Now, with a severe outbreak of H.I.V. and hepatitis due to a surge in heroin use in states including Indiana, Kentucky and West Virginia, the question of whether to let federal money support needle exchanges is back. Still, in contrast to a new willingness by state politicians to accept needle exchanges, Congress appears unlikely to overturn the moratorium even with drug problems hitting hard in states represented by those responsible for the spending bills that impose the ban. ...
Though evidence has mounted that needle exchanges are effective — the Centers for Disease Control and Prevention and the World Health Organization, among others, have recommended them — they have remained anathema to many politicians, particularly Republicans who have long framed opposition as an essential element of their antidrug image.“As Republicans, we don’t want to look like we are facilitating drug use,” said Representative Tom Cole, the Oklahoma Republican who is chairman of the appropriations subcommittee that distributes health funding. “We want to get you help, but we want to do other things.”While expressing reservations, Mr. Cole acknowledged that public funding of needle exchanges could be more cost effective than the potential public expense of treating increasing numbers of AIDS and hepatitis cases. He said he expected the issue to come up as Congress put its health spending bill together and, like [Rep. Harold] Rogers, said he was open to exploring the issue.
“If the evidence is such that it really makes a difference, it is something to look at,” Mr. Cole said.
To some Democrats, there is no question that the ban should be eliminated and that Republicans are stuck in the past when it comes to both drug and health policy.“We should lift the ban,” said Representative Rosa DeLauro of Connecticut, a senior Democrat on the appropriations subcommittee. “Health, and not ideology, should be the determining factor.”
In Indiana, an epidemic of H.I.V. related to intravenous drug use in one southeastern county led Gov. Mike Pence, a former Republican House member and longtime supporter of the ban, to back away from his opposition. In March, he signed an executive order allowing a temporary needle exchange in Scott County. This month, he signed legislation allowing counties around the state to begin exchanges if officials can demonstrate that they would be an appropriate public health response. The Kentucky Legislature, on a bipartisan basis, also passed legislation allowing needle exchange programs.