KELLY MCEVERS, HOST:
With the U.S. in the middle of an epidemic of heroin and prescription drug abuse, Congress just changed a policy that was in place for much of the last three decades. They effectively ended a ban on federal funding for needle exchanges. Those exchanges allowed drug users to get free sterile needles and help prevent the spread of disease. Just last year, almost 200 people were diagnosed with HIV in the small town of Austin, Ind., largely because people were sharing needles.
AUDIE CORNISH, HOST:
Now with this change, federal dollars still cannot go towards buying needles themselves, but they can go to things like staff salaries and counseling. Republican Congressman Hal Rogers of Kentucky used to support a total ban on funding these exchanges, but he helped lead this latest change.
HAL ROGERS: In my own district, we've have a severe problem with OxyContin abuse and overdose deaths, and I've been in those emergency rooms and seen these young people die of overdose of OxyContin and other opioids. But now it's shifting toward heroin. And that brings us to a different problem. And that is needles are used. We've got a needle problem. So we will allow funding for state and local organizations that are approved by CDC to receive monies for all of the programs that they have related to counseling and treatment but not the exchange of the needle itself.
CORNISH: Why make that distinction that the funding can't go for the syringes themselves?
ROGERS: Because we've always had a policy on the federal level of not providing needles. Now, if the state and locals want to do this and buy into the program, that's their decision and we will support that.
CORNISH: What, if any, pushback have you gotten from your colleagues? Scientific reviews have said that there's no evidence to support the idea that needle exchange actually encourage people to use drugs, but some people still politically feel like that's the message that's being sent.
ROGERS: Well, that's the prevailing viewpoint, I think, is that it does promote the use of needles. But, you know, the world that we live in these days, this problem is so widespread. In fact, CDC calls the problem the national epidemic. So we're facing with a real problem here. I think what really brought it to our attention was the problem of that small community in Indiana which had a severe outbreak of hepatitis C and HIV around needles. And it was a phenomenon that I think woke a lot of people up to the problem that the nation faces and the CDC has been warning us about for a long time.
CORNISH: Congressman Rogers, hearing you talk about emergency rooms and bringing up Indiana, do you feel like you've had a personal change of heart here as you've heard these stories?
ROGERS: Well, I'll tell you what, over the years when we saw the people that were being affected, it can't help but make a huge impact on you, and it has me. This is a national problem. It's a sickness that infects almost every family in the country - drug addiction and overdose deaths. So this problem is not going to go away. It's going to require even more and more attention as time passes.
CORNISH: That's Congressman Hal Rogers of Kentucky. He's head of the House Appropriations Committee.
Thank you so much for your time.
ROGERS: Thank you.
CORNISH: For more on what this means for needle exchange programs around the country, I'm joined by Daniel Raymond. He's policy director for the Harm Reduction Coalition. He helps communities establish and expand needle exchanges. He's been advocating for this change in law for many years. Daniel, welcome to the program.
DANIEL RAYMOND: Thank you so much.
CORNISH: All right, you've been in this business a long time. How big a deal is this change?
RAYMOND: We were thrilled when we got the news. This is something that we've wanted to see happen for years and years, and it always seemed like there was a wall, that there was an entrenched opposition, there was a polarization on this issue that we just couldn't get past. I remember back in the height of the AIDS epidemic, 25 years ago, that was the first wave of establishing needle exchange programs, mostly in the larger urban areas - the New Yorks, the Baltimores, the Chicagos, the San Franciscos - where HIV was taking a huge toll. And we saw a wave of new programs, and then a lot of that progress stalled out because it got bogged down in political controversy over use of federal funds. So the idea that we're revisiting this in the midst of another crisis, the overdose crisis, just shows how far we've come and how much further we need to go.
CORNISH: This doesn't open up any new funding, right? It just kind of unlocks access to the federal funding that already exists?
RAYMOND: That's right. It's a shift in funding policy, it's not an addition of new funds. But what that means is that if you're a state that receives federal treatment dollars then you suddenly have more options. The absence of federal funds - especially in the rural areas, smaller cities, suburban areas - has meant that a lot of good intentions have never been able to get off the ground. So my hope is that this is going have a transformative effect outside of the bigger cities which were often the first to move and spread better programs into areas that have been hard-hit by the heroin and opioid crisis.
CORNISH: Now, as we mentioned earlier, as part of the law, Congress said money can't go directly to buying the needles themselves, basically just everything else to make the exchange happen. Does that make a difference?
RAYMOND: From my point of view, that's a compromise that we can work with. I reached out to my colleagues who've been working around the country on syringe exchange programs, and I asked them, is this a deal breaker? And they said no. One of our biggest challenges is, how do we provide the funding for staff? How do we provide the funding for transportation, for facilities? So I think the message that I've gotten from the broader syringe exchange program community is that they'll find a way to purchase the syringes, but they really need the help in these other areas.
CORNISH: You've devoted much of your career to this issue. What do you say to the criticism - I also put to the Congressman - the idea that needle exchanges don't encourage people to get treatment and actually stop injecting drugs?
RAYMOND: I've worked in and with needle exchange programs over 25 years, and I can say from my own experience if I saw that happening then I would've had second thoughts about what I was doing. Instead what I see is that we're not seeing new people coming and say, I want to start injecting. We are seeing many people who've been struggling often for years say, thank you for being here, I came for the syringe but what I really want to talk about is getting help with drug treatment. And the people that we're reaching, nobody else is reaching. Those are the people who are asking us for help, and Congress's action is letting us expand our abilities to do that.
CORNISH: That's Daniel Raymond. He's policy director for the Harm Reduction Coalition. He spoke to us from New York.
Daniel Raymond, thanks so much.
RAYMOND: Thank you, my pleasure. Transcript provided by NPR, Copyright NPR.
