BY ALEXANDER LEKHTMAN JULY 22, 2021
A Congressional budget committee released a draft spending bill on July 11 that would finally erase what remains of a longstanding ban on federal funding for syringe service programs. It would dramatically increase government funding for harm reduction—just as newly-released CDC data on drug overdose deaths show that 2020 was the deadliest in US history, with over 93,000 lives lost.
“These are 93,000 of our friends, family and neighbors,” said Maritza Perez, director of the Office of National Affairs at the Drug Policy Alliance, which advocated for the spending allocation. “Each one of their lives had value and we owe it to them to quickly pass the spending bill with this funding intact, so we can prevent further unnecessary loss of life.”
The draft Labor, Health and Human Services, Education, and Related Agencies Funding Bill proposes $69.5 million for federal drug harm reduction efforts. That’s more than five times as much money as Congress allocated to harm reduction last year. The money would go to the federal Centers for Disease Control and Prevention (CDC), for its Infectious Diseases and Opioid Epidemic Program to expand syringe service programs (SSP).
If passed, this bill would consign to history a federal ban on SSP funding which dates back to 1988. Then-Senator Jesse Helms (R-NC) sponsored legislation to prevent federal tax dollars from going to such programs, at a time when many of them were first forming in cities throughout the US.
At the time, SSP were a bold new public health effort at the height of the HIV/AIDS crisis, preventing transmissions from shared needles. However, many politicians did not see it that way: They argued that SSP would normalize drug use and addiction.
Even as scientific evidence piled up that SSP are effective at reducing HIV transmissions and other harms, Congress remained obstinate. It kept the ban in place across four presidential administrations. President Obama lifted the ban in 2009, only to concede to pressure by reinstating it in 2011, after Republicans took control of the House of Representatives.
Congress finally made a positive change in January 2016. Led by then-House Appropriations Chairman Hal Rogers (R) and Senate Leader Mitch McConnell (R), Republicans and President Obama passed a partial repeal of the ban. No doubt, a disastrous and totally preventable HIV outbreak in rural Scott County, Indiana the year before finally helped change the political dialogue around syringes.
The partial repeal meant that federal funding could pay for staff, HIV and STD testing, syringe disposal, naloxone and other services to connect people with health care. But money could not be used to purchase syringes themselves, nor other drug consumption tools like cookers or pipes. Programs had to apply for funding through the CDC and prove that they were in a jurisdiction at significant risk for an HIV or hepatitis C outbreak linked to injection drug use.
Despite these caveats, it was a huge step forward for harm reduction, because syringes themselves represent a small cost for programs. It’s everything else—the staffing, HIV testing, naloxone, education and health care referrals—that requires most of the funding.
But now, more than five years later, Congress has a chance to completely repeal any ban on federal funds for SSP. It is not clear from the draft text exactly how the money could be used, and if any restrictions would apply. But both government-run and independent SSP that can “demonstrate need” should be able to benefit.
Of course, the bill has to pass the full House and Senate before it can be signed into law. But lawmakers should be well aware of the stakes. Record overdose figures are the starkest possible reminder that an effective way out of this crisis is to invest in robust public health measures—with the SSP that protect health and save lives an urgent priority.
LEKHTMAN, ALEXANDER. “Congress Plans Historic Federal Funding for Syringe Programs.” Filter, 4 Aug. 2021, filtermag.org/congress-funding-syringe-programs/.