Needle Exchange Gets Religion

“When the science is clear, when we know that something will help save lives—and choose not to do it—that is not only pigheaded, it is immoral.” This was the view expressed by Dr. William Martin, Professor Emeritus of Religion and Public Policy at Rice University (and authoritative biographer of Billy Graham) in a conversation following a recent panel discussion I attended on Capitol Hill.

The “Needle Exchange Programs; A Moral Imperative” panel, co-sponsored by the Drug Policy Alliance and the Interfaith Drug Policy Initiative, featured five religious leaders who came to Washington to urge Congress to overturn the 20-year-old ban on the use of federal funding (both domestically and abroad) for needle exchange programs (NEPs). Initiated under the Reagan administration, the ban remained in place throughout the Clinton years (over the objections of his Secretary of Health and Human Services, Donna Shalala), and will be included in the Bush administration’s fiscal year 2009 appropriations for the department.

In a sign of the changing times, 120 US cities now fund their own needle exchange programs for injecting drug users. An even more significant sign may be the growing voice(s) of religion, joining science and faith in holy matrimony.

In the last decade or so, since religion has taken on the HIV/AIDS pandemic, it has done so unevenly and in fits and starts. In areas of care and treatment, the concept of sin has given way to human weakness, and punishment to compassion. On the issue of prevention (especially regarding substances and extramarital sex), religion has been dominated by dogma and morality narratives. With the sizable exception of the Catholic Church, there has been some movement on the use of condoms—within marriage and quietly in practice. And likewise, now, with needle exchange; a proven method of protecting drug users from infecting themselves with HIV or AIDS, Hepatitis C, and other blood-borne diseases through the use of contaminated or dirty needles.

The five leaders presented official resolutions (actually dating back to 1994) from several denominations, including the House of Bishops of the Episcopal Church, the Central Conference of American Rabbis, the Presbyterian Church, and the Society of Christian Ethics, a thousand-member organization of Christian, Jewish, and Muslim theologians.

As for the Vatican stance, Mary Joy Iozzio, professor of theology at Barry University in Florida and Catholic member of the Society of Christian Ethics, has been closely monitoring the website of the US Conference of Catholic Bishops for its rhetorical nuances. “They do not say we do not approve; nor do they say we approve,” she said. “The closest they come is to recognize that HIV is spread through dirty needles and that one way to prevent HIV transmission is to not share needles and to use new syringes.” This brings them closer to the next step, although they haven’t yet taken a formal position.

So which harm is worse? That done to society by drug use, or the harm done to millions of people by refusing to support proven interventions that prevent HIV and save lives? In some regions and countries, including South Asia, Eastern Europe, and the United States, intravenous drug use has become the major cause of HIV infection and is three times more likely to cause HIV infection than unprotected sex. Emphasizing the proven, Dr. Martin cited, chapter and verse, the irrefutable evidence published by every major health institution from NIH, CDC, IOM, WHO, and others. He also noted that NEPs do not promote or give tacit approval toward drug use, nor do they lead to injecting drug behavior in non-addicts. If anything, they save lives and money by bringing addicts into treatment and by reducing careless and dangerous dropping of disposable needles onto playgrounds where children pick them up.

Martin recalled the courageous stand of C. Everett Koop, President Reagan’s Surgeon General, who landed in hot water for using his “pro-life” conviction to support clean needles (and condoms). Evangelicals have come a long way since then, Martin said. “The more they hear the science, the more they come around,” he noted, pointing to a recent study by one of his students. From interviews with twenty-seven Texas clergy representing 14 denominations, the student found that when they understood the science, 19 declared themselves in favor of the needle exchange program.

It is, of course hard to forget Karl Rove’s masterful 2004 call to the entire evangelical movement to re-anoint President Bush for his across-the-board, at-all-costs protection of their “conservative” views on social issues and the primacy of faith over science. Yet, just four years later we are hearing about huge numbers of younger evangelical Christians voting democratic and supporting all manner of progressive issues, including combating climate change. They are not abandoning their core issues, such as their opposition to abortion and homosexuality, Martin explained. “But punishing sin has gone down on the scale, while social justice, poverty, racial equality and HIV/AIDS have come up a notch.” With this has come support for condoms—within marriage—and needle exchange.

In this case at least, the evidence informs the faith. While religion can seldom be accused of turning to Earth-bound evidence for its dogma, the science is so clear as to leave little theological wiggle room. “Injecting drug users are social lepers,” said Martin. While Jesus had nothing to say about needle exchange, “we know how he felt about lepers (even without statistics) and legalistic self-righteousness.”

Panelists cited the commands of Leviticus and Deuteronomy to protect from harm the widow, orphan, the marginalized, the vulnerable and the poor sojourner in their midst. “Do not stand idly by the blood of your neighbor. I am Adona” (Lev. 19:16b).

“Today we recognize that this command extends to all people who are vulnerable, without voice and without power,” said Iozzio. To do anything less than provide drug users, their co-users, sex partners, and children with the services that will reduce and/or remove the potential harms through needle exchange constitutes failure “to save human lives, to acknowledge the dignity of every human life, and to respond in solidarity to those who are marginalized by an addiction that places them and their associates at risk of life, limb, and love.”

But the White House and its Conservative allies in Congress refused to budge, and in fact, came close to overturning the new bill allowing the District of Columbia to use its own funds for needle exchange. Misguided fears of condoning illegal drug use and election-year worries keep the door closed tight on both science and faith—at least until next year.

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