ATLANTA — A bill to clarify state rules related to HIV tests sailed through the Georgia House in February without a dissenting vote. It arrived in the Senate with little fanfare and with good prospects for passage. But a provision in House Bill 1058 that would have promoted ”needle exchanges” for injection drug users was stripped out of the bill in the Senate, as a health committee took up the proposal.
The bill’s sponsor, Rep. Betty Price (R-Roswell), said at that Senate Health and Human Services Committee hearing that the needle or syringe exchange “was removed due to some controversial aspects to it.” Needle exchanges, which let drug users trade dirty syringes for clean ones, have been a contentious issue. They are intended to prevent the transmission of infections – such as HIV, the virus that causes AIDS – through dirty needles. But critics fear that providing any kind of equipment for injections offers tacit encouragement of drug abuse.
Despite the controversy, an increasing number of states and communities have adopted the practice as a way to decrease HIV and hepatitis infections, along with getting more drug users into treatment. Injection drug users become infected and transmit the viruses to others through sharing contaminated syringes and other drug injection equipment. According to a CDC study of cities with high levels of HIV, about one-third of people who inject drugs reported sharing syringes, and more than half reported sharing other injection equipment in the past 12 months.
Congress recently lifted the nation’s longstanding ban on federal funding for needle exchange programs.Although those funds still cannot be used for the syringes themselves, they can go toward expenses associated with these programs, such as staff,vans, substance abuse counseling, referral to treatment and outreach in at-risk communities. The goal of the exchange provision in House Bill 1058 was to address Georgia’s alarming statistics on HIV, hepatitis and drug overdoses.
The state ranked second among the 50 states in 2013 in its rate of new HIV diagnoses, with Atlanta ranking fifth among metro areas. Hepatitis C, meanwhile, increased 67 percent in the state from 2009 to 2013. The state Department of Public Health says Georgians under 30 have seen a doubling of hepatitis C infections, a surge linked to an increase in injection drug use. Heroin use has skyrocketed in Atlanta and its northern suburbs. In 2010, four people died from heroin overdoses in Fulton County (which contains most of the city of Atlanta), while in 2015, 82 people died, WABE reported. Rep. Price, who is also a physician, noted that the GBI says the presence of heroin at crime scenes has increased significantly.
Indiana Gov. Mike Pence, though opposing needle exchanges, signed an executive order last year allowing clean needles to be distributed in one county with a high rate of HIV infections. In that HIV outbreak, centered on a rural town, health officials diagnosed as many as 22 new cases a week, fueled by an intravenous drug epidemic. Pence then signed legislation that will make it easier for other counties to launch needle exchange programs to combat diseases passed through intravenous drug use. And Indiana’s southern neighbor, Kentucky, enacted an anti-heroin law last year that includes allowing local health departments to establish needle exchanges.
Nationally, there are at least 194 needle exchanges operating under budgets ranging from $100,000 to $300,000, said MonicaRuiz of George Washington University, USA Today reported this year. “These programs are highly effective and don’t lead to increased crime,” said Jeff Graham, executive director of GeorgiaEquality. “It’s a benefit to public health and public safety, and addresses a number of epidemics.” A study released last year found the average monthly rate of new HIV infections among drug users in the nation’s capital dropped by about 70 percent after the District of Columbia implemented a needle exchange program in 2008, the Washington Post reported. Price told GHN that such programs continue to be face opposition. But she added, “The data is there. It really, really helps.”
After the needle provision was dropped, the Georgia bill passed the state Senate, and it is likely to become law. The legislation eases HIV testing for minors. And Price noted that the bill would allow medical providers to order an HIV test on a patient if there’s an incident that exposes a provider to any of that patient’s body fluids. Dr. Melanie Thompson, principal investigator for the AIDS Research Consortium of Atlanta, told GHN that some needle-exchange work is already being done in Georgia. But the language removed from House Bill 1058, she said, would have clarified the legality of the practice – and increased needle exchanges in the state. “The interpretation of [current] law is worrisome for some people,” Thompson said. Needle exchanges help get people into drug treatment and also lower the infection rates, she said. “We won’t give up,” Thompson said. “We’ll continue to advocate for what’s scientifically sound.”