Sunday, December 26, 2004

Sen. Lindsay Gets Smart on Crime

To his great credit, Texas state Sen. Jon Lindsay, R-Houston, last week in Austin filed SB 127, which would help prevent the spread of communicable diseases like AIDS and Hepatitis C by allowing local governments to implement anonymous syringe exchange programs.

Dead addicts don't recover. Sharing dirty needles has become the single most common method of transmitting HIV and Hep C among injection drug users. Far from encouraging drug activity, syringe exchange offers drug treatment providers and medical professionals access to a hard-to-reach population that otherwise tends to avoid interaction with public health officials. Too often, though, society prioritizes enforcing the drug ban over helping drug-addicted indviduals, one by one, up out of the mire.

Syringe access programs encourage personal responsibility among drug users, asking them to be accountable for their own health and that of their friends. Sometimes that simple act of self preservation can turn out to be a first step toward confronting, maybe even resolving one's personal drug abuse crisis. At least it gives them an access point to get help.

It's not surprising Sen. Lindsay, a former Harris County Judge (that's the head of county government, analogous to the mayor of a city, not a courtroom judge) is looking for answers. But even when evidence clearly supports the idea, as in the case of needle exchange, it takes courage to file a bill that tacks against the prevailing drug war winds, so the good senator deserves great credit for the effort. He filed similar legislation in the 78th session, but this bill seems more tightly drafted and well-thought through. Hopefully that means he's really serious about passing it.

Growing costs for public health obligations in big cities threaten municipal budgets everywhere in the country. For the most part, emergency rooms in public hospitals cannot turn away sick patients, even if they don't have insurance. What's more, to the extent that injection drug users are engaged in criminal activity that might wind them up in jail, often the public winds up paying for their healthcare costs anyway, as
Grits reported last week about Wichita Falls. Urban areas like Harris County with extremely expensive public hospital districts are searching for any way they can, not even to lower public health costs, but just to lower the rate of spending increase.

Syringe exchange programs can help stave off long-term costs that ultimately fall on local taxpayers.
According to Kate Ksobiech of the Wisconsin based Center for AIDS Intervention Research, "
Both establishing and maintaining NEPs can lead to substantial economic benefit to society via cost savings in long-term health care for uninsured/underinsured HIV+ individuals (see, for example, Holtgrave et al. [3])."

A decade ago, syringe exchange programs were pretty controversial, but it's hard to argue against success. They've proven effective at preventing the spread of disease and have been implemented nearly all over the country. Even Arnold Schwarzenegger signed a California bill earlier this year allowing pharmacists to sell up to ten "points" to addicts over the counter without a prescription. Syringe exchange has been endorsed by the American Medical Association, the American Bar Association, the American Public Health Association, the U.S. Conference of Mayors, the National Commission on AIDS and the Centers for Disease Control.

Maybe the time is ripe for Sen. Lindsay's improved bill to pass next year in Texas, too.