Happy 4th of July!

I've been spending the weekend away from the Bay State in the ancestral homeland up in the Adirondacks of New York. Despite what Kerry Healey and others might say, even though it's legal in New York to sell hypodermic needles over the counter at a drug store, I did not have to wade through a pile of syringes to get here. In fact, I actually went to a CVS, and there were no hoards of junkies clamoring to get through the door. The cashiers and pharmacists did not live in constant fear of needle attacks. In fact, I would say that the only difference between the CVS I went to here and one in the Boston area is that you can't buy Red Sox caps around these parts. While that might seem like a horrible dystopia to some of you, I don't think it has anything to do with the availablity of clean syringes.

More Healey/Hillman Fear Mongering on Needles

Current Republican Lieutenant Governor Kerry Healey and her would be successor, candidate Reed Hillman, are running around the state campaigning hard against the bill legallizing over-the-counter sales of hypodermic needles that the legislature passed but Governor Romney is expected to veto. Healey and Hillman both continue to make assertions unsupported by any facts, despite the fact that Healey claims to be an expert on crime and Hillman was formerly the state's top trooper.

Here is Reed Hillman as quoted in the Globe's political blog:

"I'm not ready to give someone who is abusing heroin the benefit of the doubt when it comes to properly disposing a dirty needle."

Here's what Hillman fails to point out: in areas without needle exchange programs, there is currently no way for users to properly dispose of dirty needles short of sneaking into a hospital. The bill under consideration creates needle collection centers. Not only does this add a point of contact with addicts that could aid intervention, but if even one user disposes of their dirty needle correctly, it's an infinite percentage better than the 0% that are currently doing so.

As far as increasing the amount of syringes lying around goes, Johns Hopkins did a two month study with a two year later follow-up after Baltimore started up a needle exchange program in 1994. The first study showed that discarded syringes as a percentage of total waste did not increase in the months following the program's initiation compared to a measure taken before it started. Not only that, but in the follow-up study, the amount of needle litter actually decreased. One might argue that maybe there was less litter because there were fewer addicts, but then you can't claim, as Reed Hillman does, that increased access to clean needles increases drug use.

In addition, a 2003 study of New York's syringe program showed that access to clean needles did not increase discarded needles or syringes on the street or in the regular trash recepticals. In fact, the law brought about educational efforts promoting the safe disposal of used needles. New York experienced neither an increase in needlestick injuries to municipal workers (law enforcement, sanitation, etc) or an increase criminal drug-related activity.

Opponents of the bill also raise the specter of bandits holding up stores with newfound needles. This strikes me as absurd on the face of it. How many establishments are held up with needles (illegal) compared to guns (legal) or knives (also legal)? Heck, there have been more than 200 shootings in Boston alone this year, and I don't see the state GOP saying we should ban guns. Not only that, but as I mentioned previously, there was a 66% decrease in syringe stick injuries to police officers over a six-month period after pharmacy sales legislation passed in Connecticut. In Canada, when they were considering needle exchange programs in prisons, they studied prisons in Europe that gave inmates access to clean needles. They found no evidence that the prisoners were using the syringes as weapons, and there was no increased danger to the staff. I know it's not exactly comparable, but one would think that if any population was more likely to use sharps as shivs, it would be convicted criminals. The evidence did not bear that out.

I don't know why this issue gets under my skin (pardon the pun) so much -- I don't work in public health or AIDS advocacy or anything and I don't have any particular sympathy for junkies. I think it's because Healey and Hillman are making claims without any evidence to back them up, aside from the fact that little Billy once found a syringe on the Common. They are purposely misleading the public with scenarios that run contrary to the experiences of the 47 other states where syringes are legal (including every state that borders Massachusetts). If this is the kind of leadership we can expect from a Healey/Hillman administration, then count me out.

Kerry Healey Should Know Better

The Phoenix's Adam Reilly has some of Lieutenant Governor Kerry Healey's remarks opposing legalized syringe sales from the statehouse today. Healey is opposed to allowing over-the-counter sale of syringes, even though it is proven to reduce the spread of blood borne diseases like AIDS and hepatitis, because a ten-year-old once found a needle on Boston Common and someone held up a convenience store with one. Note first, that these things happened even though needles are not legal to buy over the counter currently. Healey does not bother to explain why keeping them illegal would stop such things from happening. Also, as Adam points out, Healey is basing her opposition completely on anecdotal evidence, and not on any data or any study. The reason, of course, is because there are no studies that show an increase in needle waste, needle assaults or IV drug use after other states remove their bans on over the counter syringe sales.

The Mass Democrats released a statement today blasting Healey for her opposition to this important public safety measure. Current Middlesex DA and future Attorney General Martha Coakley had this to say about the bill:

"Based on the findings of several states that have already adopted similar legislation, there is no evidence that giving the public access to syringes will increase rates for crime and/or drug abuse," said Middlesex District Attorney Martha Coakley. "adopting this bill is a cost-effective measure that would help prevent the spread of HIV and other infectious diseases. Although studies reflect the benefits of increased syringe access, common sense tells us that adopting this legislation will put the Commonwealth on the path towards prevention of deadly infectious diseases."

The worst thing about this is that Kerry Healey should know better. She is, or at least claims to be, an expert in criminology. I saw her on NECN (I think it was Jim Braude's show, but I don't recall) saying that she decided to get into government because she saw a disconnect between the wealth of research that they had in the academic world and the decisions they made in government. Well, here's here chance. There's plenty of research that says over-the-counter sales of needles don't increase intravenous drug use. I pointed to some of it last week. Instead of relying on this research or the experience of the 47 other states that have this law, she decides do base her position on the fact that someone found a needle on the Common. She is clearly pandering at the expense of public health.

Facts For Needle Debate

On Wednesday, the state Senate passed a bill that would legalize the sale of syringes without a prescription. Increasing the availability of these needles, supporters say, will help prevent the spread of diseases like AIDS and hepatitis B and C among intravenous drug users. More needles, less needle sharing, fewer opportunities to spread blood-borne disease.

The House passed a similar bill in November, but for some unexplained procedural reason must pass both houses again before going to Governor Mitt Romney who plans to veto the measure. Romney's spokesman raised fears of the program undermining our ability to enforce drug laws and claimed that we'd now be seeing dirty needles all over our parks and playgrounds. Kerry Healey, who also opposes the measure, called it a threat to public safety, since it makes it easier for drug users to use drugs.

Of course, what the bill's opponents don't ever seem to mention is that 47 other states already have this law on their books. If it were a public safety disaster, you would think that fewer than 94% of the US would allow over-the-counter sale of these needles. It also means that there should be lots of data about what actually happens once this law is implemented.

To my mind, there are four questions that I am interested in regarding this bill:

1) Does it reduce the spread of blood-borne diseases? If the law doesn't help curb AIDS and hepatitis, then there's no point in enacting it. Help Stop AIDS cites evidence from Connecticut that syringe sharing dropped 40% after enacting this law. Access to clean needles has been shown to reduce AIDS or hepatitis in New Haven, Tacoma, Australia and New York City.

2) Does it increase the use of illegal intravenous drugs? Opponents all claim that it makes using these drugs easier, so intuitively one might think that increasing the availability of needles will increase the use of drugs that require needles. The Drug Policy Alliance notes that there have been seven major government-funded reports which show that access to sterile syringes does not increase drug use. There have been no reports that contradict these findings. A study published in 2001 in the American Journal of Public Health found no statistically significant increase in IV drug use between cities where needles were available over-the-counter and those where they were not.

3) Does it increase the risk to law enforcement officers of needlestick injuries? If there are more needles available, will they be increasingly used as weapons? According to the Drug Policy Forum of MA, in Connecticut, there was a 66% decrease in syringe stick injuries to police officers over a six-month period after pharmacy sales legislation passed. I have not found any studies that show an increase in needlestick injuries after allowing over-the-counter sales of syringes.

4) Does it increase needle waste? The bill that was passed by the Senate just legalizes the sale of these needles, and is not a needle exchange program. With needle exchange programs, there is not a risk of increased needle waste because one has to return used needles before getting clean ones. To combat needle waste, the bill also proposes fines of up to $15,000 for needle litterers. It also creates needle collection centers through the department of health, medical facilities and the pharmacies themselves. A pilot program in Baltimore that created boxes for needle disposal was a success there.

Those questions answered, the only thing left to ask is why, since she is supposed to be an expert criminologist, Kerry Healey does not support these measures.