislative session adjourned on Monday without hearing HB 117, which would have allowed local options for setting up disease prevention programs including syringe exchange. It would appear that conservative politics and a one member hold up prevented the bill from receiving a hearing in the House Committee on Public Health, despite pleas for a hearing from concerned individuals, officials, and community and medical organizations across Texas including county judges and sheriffs, Texas Hospital Association, Texas Infectious Diseases Society, Mothers Against Teen Violence, Association of Nurses in AIDS Care, Texas Medical Association, and many others.

The legislature will not meet again for a regular session until January 2013. While similar legislation made history last session, we've lost some ground this session; making it even more important to continue to build coalitions, maintain support, and keep stakeholders engaged during the interim.

As this blog stated in 2009:

"So what now?

Over the summer House Speaker Joe Straus will be considering the issues he will direct House Committees to study during the interim. In order for House members and the public to have an even better understanding of the need for allowing syringe exchange programs to operate throughout Texas, it would be wonderful to see Speaker Straus direct the Public Health Committee to investigate the issue further and to provide a space for regional feedback on the issue from the public.

The committee could review the effectiveness of current efforts in Texas to curb the spread of HIV and hepatitis B & C among Texas' injection drug using population, and provide recommendations for how these efforts could be improved in order to save lives and reduce indigent health care costs to the state. Committee members might even be directed to travel to a state such as Maryland to visit longstanding successful syringe exchange programs where they can witness firsthand the measurable benefits of allowing such programs."

Remind your legislators why this issue is an important, compassionate, cost-saving and lifesaving measure during the remainder of their term in office, and especially during election season in 2012. Let them know that you, the constituent, are concerned about skyrocketing rates of HIV and hepatitis C in Texas. Let them know that you support measures to not only reduce disease, but reach out to individuals and families struggling with addiction; in order to build a network of support on a foundation of compassion and non-judgement.

Boulder County, Colorado needle exchange becomes legal after 22 years

After 22 years in operation, a needle exchange program in Boulder County, Colorado is now considered legal. The program has been approved by the Boulder County Board of Health. To read more about Boulder County Public Health syringe exchange becoming legal click here and here.

Attempt to amend HB 2229 to include needle exchange provision fails

Failing Public Health Committee Chair Kolkhorst's willingness to give House Bill 117 a hearing this session, bill author Rules and Resolutions (Procedural) Chair McClendon attempted to pass an amendment to an HIV-related bill that would have allowed needle exchange.

As reported by the Dallas Voice:

"HB 2229 seemed poised to pass until an amendment to the bill by Rep. Ruth Jones McClendon, D-San Antonio, added a needle exchange program, a proven way to reduce the transmission of HIV and other blood-born diseases. Many House Republicans oppose such programs arguing that, by providing clean needles to IV drug users, they condone drug use. The House voted on HB 2229 and it failed to pass, 53-89. Fearing the demise of the bill, McClendon asked for an opportunity to withdraw her amendment. After she did the House tentatively approved HB 2229, 104-36. The final vote for House approval on Wednesday was 88-57."

With the session running out of time an amendment to a related bill is the only hope at this point for passing legislation that allows syringe exchange programs in Texas. Despite the success of needle exchange legislation in the Texas Senate and in the Public Health Committee during the 2009 session, the support of every major medical association in the United States and Texas, and over 50 letters from individuals and medical associations asking Chair Kolkhorst to schedule a hearing for House Bill 117 she has adamantly refused without offering a rational excuse as to why.

Representative Hernandez Luna signs on to HB 117

With only a few weeks left hoping HB 117 will get a hearing the bill has picked up another Coauthor. Vice Chair Hernandez Luna (D-Houston) has signed on. Thank you Rep. Hernandez Luna!

Successful needle exchange program in Albany, NY run by local Catholic Charities

The first year operation of a needle exchange program in Albany, New York has met with great success. The local program, Project Safe Point, is an AIDS services project of Catholic Charities of the Diocese of Albany. In an article in The Albany Times Union, profiling the success of the program, Angela Keller, executive director of Catholic Charities' AIDS Services reports:

"This is a health problem that's not going to go away and we've learned in our first year that it's a greatly needed service."

"We help people who are ready to take the steps of not using drugs anymore," Keller said. "They come to us when they've decided they're tired of living that way and want to get help."

Project Safe Point collected over 8,500 used syringes and referred 13% of its clients to drug treatment in its first year of operation.

Kudos Project Safe Point!

Read more here: Program shows a need for needle exchanges

Syringe Exchange: Responsible, Prudent, Compassionate

Check out Bill Martin's article, "Syringe Exchange: Responsible, Prudent, Compassionate," in the April 2011 issue of Recovery Today online.

Excerpts from the article:

"Recognizing that HIV and hepatitis were both spreading at alarming rates among injecting drug users (IDUs), public health officials in both the Netherlands and Australia began experimenting in the mid- 1980s with programs to supply addicts with clean needles in exchange for their used ones. The immediate and obvious success of these programs in reducing the incidence of both diseases—the rates quickly dropped as much as one third— led authorities in Canada and numerous European, Asian, Middle Eastern, and Latin American countries to follow suit. In some locales, sterile syringes can be exchanged at pharmacies, police stations, and even from specially designed vending machines. At St. Vincent's Hospital, in Sydney, nuns operate the exchange. Even the hyper-conservative mullahs in Iran have approved of syringe exchange as an acceptable way to fight an HIV/AIDS epidemic spread mainly by drug users."

"Even more striking, at the November 2010 Harm Reduction Conference in Austin, Texas, Dr. Don Des Jarlais, Professor of Epidemiology at New York's Albert Einstein College of Medicine, reported that the incidence of new HIV infections among IDUs in in New York City has dropped to under one percent per year. "We appear," he said, "to be very close to eliminating injecting-related transmissions in a city with over 100,000 injecting drug users."

"No one seriously any longer seriously disputes the health and financial benefits of SEPs. In 2009, Congress finally removed its long-standing ban on using federal funds to support such programs. State laws vary, but 36 states have syringe- exchange programs and 13 others make other provisions for IDUs to obtain sterile needles. Only Texas still flatly prohibits the purchase or possession of syringes for the purpose of injecting illegal drugs, and that prohibition may not survive the state's 2011 session of its legislature."

Read full article here.

Letters of support continue to pour in while HB 117 awaits hearing

Letters from individuals who support House Bill 117, including a mother, several concerned Republicans and Christians, a family member who lost a loved one to HIV/AIDS, and an United States Army Veteran of Operation Iraqi Freedom continue to urge Public Health Chair Kolkhorst to give this bill a hearing if legislators are serious about saving money and saving lives. Their letters reiterate that House Bill 117 would save lives without encouraging drug use, would save the individual taxpayer the expense of treating further disease by halting its spread, would protect the community by decreasing the risk of children and adults finding improperly discarded drug paraphernalia in parks and public spaces as they do currently, and promotes an evidence-based disease prevention model. One Republican and Christian supporter states:

"I have seen the costs of inflicted on taxpayers from the spread of diseases which can be prevented through these programs. State funds are so critical and changes must be made for Texas to remain a strong state. This bill requires none of those decreasing funds."

A mother writes:

"I don't wish for my son to carry the burden of the cost to treat individuals infected by carrying a needle carrying an explosive disease that can then be spread to other users and non-users when a simple and effective program such as syringe exchange could be operating in our state. These programs are designed to protect law enforcement, medical professionals and the common man."

A letter from The CHOW Project (click on photo at right to join The CHOW Project on facebook) in Hawai'i, a statewide syringe exchange program in existence for over twenty years, asks Texas to join them in "helping stop the spread of blood-borne pathogens and making our communities safer for everyone." Research has shown that, for every year that it has been in operation, the Hawai'i program is not only cost-effective but has decreased the transmission of infectious disease, lowered the chance of needle stick injuries in public spaces by ensuring proper disposal of contaminated syringes, and connected drug users with treatment and other services. Texas could realize these same benefits by passing HB 117 and allowing syringe exchange to operate in jurisdictions that opt to authorize programs, and all without requiring the use of state funds.

Write to Chair Kolkhorst urging her to schedule a Public Health Committee hearing for House Bill 117! Write to your Texas House Representative urging them to help save lives, reduce disease and drug use, and save taxpayer money by supporting syringe exchange as disease prevention.

Texas Hospital Association hand-delivers letter of support

Texas Hospital Association (THA) has hand-delivered a letter in support of HB 117 to the bill's author, Chair McClendon, and to Public Health Chair Kolkhorst's office as of this morning. THA represents more than 450 hospitals and hospital systems in Texas and is a well-respected and oft sought leader in hospital-related education, advocacy, and issues.

THA's letter states:

"Allowing local jurisdictions in Texas the option to allow syringe exchange programs will prevent new HIV, HBV and HCV infections, improve public health, and save lives without requiring the use of state funds. As hospitals and the health care system implement more cost-saving initiatives and preventive medicine, it is imperative that the state embraces programs that are proven to achieve these goals."

"Based on numerous, extensive research studies, the science is clear: syringe exchange programs are highly cost-effective, lifesaving and do not promote drug use."

THA has consistently support similar legislation in previous sessions. Thank you THA!

Association of Nurses in AIDS Care urges passage of HB 117

In a letter to Public Health Chair Kolkhorst the Association of Nurses in AIDS Care (ANAC) writes, on behalf of its 84 members who reside in Texas, in support of HB 117 and its passage.

ANAC reminds Chair Kolkhorst that House Bill 117 would not require state funds, while reducing the risk of further HIV infection and associated costs. ANAC reminds Chair Kolkhorst:

"HIV/AIDS rates in Texas remain high, and Texas has the fourth highest rate of HIV/AIDS of any state. Needle exchange programs as part of a comprehensive HIV prevention package will save lives. Needle exchange programs are one of the most scientifically-based methods for reducing HIV."

Click on letter image below to read the Association of Nurses in AIDS Care's statement in support of HB 117.

Representative Donna Howard signs on to HB 117

House Bill 117 picks up another Coauthor this morning, House Administration (Procedural) Vice Chair Donna Howard. Representative Howard has worked as a critical-care nurse, a Health Education instructor at the University of Texas, and has been president of the Texas Nurses Association (which supports access to sterile syringes as effective disease prevention). Thank you Representative Howard!

Texas Infectious Diseases Society urges legislators to pass HB 117 without delay

In a letter to Representatives McClendon (House Bill 117 Author) and Kolkhorst (Public Health Committee Chair) the President of the Texas Infectious Diseases Society writes on behalf of over 270 infectious disease physicians and scientists in support of HB 117, which would allow local entities to operate voluntary needle exchange programs. Dr. Septimus urges legislators to 'move this important legislation forward and enact it this session without delay.'

An excerpt from the letter (see full letter below):

" Based on numerous studies and extensive research evidence, the science is clear: needle exchange programs are highly cost-effective, lifesaving, and do not promote drug use. In addition to the reduced risks for disease, sterile syringe access programs facilitate greater access to drug treatment by providing a crucial entry point into medical care, detox and rehabilitation, and mental health treatment. Nearly 200 syringe exchange programs successfully operate in 38 states, Puerto Rico, Washington DC, and Indian Lands. Allowing local jurisdictions in Texas the option to support these programs will prevent new HIV, HBV and HCV infections, improve public health and save lives."

The letter also reminds legislators that Texas is currently wasting taxpayer dollars treating blood borne infections that it could be preventing through the simple measure of access to sterile syringes.

When legislators and fellow Texans are ready to listen to science and reason, and support effective disease prevention programs, savings will follow.

Representative Elliott Naishtat signs on to HB 117 as Joint Author

Public Health Vice Chair Elliott Naishtat has signed on to House Bill 117. Thank you Representative Naishtat!

Organizational support for allowing syringe exchange in Texas continues to grow

AIDS Arms, Coastal Bend AIDS Foundation, and Mothers Against Teen Violence join an impressive list of Texas organizations supporting syringe access:

• AIDS ARMS
  
• AIDS SERVICES OF AUSTIN, INC.
  
• AMERICAN CIVIL LIBERTIES UNION OF TEXAS
  
• BEXAR AREA HARM REDUCTION COALITION
• BEXAR COUNTY COMMISSIONERS COURT
• CLEAT
  
• COALITION FOR NURSES IN ADVANCED PRACTICE
  
• COASTAL BEND AIDS FOUNDATION
  
• COUNTY JUDGES & COMMISSIONERS ASSOCIATION OF TEXAS
• CHRISTUS SANTA ROSA HEALTH CARE
• HARRIS COUNTY HEALTHCARE ALLIANCE
  
• HEPATITIS C ADVOCATE NETWORK
  
• HOUSTON AREA IMMUNIZATION PARTNERSHIP
• LATINO HIV TASK FORCE
• LEAGUE OF WOMEN VOTERS OF TEXAS
  
• LEGACY COMMUNITY HEALTH SERVICES
• LIVER HEALTH TODAY, HOUSTON
  
• MOTHERS AGAINST TEEN VIOLENCE
  
• PARKLAND HOSPITAL
  
• SAINT MARK'S EPISCOPAL CHURCH, SAN ANTONIO
• SAN ANTONIO AIDS FOUNDATION
• SCOTT & WHITE CENTER FOR HEALTHCARE POLICY
  
• SOUTH TEXAS SUBSTANCE ABUSE RECOVERY SERVICES
• TEXAS ACADEMY OF FAMILY PHYSICIANS
• TEXAS ACADEMY OF INTERNAL MEDICINE
• TEXAS ADVOCACY PROJECT
  
• TEXAS HOSPITAL ASSOCIATION
• TEXAS IMPACT
  
• TEXAS MEDICAL ASSOCIATION
  
• TEXAS NURSES ASSOCIATION
  
• TEXAS PEDIATRIC SOCIETY
• TRINITY COUNTY
  

In a letter of support for House Bill 117 (see below), Joy Strickland, CEO Of Mothers Against Teen Violence, states "SEPs are in line with a public health approach to drug addiction, which is a medical/mental health problem. All Texans stand to benefit from fewer blood borne disease infections and from the safe disposal of used syringes.

Bill Hoelscher, Executive Director of Coastal Bend AIDS Foundation, states in a letter (see below) to HB 117 author Rep. McClendon (D-San Antonio), "Some may have concern that allowing needle exchange programs in Texas will be a nod of approval, that substance use is acceptable. Reality is that no has an answer to stop the wide spread use of drugs in Texas, but there is the potential to stop the spread of a disease that is costing us millions of dollars each year."

Several Texas County Judges and Sheriffs have written letters to their State Representatives supporting House Bill 117 and the potential for syringe exchange programs to avert new cases of HIV and reduce drug use in their localities.

U.S. Surgeon General supports needle exchange

Until 2009, federal law banned spending federal funds to support syringe access. This ban inhibited medical providers from operating syringe access programs in order to address the dual problems of infectious disease and addiction.

In 2009 Congress voted to remove the ban on funding syringe access, allowing states, local governments and non-profits to offer cost effective disease prevention that is in the best interest of their communities.

Last month, the U.S. Surgeon General issued a statement affirming the public health value of syringe services programs (SSPs). The notice reiterates that syringe exchange services are an effective way of reducing HIV, while also encouraging people to enter drug treatment. The Surgeon General's notice cites a study that found that participants of a syringe exchange program were five times more likely to enter drug treatment than people using injection drugs who did not have access to or visit a syringe exchange program (Hagan et al. 2000).

To view the notice, issued by the Health and Human Services Department on February 23, 2011, click here. The notice was issued in the Federal Register Vol. 76, No. 36 page 10038. Please visit SAMHSA's (Substance Abuse and Mental Health Services Administration) "Bibliographic Support for the Syringe Services Program" for a list of studies supporting the efficacy of syringe exchange.

Senator Deuell poised to sponsor HB 117

In a letter distributed to every member of the Texas House of Representatives, along with a copy of "The Conservative Case for Needle Exchange," Senator Bob Deuell (R-Greenville) reaffirms his support for passing syringe exchange legislation. Doctor Deuell's commitment to disease prevention outreach programs has remained strong and steady, as a physician, as a conservative, and especially as a Christian. Senator Deuell has stood by his conviction that every life is worth saving, and that every individual deserves compassion.

Senator Deuell's initial feelings of trepidation toward the subject of syringe exchange were quickly dispelled when presented with the scientific facts and figures in support of these lifesaving interventions. In his letter he states:

"If you had asked me just a few years ago how I felt about allowing drug addicts to trade their dirty needles for clean ones, I likely would have said I opposed it. But once I looked at the studies, I saw that these programs work. And they do not increase drug use. On the contrary, these programs often help get drug addicts into rehabilitation where they can be helped.

As a physician, I support needle exchange programs because I want to see HIV and Hepatitis B and C fought with the best tools available.

As a Christian, I support needle exchange programs because I know every life has value to God, who does not allow me to give up on anyone."

"I wish this was not an issue which we needed to address. I would much prefer that no one in Texas would ever get addicted to injected drugs or put themselves and others at risk for dangerous and often deadly diseases. But since these problems exist, we must fight them with the very best tools at our disposal."

Senator Deuell has passed syringe exchange legislation in the Senate in 2007 and 2009 (23-6 Senators voted in favor of SB 188) and is ready to do so again if the House approves HB 117. HB 117 would provide counties with a population of over 300,000 the option of authorizing syringe exchange programs. There are many private funding options for syringe exchange services which would allow the state and counties to avoid spending public money while authorizing programs that would save the state the cost of treating additional cases of HIV and blood borne infections. It's a win-win situation. And on the face of things this bill appears to align perfectly with the conservative platform: it aims to preserve and save lives, it is a local control measure, and it would save the state and the taxpayer millions of valuable dollars by sparing counties and public hospitals the burden of treating additional infectious disease among the uninsured by preventing it in the first place.

If Texas legislators are sincere about implementing successful and sound measures to save the state money then there is absolutely no good reason for not supporting House Bill 117. There is no rational excuse for Public Health Committee Chair, Rep. Lois Kolkhorst, not scheduling a hearing. And there is no sense in keeping Texas from having access to the second most effective HIV intervention, syringe exchange.

Representative Eric Johnson signs on to HB 117

Representative Eric Johnson (D-Dallas) has signed on to HB 117 as Coauthor. Dallas County has been one of the counties hardest hit by HIV in Texas. With over 13,000 people living with HIV/AIDS, Dallas County has the highest rate of HIV infection in Texas. Thank you Rep. Johnson for supporting sensible HIV interventions that would not only bring people who struggle with drug dependence into services, but also reduce drug abuse and disease!

Senior Fellow in Religion and Public Policy makes 'The Conservative Case for Needle Exchange'

William Martin, Harry and Hazel Chavanne Senior Fellow in Religion and Public Policy at the James A. Baker III Institute for Public Policy at Rice University, has once again delivered a stunning commentary on why needle exchange in Texas and why now more than ever. The article in today's Texas Tribune, "The Conservative Case for Needle Exchange," reminds Texans that needle exchange programs are an essential component in addressing addiction, helping people seek treatment for their addiction, and saving the state piles of money while decreasing the burden of disease.

In 2007 and 2009, Senator Bob Deuell championed syringe exchange in the Texas Senate. Martin recalls Deuell's support for syringe exchange as grounded in not only science, but also in compassion and Christianity.

'Sen. Bob Deuell, a conservative Republican and a practicing doctor, sponsored similar bills in both 2007 and 2009. "At one time," he recalled, "I was opposed, but I looked at the data. When people have disagreed with my vote, I've shown them the data and asked them, 'How could I argue with that?'" A fiscal conservative, Deuell also noted that syringe exchange makes good economic sense: "It costs us a fortune to treat HIV and hepatitis C. It's breaking the budget."

Deuell's support of needle exchange does not rest on science and economics alone. "I look at it from the Christian viewpoint," he said. "What would Jesus do? We need to show compassion and try to help. [Addicts] are God's children, too. When they need new needles, this puts them in touch with someone who might reach them. The very act of handing them clean needles says, 'Your life has value to me. I want you to know that we care about you. When you want to get off, we're here to help you.' If they're in a back alley, using a dirty needle, there's no chance of that."'

States that offer syringe exchange programs have significantly reduced the incidence of HIV among injection drug users.

'A Johns Hopkins study of the Baltimore City Needle Exchange found that, after six years in operation, the incidence of HIV in Baltimore decreased by 35 percent overall and 70 percent among the approximately 10,000 participants in the program. Even more striking, epidemiologist Don Des Jarlais, director of research at New York’s Beth Israel Medical Center and a leading expert on syringe exchange, reports that the incidence of new HIV infections among injecting drug users in New York City has dropped to less than 1 percent per year. "We appear," he said, "to be very close to eliminating injecting-related transmission in a city with over 100,000 injecting drug users." '

Thank you Mr. Martin for presenting the facts and reminding us that syringe exchange as disease prevention has had strong support, from Republicans, Democrats and Christians alike, here in Texas.

Read full article.

Representative Susan King signs on to HB 117 as Joint Author

Appropriations, House Administration (Procedural), and Public Health Committee member Susan King has signed on to House Bill 117. The Primary and Joint Authors of HB 117 reaffirm that providing counties with the option of allowing disease prevention outreach programs that address the consequences of injection drug use at the point of preventing further transmission of deadly disease remains an issue with strong bipartisan support here in Texas:

• Primary Author, Rules and Resolutions (Procedural) Chair Ruth Jones McClendon; and
• Joint Authors Appropriations Subcommittee on Article II Chair Doctor John Zerwas,
• County Affairs Chair Garnet F. Coleman, and
• Appropriations, House Administration (Procedural), and Public Health Committee member Susan King.
  

A sincere thank you to Representative King, a Registered Nurse and staunch supporter of disease prevention outreach programs!

Representative Garnet Coleman signs on to HB 117 as Joint Author

County Affairs Chair and Public Health Committee member Garnet Coleman has signed on to House Bill 117, by Representative Ruth Jones McClendon. Representative Coleman has been a strong supporter and champion of HIV disease prevention outreach programs. A heartfelt thank you to Representative Coleman!

HB 117 referred to House Committee on Public Health

House Bill 117, by Representative Ruth Jones McClendon, received its first reading and was then referred to the Committee on Public Health. Representative John Zerwas, Public Health committee member, signed on two weeks ago as joint author. Representative Zerwas, along with five other members of the current Committee on Public Health (Vice Chair Elliott Naishtat, Chair Garnet Coleman, Chair Veronica Gonzales, Representative Susan King, and Chair Vicki Truitt), voted in favor of the same piece of legislation when it came before the committee last session.

New Mexico Department of Health reduces disease through needle exchange program

The New Mexico Department of Health's needle exchange program has been tasked with reducing new cases of AIDS in New Mexico since 1998. The New Mexico Harm Reduction Act was passed in 1997 to reduce the spread of blood borne diseases that are transmitted by the reuse of needles and/or syringes. In addition to promoting public health by reducing the number of cases of deadly disease, such as HIV and hepatitis C, the program is keeping communities safer by minimizing the number of improperly discarded syringes found in parks and playgrounds. As part of its harm reduction and needle exchange services the Department of Health also offers hepatitis screening, hepatitis A and B vaccinations, overdose prevention training, health promotion and disease prevention education, primary medical care and drug treatment referrals.

The purpose of the program according to Dave Daniels, an HIV educator in Las Cruces, New Mexico is 'first is to get possible infected needles out of the community and the second is to develop trust with the participants so when they are ready to start fighting the addiction, they have a person to turn to whom they trust.'

New Mexico has also had extensive support from law enforcement. A powerpoint presentation by Sonny Leeper, former Captain of the Albuquerque Police Department, explains the New Mexico Harm Reduction Act of 1997 and explains how needle exchange helps protect police officers from the risk of needlestick injury.

Read more about needle exchange in New Mexico here.

HB 117 picks up a Joint Author

Representative and physician John Zerwas signs on to House Bill 117, by Representative Ruth Jones McClendon. Representative Zerwas worked hard with fellow members of the House Committee on Public Health last session to strengthen similar legislation, which was successfully voted out of committee. Thank you again Representative Zerwas!

House Bill 117 leads into 82nd legislative session

At least one syringe exchange bill has been pre-filed leading up to the 82nd Texas legislative session. House Bill 117, filed by Representative Ruth Jones McClendon, would provide local authorities (in Texas counties with a population over 300,000) the option of authorizing disease prevention outreach programs, such as syringe exchange. This would allow community-based and faith-based organizations to provide compassionate, evidence-based outreach services that reduce blood borne disease transmission among individuals, and their loved ones, struggling with drug addiction here in Texas. In addition to reducing disease, syringe exchange programs make communities safer through proper disposal of used syringes, reducing rates of drug use, reducing the number of needle stick injuries to first responders and law enforcement, providing referrals to drug treatment, and increasing the likelihood of successful treatment outcomes. See full text of bill here.

Legislature has easy way to cut spending in Texas

Check out the Op-ed on syringe exchange in today's issue of the Houston Chronicle. An excerpt:

"Syringe exchange is life preservation, not drug support. Drug addiction is painful and costly enough. If we know how to keep HIV and HCV out of the picture, it would be irresponsible and expensive to continue not to do so here in Texas. Evidence-based interventions that reduce HIV transmission, such as syringe exchanges, are vital to the health and well-being of all Texans."

Read more here.

UN Reference group on HIV and injecting drug use calls for evidence based approach

The 2010 Consensus Statement of the Reference Group to the United Nations on HIV and Injecting Drug Use calls for an evidence-based approach to control the spread of HIV among people who use drugs and their non-using partners. The Reference group identifies key issues and makes recommendations to respond to the dual crisis of injection drug use and HIV.

The Statement calls for a human rights, comprehensive, evidence-based approach that includes:

1. Needle and syringe programmes (NSPs)

2. Opioid substitution therapy (OST) and other drug dependence treatment

3. HIV testing and counselling (T&C)

4. Antiretroviral therapy (AR T)

5. Prevention and treatment of sexually transmitted infections (STIs)

6. Condom programmes for IDUs and their sexual partners

7. Targeted information, education and communication (IEC) for IDUs and their sexual partners

8. Vaccination, diagnosis and treatment of viral hepatitis

9. Prevention, diagnosis and treatment of tuberculosis (TB)

The report urges legislators to remove legal barriers to syringe exchange and calls for a cooperative effort among law enforcement and health workers in order to increase access to HIV prevention, treatment and care.

Needle exchange in Iran

Tina Rosenberg's opinion piece in the New York Times, "An Enlightenend Exchange in Iran," paints a compelling portrait of the power of treating drug abuse as health policy. Iran has successfully averted an HIV nightmare by aggressively embracing harm reduction and needle exchange. In Iran, 68% of HIV infections come from sharing a contaminated syringe. Despite its reputation as one of the most repressive regimes in the world Iran has adopted a policy of treating drug abuse as a disease, not a crime. And as health policy, drug abuse "is a health issue — not just for drug users, but for everyone" (see the follow up article, "How Iran Derailed a Health Crisis").

An excerpt from "An Enlightened Exchange in Iran":

"The rate of new H.I.V. infections in Iran rose until 2005, and has dropped ever since. A top drug control official, Saeed Sefatian, said in 2008 that 18 percent of injecting drug users were H.I.V.-positive, but estimated that if it weren’t for harm reduction, that number would have been 40 percent. New infections among drug users have continued to drop. Surveys at sentinel sites in pre-natal clinics have not yet turned up not a single pregnant woman with H.I.V. (UNAIDS report, p. 97) ─ an excellent indication that the epidemic has been contained.

By pointing out the success of this program, I do not mean to endorse Iran’s prisons, where political dissidents are being tortured. Nor does Iran’s modern approach to harm reduction redeem the government’s stone-age approach to just about everything else. The same ayatollah who told judges not to get in the way of harm reduction was the man who closed dozens of newspapers. The important point here is that even a theocracy as repressive and rigid as Iran ─ the anti-Amsterdam ─ managed to create policies that have likely saved the country from an AIDS and drug disaster."

If Iran can, why can't Texas?

World AIDS Day 2010

Today is World AIDS Day. The current World AIDS Day Campaign theme is Universal Access and Human Rights. Universal access includes the right to care, treatment and prevention. The Harm Reduction Coalition issued this World AIDS day statement:

"Responses to both the domestic and the global HIV/AIDS epidemics among people who inject drugs face similar challenges: drug-related stigma that underpins repressive policies, lack of political will, and limited funding. Moreover, access to care and treatment remains limited for HIV+ drug users, who face multiple obstacles to obtaining antiretroviral therapy along with the associated health risks of hepatitis C, tuberculosis, and overdose. The 2010 World AIDS Day theme of Universal Access and Human Rights has a special urgency for people who use drugs, signifying an unrealized promise and demanding immediate action. The Harm Reduction Coalition calls upon governments and civil society to recommit to making Universal Access and Human Rights a reality for all people who use drugs as a necessary foundation for ending the HIV/AIDS epidemic."

Dr. David Lakey, Commissioner of the Texas Department of State Health Services reminds us in a special article to the Star-Telegram that 1 out of every 387 Texans are HIV-infected. The rate of new HIV infections in Texas is stable, but not decreasing. In addition, Texas is a late to diagnose state: 1 in 3 people diagnosed with HIV will progress to AIDS within a year. Dr. Lakey urges 'know your status; protect each other.'

Syringe exchange is the second most effective intervention at reducing HIV transmission, next to only PMTCT (prevention of mother-to-child transmission). Yet, Texas continues to remain one of the only states in which access to sterile syringes is prohibited, which gets in the way of preventing new infections and saving lives. Please take a moment today to remember loved ones lost and continue to commemorate them by supporting sensible disease prevention programs that will protect others from needless pain and suffering.

Legislative briefing draws experts from across the U.S.

Today's briefing on syringe access occurred on the eve of the 8th National Harm Reduction Conference, the nation's leading gathering of harm reduction enthusiasts and experts from around the globe. A panel of six speakers convened in the Texas Capitol Legislative Conference Center to reinforce the importance of syringe access as a successful disease prevention tool that Texas has gone far too long without and paid too high a price.

Don Des Jarlais (pictured above), Director of Research at Beth Israel Medical Center, spoke about the safety and efficacy of syringe exchange. He is a leading researcher on AIDS and injection drug use. He reminded listeners that syringe exchange programs offer a low cost and cost effective way to reduce the burden on the public system of treating the expensive twin epidemics of HIV and hepatitis C.

Allan Clear, Executive Director of the Harm Reduction Coalition and a nationally and internationally renowned harm reduction expert, spoke about the decision of the U.S. Congress to end a twenty year ban on the use of federal funds for syringe exchange in December 2009. He noted that cities such as New York, that offered syringe exchange early on, were able to avert large-scale HIV epidemics in drug users. He reminded us that while there may have been reason to be skeptical about syringe exchange twenty years ago when no one knew or understood what these programs were, we now know that syringe exchange is the second most scientifically proven effective HIV prevention method, next to only prevention of mother-to-child transmission.

Ruthie Burich, Prevention Specialist at AIDS Resource Center of Wisconsin (ARCW), spoke about her experience providing syringe exchange services and HIV testing and counseling to injection drug users in a state that has successfully reduced rates of HIV in this high risk population. ARCW operates Lifepoint, one of the nation's leading statewide needle exchange programs. Lifepoint serves clients and families in eleven cities throughout the state. Ruthie explained that programs not only offer access to sterile syringes, but also often provide primary health care services and referral to drug treatment.

Heather Edney, a marketing consultant from Southern California shared how syringe exchange programs saved her life after she became addicted to drugs at the age of fifteen and throughout her high-achieving teenage and college years. She explained how access to sterile syringes kept her from getting HIV, hepatitis C and other deadly blood borne infections until she was ready and able to successfully seek drug abuse treatment services. She pointed out that one syringe may cost as little as 0.08 cents, which seems reasonable compared to the price of doing nothing.

Jill Rips (left), Deputy Executive Director at San Antonio AIDS Foundation, has supported establishing syringe exchange programs in San Antonio where rates of hepatitis C and AIDS in injection drug using populations remain alarmingly high. Clients in Texas who continue to struggle with addiction and disease are left with very few options and resources, despite a willingness to protect themselves and loved ones from further transmission of HIV and other infections.

Tracey Hayes, Field Organizer at the ACLU of Texas and Project Director of The Access Project for over six years, spoke about the success of syringe exchange legislation in the 81st legislative session. She reminded the audience that the issue continues to bring together parties on both sides of the aisle and maintains a strong bipartisan coalition of supporters who support these sensible programs that save lives and taxpayer dollars.

A very special thank you to our panelists and guests today! Here's to hoping the legislature is poised and ready in 2011 to pass legislation that will immediately begin saving the public system from continuing to pay millions of dollars in expensive emergency room visits and chronic HIV and hepatitis C treatment costs, which is where drug users end up when we choose to do nothing.

8th National Harm Reduction Conference comes to Texas Nov. 18th-21st

Dear friend,

As we reflect upon history made by the Texas Legislature in 2009 and prepare for the 2011 82^nd Legislative Session, we are happy to report that the ban on the use of federal funds for syringe exchange programs has finally come to an end in the interim. As proposed in 2009, Texas Senate Bill 188 would have allowed local options for disease prevention programs including syringe exchange. Senate Bill 188 made history by making it farther through the legislature than any similar legislation filed since 1993, inspiring the largest bi-partisan coalition of House and Senate bill authors and supporters ever on this issue, and bringing together an unprecedented and diverse coalition of supporting organizations from around the state. We are optimistic that in 2011 Texas will follow the lead of the U.S. Congress and keep pace with the nation in allowing programs that effectively save lives and taxpayer money.

As of 2008, 14,147 Texans were living with HIV/AIDS as a result of having acquired this deadly disease directly from injection drug use, or indirectly as a partner or child of an injection drug user. An estimated 300,000 Texans are infected with hepatitis C virus (HCV), the leading cause of liver disease. Injection drug use is the number one risk factor for HCV. Syringe exchange programs safely and effectively reduce the transmission of these diseases and save the state from bearing the burden of millions of dollars in treatment costs.

Austin is fortunate to host the 2010 8^th National Harm Reduction Conference, Harm Reduction Beyond Borders, November 18 - 21. The conference takes place at the Renaissance Hotel at 9721 Arboretum Boulevard. Please visit the website for further details (www.8thnationalharmreductionconference.com). We invite you to join like-minded Texans at a special conference session hosted by The Access Project, Texans Mobilizing for 2011: Syringe Exchange in the 82nd Texas Legislative Session, on Thursday, November 18^th, 2010 at 7:15 p.m. The Access Project looks to bring stakeholders to the table to organize and plan advocacy action steps for the upcoming legislative session.

For further information on the history, safety and effectiveness of these lifesaving programs please visit The Access Project website (www.texasaccessproject.org) or contact Jenny Panzo, Education Coordinator at The Access Project, at jenny@texasaccessproject.org. The Access Project looks forward to seeing you at the conference!

Kind regards,

Jenny Panzo, MPH