It’s been over 25 years since Congress decided to ban the use of federal dollars for programs that distribute sterile syringes to intravenous drug users, over the objections of scientists and health experts. But emerging public health crises across the country — like rising heroin use and serious HIV outbreaks — may have triggered a change of heart.
In its massive year-end spending bill, Congress quietly included crucial permission for the Department of Health to fund syringe-exchange programs across the country. This unexpected addition, a move blocked in previous years by the GOP-dominated Congress, comes with equally unexpected sponsors: Republican lawmakers.
Weeks before a New Hampshire forum where GOP presidential candidates unveiled plans to combat heroin addiction, the bill’s passing may reflect a bigger shift in the Republican party’s decades-old outlook on drug policy.
“If you’d spoken to me at the beginning of last year, I’d have said we’re playing the long game, can we even identify a single Republican to champion this,” Michael Collins, Deputy Director of the Drug Policy Alliance, told BuzzFeed News this week.
Rep. Hal Rogers and Senate Majority Leader Mitch McConnell, both Kentucky Republicans, spearheaded the push to include the funds, according to BuzzFeed. The federal push follows similar policy change in their home state. Last March, Kentucky passed a bill allowing health departments to establish needle exchanges just before a record-breaking HIV outbreak hit neighboring Indiana — and crawled over state lines.
In addition to the spread of HIV, local lawmakers have also been forced to grapple with a rise in heroin use plaguing GOP-led states. According to the Center for Disease Control and Prevention, the rate of heroin-related overdose deaths have nearly quadrupled over the past decade. And the epidemic continues to grow.
It’s important to note that the funds included in the omnibus bill don’t directly go toward the purchase of syringes. Instead, the Department of Health is allowed to fund everything but: Staff payroll, rent, the purchase of distribution vans, gas, and any other necessities to keep a program afloat. This decision was likely made to appease the conservatives still in opposition to directly distributing syringes. However, syringes are often the cheapest part of an exchange program, Collins said.
Up until recently, syringe-exchange programs have been supported solely by liberal lawmakers, including President Barack Obama. Of the 33 states that have syringe-exchange programs, the majority are led by Democrats. Conservative lawmakers have traditionally said that handing out free syringes simply endorses the use of illicit drugs. But to McConnell, usually quick to oppose any Obama-backed health policies, this has now become a bipartisan issue.
“This is an area where there is no partisan difference,” McConnell said at an April meeting. “We’re all in this together.”
GOP presidential candidates seem to agree. In July, Ohio Gov. John Kasich, a GOP presidential candidate, signed legislation that would make Naloxone, a drug that can reverse the effects of an heroin overdose, available at a pharmacy without a prescription. And in Tuesday’s New Hampshire forum on heroin addiction — a growing epidemic in the state — multiple impassioned candidates spoke out about their personal experiences with drug use. Both Carly Fiorina and former Gov. Jeb Bush have watched their children battle serious addiction. Fiorina even called for a hard look at how the justice system handles addicts.
“If we continue to criminalize drug addiction, we’re not treating it. And the system we have today is part of the problem now, not part of the solution,” said Fiorina. “We now have the highest incarceration rates in the world. And the majority of people we have in prison are people like my daughter, Lori, struggling with addiction.”
Syringe-exchange programs have been endorsed for decades by a wide range of public health experts and HIV prevention groups as an effective means of combating the spread of infectious diseases. And federally-funded studies have showed how access to clean syringes greatly decrease HIV rates without increasing the rates of drug use. But GOP members of Congress and Republican governors have continued to echo the 1988 bill banning federal funding of such programs, saying any support would make it look like the government supported illegal drug use. Until now.
GOP Senator Shelley Moore Capito of West Virginia, a state hit especially hard by the heroin epidemic, came out in support of a federal syringe exchange last summer — and some believe she helped the recent funding fall into place.
“You’re going to a health official to exchange needles, so somebody’s going to be having a contact and be aware that this is an issue for you as an individual. Hopefully from a public health stand point, we’ll see some good results from this,” she said in August. “Maybe [it] will help with the addiction issue as well.”