If Rhode Island continues its existing laws, which promote the spread of HIV and hepatitis in our community, the financial burdens are only going to increase. It is time for a bold new approach.
Rhode Island is in the midst of deadly and costly epidemics of HIV/AIDS, hepatitis B and hepatitis C. Legislation has passed in the General Assembly that gives the state an opportunity to substantially curtail these diseases and their associated suffering and cost. In Rhode Island, the majority of these infections are caused by the reuse of contaminated syringes.
This includes more than 52 percent of the AIDS cases in the state, which distinguishes Rhode Island as one of only four states where the majority of the AIDS cases are related to injection drug use. This extraordinarily high rate of infection by contaminated syringes is an unintended consequence of laws that have criminalized the purchase, possession and sale of syringes without a prescription, enacted in a misguided attempt to reduce drug use.
These laws, which came into place long before the AIDS/hepatitis epidemics, clearly have not stopped injection drug use. What they have done is encouraged sharing of syringes, because they are scarce. In Rhode Island, these laws have been stricter than in most states.
Until 1998, it was a felony punishable by up to five years' imprisonment to possess a single syringe. If we are to attack this problem in a meaningful way, Rhode Island must join Connecticut and several other states in decriminalizing the sale and possession of syringes.
In 1992, Connecticut changed its law to allow legal sale and possession of syringes; Maine and Minnesota subsequently did the same. In Connecticut, there was a dramatic decline in syringe reuse (39 percent in the first year), no increase in drug use, and no increase in publicly discarded syringes.
Connecticut Department of Health officials believe that this has helped reduce the spread of HIV and hepatitis viruses in Connecticut. A statutory reduction of the penalty for syringe possession from a felony to a misdemeanor in Rhode Island two years ago has not reduced the incidence of needle-sharing, because sale and possession is still a crime and so it has not made syringes any less scarce.
Concern is often raised that decriminalizing possession of syringes would be interpreted as somehow sanctioning or condoning drug use; this has not been the case. People do not begin to inject drugs because a syringe is available. If that were the case, we would have seen an increase in drug use in Connecticut, Maine and Minnesota when the law was changed, and there has been no increase in those states.
On the other hand, as evidenced by Rhode Island's ongoing epidemic of injection drug use, trying to control drug use by restricting access to syringes does not work. It just encourages syringe-sharing and therefore the spread of diseases.
Rhode Island's Gov. Lincoln Almond has an opportunity to sign into law a bill that would not simply eliminate the criminal penalty for sale and possession of syringes. The bill also would regulate the sale of syringes by pharmacies in ways that would bring drug users into contact with highly trained health professionals who actively interact with the public - registered pharmacists. This would provide the opportunity to encourage persons to enter substance-abuse treatment and become educated about reducing the risks associated with injection drug use.
Many pharmacists in the state are eager to help with HIV prevention, and their involvement can have a dramatic impact. The alternative is to continue to alienate drug users from the medical profession and encourage the spread of deadly diseases.
This legislation is supported by the Rhode Island Medical Society, the Rhode Island Pharmacists Association, the Rhode Island Diabetes Foundation, the Rhode Island Criminal Trial Lawyers' Association, the American Medical Association, the Centers for Disease Control and Prevention, Providence Mayor Vincent A. Cianci Jr., Providence Police Chief Urbano Prignano, Providence Public Safety Commissioner John J. Partington and many others.
It is important to contact Governor Almond to urge him to sign the bill.
In Rhode Island, we have nearly 2,000 AIDS cases and twice as many HIV-positive tests. In our state, there are at least five people with hepatitis C for each person with HIV infection. The cost of treating all these diseases is enormous, and will be largely borne by taxpayers. The medication cost alone for a one-year course of treatment for hepatitis C is $16,000, and the "cocktail" of medications used to treat HIV is more than $20,000 a year.
If we continue the existing laws that promote the spread of HIV and hepatitis in our community, the financial burdens are only going to increase. It is time for a bold new approach.