Needle exchange bill pits small government Republicans vs. authoritarian wing

Paul Burka noticed that that Governor Rick Perry took an odd swipe this week at needle exchange legislation authored by Republican state Sen. Bob Deuell, which recently passed out of the Texas Senate. SB 308 is scheduled for a hearing in the House Public Health Committee on Monday.

Contrary to many naysayers' predictions, Committee Chair Diane Delisi's decision to grant the bill a hearing means the bill is still very much alive. IMO it has a good chance to make it all the way to the Governor's desk, which would mean that Perry's opinions become much more important on the matter.

Unfortunately an issue that should be focused on health concerns has been dragged into an unrelated, highly controversial debate. In a speech regarding legislation to override his executive order on the controversial HPV vaccine, Perry offered his first public pronouncement on the needle exchange bill in an odd and highly polticized fashion:

"It is also confounding that some members of the legislature who complained my executive order encourages sexual promiscuity later voted for a needle exchange program that provides free needles to drug addicts. If we are worried about the messages we send, it would seem that the mission of discouraging illegal drugs would be just as significant, if not moreso, than discouraging sexual activity among a population that is mostly not engaged in sexual activity yet (girls entering the sixth grade)."

I responded in the comments to Burka's piece that such critics overlooked important differences between the two pieces of legislation:

A key difference is that the needle exchange bill has a zero fiscal note - it only allows nonprofits to do it if local government lets them. Taxpayers wouldn't finance anything.

With the HPV vaccine, the executive order would have cost in the mid-nine figures to implement and the decision didn't go through the regular legislative or budgeting process. To me, that's what makes the Governor's argument a red herring - he ignores the obvious differences that makes his comparison inapplicable.

Later in the day Sen. Bob Deuell, who I find to be a contemplative, open minded conservative who I really like (even though he was the Senate sponsor of Jessica's Law), issued his own response to the Governor, which I reprint in its entirety here:

May 9, 2007

The Honorable Rick Perry
Governor of Texas
1100 Congress, Room 2S.1
Austin, Texas 78701

Dear Governor Perry:

During your statement on May 8 regarding HB 1098, you included the following sentence:

"I am also mystified by the argument that making this vaccine widely available encourages promiscuity, especially from legislators who voted for a needle exchange program that encourages drug addicts to continue to abuse illegal drugs."

I would respectfully suggest that you have been misinformed on needle exchange programs. I know of no research that indicates needle exchange programs encourage drug use. On the contrary, numerous studies, including reports from the U.S. Surgeon General and the National Institutes of Health, have concluded that needle exchange programs do not increase drug use and may actually decrease it. One study, published in the Journal of Substance Abuse Treatment, found new participants in an exchange program in Seattle were five times more likely to enter treatment than those who had never used the exchange.

My legislation permitting voluntary needle exchange programs, SB 308, did not have a single witness testify against it. If it really did increase drug use, there would have been numerous anti-drug groups attending the hearing and working against it. Instead, many of these groups are working for the passage of this bill. They see this as a way to establish contact with injection drug users so they can get them into rehabilitation.

I would also call to your attention the significant impact needle exchange programs can have on reducing HIV and Hepatitis C rates. About half of new HIV infections and 40% of Hepatitis C infections come, directly or indirectly, from injection drug use. A new case of HIV will cost about $385,000 over the patients' lifetime and Medicaid will pick up the tab for much of this. The cost to Medicaid for Hepatitis C in Texas is about $30 million per year. The National Institutes of Health estimates that needle exchange programs reduce HIV transmission rates by about 30%. As you can see, that can save a lot of lives and money in our state.

Given these facts, it is easy to understand why 49 states now allow voluntary needle exchange programs. I am pleased that the Texas Senate made the wise and compassionate decision last month to join the rest of the nation in allowing these programs.

I would be happy to discuss this issue with you at your convenience. I would also encourage you to talk about the concept of needle exchange with anyone who works in the area of disease prevention or drug abuse. I am confident you will find the facts support this idea and that it is time for Texas to permit it.

Sincerely,
Robert F. Deuell, M.D.
District Two

Sen. Deuell has studied this issue carefully and armed himself with all the necessary facts to quell opposition, at least if critics like Gov. Perry give him a chance to present them. The best evidence of the East Texas doctor's persuasiveness was Sen. Jane Nelson's decision to change her vote - she opposed identical legislation in 2003 and 2005 when Sen. Jon Lindsay carried it, but this year supported Deuell's bill.

I'm personally excited this legislation has moved so far, even receiving unlikely but welcome support from the conservative Lone Start Times blog. Governor Perry's apparent slap against the bill doesn't worry me that much. The rest of his comments actually framed arguments in terms that support needle exchange as a concept. He declared:

[I]t is the tone of this debate that has disturbed me most. The notion of forgiveness and grace has been totally lost in this debate. People make wrong choices. Our society is full of such individuals who have found redemption from past mistakes.

But if we had a vaccine for lung cancer, would we stop its widespread use because it might send a message that it is okay to engage in an unhealthy behavior like smoking?

The sad irony is, if you or I had a family member suffering from cervical cancer, there is no treatment we would rob them of if it could take away the pain and bring them back to health. And yet, we won't provide them the vaccine that can prevent all that pain and suffering - that death sentence - to begin with because of the message it might send? What about a message of grace, compassion and forgiveness for anyone who has made wrong choices? Have we lost sight of that?

Those are the identical reasons the Governor should support allowing voluntary, local needle exchanges. That's one reason why, if Dr. Deuell's SB 308 makes it to the Governor's desk, I still harbor hope that Rick Perry might still approve it based on these stated values of "grace, compassion and forgiveness for anyone who has made wrong choices."

Supporters of establishing legal Texas needle exchange programs have never been closer to achieving their goals, but the process is far from over. Here are the members of the House Public Health Committee. If any of these folks represent you, call and ask them to support SB 308 on Monday. And if you only have time to make one phone call on this, it's probably particularly important to ask Committee Chair Dianne Delisi to support the legislation, or at least allow it to receive a vote.

See prior, related Grits coverage:

• Texas Senate prescribes needle exchange
• Texas Monthly messengers pro-needle exchange article to Texas state senators
• Dr. Deuell prescribes needle exchange bill
• GOP doctor files needle exchange in the Senate
• League of Women Voters Backs Needle Exchange