Drug Policy Foundation Releases Secret Internal Administration Reports on Needle Exchange

AIDS/NEEDLE EXCHANGE March 1995

The Drug Policy Foundation (DPF) recently released two confidential internal Clinton administration reports that urge the President to lift the ban on federal support for needle exchange programs to curb the spread of AIDS.

The two reports by the Centers for Disease Control and Prevention (CDC) review research on needle exchange programs and find that they reduce the spread of the virus that causes AIDS and do not increase rates of drug use. The ban on federal funding of needle exchange programs has been renewed every year by Congress since 1988, but the Surgeon General can overturn it with scientific proof that needle exchange programs are effective in reducing the spread of the AIDS virus while not increasing drug use.*

AIDS researcher Peter Lurie, MD, MPH, from the University of California at Berkeley School of Public Health is an author of one of the studies reviewed in the reports. At a forum held by DPF to release the reports, Lurie blasted the adminstration for not acting on this information. Officials are "cowering behind a legalistic fig leaf when the lives of drug users, their sex partners and their babies are at stake," he said. "For them to sit on their hands is really the height of public health irresponsibility. It's infuriating."

When Lurie's study was released in 1993, the Department of Health and Human Services (HHS) asked the CDC to review it. The CDC concluded that the study's findings were valid and added, "the ban on federal funding of NEPs [needle exchange programs] should be lifted to allow communities and states to use federal funds to suport NEPs as components of comprehensive HIV prevention programs." HHS ordered another review, and the CDC again confirmed the findings, including new research on the benefit of needle exchange programs in its report. The administration is continuing to review needle exchange policy, and neither CDC review was made public.

Philip R. Lee, assistant secretary for health, said that the CDC reviews are not enough to overturn the ban. "I have not been convinced on the evidence that has been presented so far," he said, adding that recently published studies have "raised further doubts -- in my mind, at least -- whether HIV transmission is in fact reduced in needle exchange programs."

HHS spokesperson Avis LaVelle said that the CDC reviews do not show that needle exchange programs reduce drug abuse, although they do "offer conclusive evidence of the effectiveness of needle exchange for curbing the transmission of HIV virus." [Reduction of drug abuse, however, is not the purpose of NEPs. -- EES]

"Every day of federal inaction on needle exchange costs lives," said DPF Executive Director David Condliffe.

* See Public Law 103-333, Sept. 30, 1994, Sec. 506: "Notwithstanding any other provision of this Act, no funds appropriated under this Act shall be used to carry out any program of distributing sterile needles for the hypodermic injection of any illegal drug unless the Surgeon General of the United States determines that such programs are effective in preventing the spread of HIV and do not encourage the use of illegal drugs, except that such funds may be used for such purposes in furtherance of demonstrations or studies authorized in the ADAMHA Reorganization Act (Public Law 102-321)."

[For more information about these reports and the needle exchange forum, contact Dave Fratello or Rob Stewart at the Drug Policy Foundation, 4455 Connecticut Avenue, NW, Suite B-500, Washington, DC 20008, 202-537-5005. Also see John Schwartz, "Reports Back Needle Exchange Programs," Washington Post, Feb. 16, 1995, p. A6; Richard O. Mara, "Scientists Urge Lifting of Ban on Neele Exchanges for Addicts," Baltimore Sun, Mar. 11, 1995, p. 10A; "Legalization Group Back Needle Exchange," Drug Policy Report, Mar. 1995, p. 7.]