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Sticking point
Massachusetts may finally legalize over-the-counter syringe sales

The new health-care bill from the Massachusetts House of Representatives dominated the headlines last week, and rightly so — it’s an ambitious, aggressive piece of lawmaking. But another major health-related development on Beacon Hill went virtually unnoticed amid the hoopla. On November 3, hours before hammering out the aforementioned health-care bill, the House used a voice vote to advance House 4176, a bit of legislation that would legalize over-the-counter syringe sales in Massachusetts. Right now, the syringe bill is sitting in the House’s Committee on Third Reading. But insiders say the House is likely to pass it and send it on to the Senate by November 16, the formal close of the legislature’s fall session.

Common sense suggests that the syringe bill should pass. Massachusetts is one of just three states that prohibit the purchase of syringes without a physician’s prescription. (The others are New Jersey and Delaware.) The problem, of course, is that this doesn’t keep intravenous drug users from using — instead, it invites the use of dirty needles to feed their addiction.

The public-health consequences are disastrous. Of the 1000 or so new HIV infections Massachusetts sees every year, nearly 400 are thought to be needle-related. (After infecting themselves, HIV-positive drug users often infect their sexual partners.) The link between needle use and HIV is especially strong among women; 60 percent of the state’s female HIV/AIDS cases are linked to intravenous drug use. What’s more, the vast majority of the 100,000 hepatitis C sufferers living in Massachusetts contracted that disease via unsafe needle use.

All these numbers suggest that Massachusetts’s current approach to needle safety — which allows individual cities and towns to implement needle-exchange programs and manage the problem locally — simply isn’t working. (Only four communities currently have needle-exchange programs, due to the fact that most cities and towns, even those with serious IV drug-use problems, worry that adopting such a program would invite a new influx of addicts.)

The pending syringe bill wouldn’t end the problem overnight. To begin with, the minimum age for legal syringe purchase would be 18, so infections among younger users might not change much. Furthermore, some older users might not have the patience or presence of mind to stop by CVS before shooting up. But advocates insist that, over time, the infection rate would drop sharply. "Look at Rhode Island’s reduction," argues Rebecca Haag, executive director of the AIDS Action Committee. (Rhode Island decriminalized syringe purchases in 2000; by 2004, needle-related HIV transmission had dropped nearly 40 percent.) "We’re going to have to let people know about the program and educate them a little more about it. I’m hopeful that, over several years, we could get that number" — the 400 new needle-related HIV infections each year — "close to zero."


Sounds reasonable — but in politics, common sense is frequently trumped by expediency and skittishness. And that could be the case here as well. The last time similar legislation was filed, it was left to die in the House Ways and Means Committee, presumably because then-Speaker Tom Finneran viewed it with disapproval.

The current Speaker of the House, Sal DiMasi, is more socially liberal than his predecessor and has publicly identified himself as a supporter of the bill. Senate President Robert Travaglini, too, is a social liberal, and is viewed as a likely ally by advocates of needle-policy reform. Governor Mitt Romney is another story, however. Julie Teer, Romney’s spokesperson, did not respond to several requests from the Phoenix to identify the governor’s position on the issue. But when a similar bill sponsored by state senator Robert O’Leary (D-Barnstable) had a State House hearing back in May, Eric Fehrnstrom, the governor’s communications director, told the Globe that Romney doesn’t "want to do anything that facilitates illegal drug use."

The merit of this position is dubious at best. To begin with, there’s broad consensus that legalizing syringe purchases does not increase IV drug-use rates — or, for that matter, exacerbate drug-related crime. During the May State House hearing, this point was emphasized by Middlesex County District Attorney Martha Coakley and Suffolk County District Attorney Dan Conley, both of whom support the proposed change. ("If I thought for one second that my support of this legislation would, in any way, increase drug abuse, I would never support it," Conley said at the time.)

In fact, the bill’s backing among law-enforcement professionals is substantial. In addition to Coakley and Conley, Norfolk County DA William Keating and Essex County DA Jonathan Blodgett have endorsed the bill. So has Boston Police Commissioner Kathleen O’Toole. This collective backing is due, in large part, to an instinct for self-preservation: any police officer frisking a suspect risks being stuck by a hidden syringe, but if syringe possession were decriminalized, this risk would presumably diminish. (One year after Connecticut legalized syringe purchases, the number of police officers being stuck by needles had dropped 66 percent.)

Throw in the fact that Romney’s own public-health department has voiced support for the proposed change, and it seems clear that the governor’s opposition is driven as much by political considerations (and perhaps a moralistic view of drug use and addiction) as by genuine public-policy concerns. With over-the-counter syringe purchases legal in 47 states, this clearly isn’t a Red State–Blue State issue. But as Romney gears up for his presidential campaign, he’s trying to add accomplishments to his résumé, not to give his opponents ammunition. And if Massachusetts legalizes syringe purchases under Romney’s watch, you can be sure the rest of the Republican field will play the issue for maximum effect once the ’08 campaign starts in earnest.

Come to think of it, they might want to follow the same approach the Massachusetts Republican Party used in 2004. During the state GOP’s ill-fated effort to roll back the Democratic majority on Beacon Hill, the Republicans targeted O’Leary, the state senator from Barnstable, with a mailing that played up his support for legalized syringe sales. The flier pictured a mother and child playing happily on an unnamed beach, seemingly oblivious to the larger-than-life hypodermic needles that surrounded them. The obvious implication was that changing state law would flood public places with dirty sharps. In fact, as vigilant pedestrians around the state can attest, the illegality of syringes hasn’t led to safe disposal habits. And since House 4176 calls for syringes to be sold with an insert discussing safe disposal, drug treatment, and disease prevention, discarded sharps might well become less prevalent if the bill becomes law.

The good news — for anyone who sees the status quo as antiquated and harmful — is that the attack against O’Leary didn’t work. Instead, the senator beat his opponent, Republican Gail Lese, by nearly 17,000 votes. "Don’t underestimate the public’s ability to see beyond the rhetoric," O’Leary says today. "In the end, people rejected it. They saw these ads for what they were — smears."

In the coming weeks, O’Leary’s example might sufficiently embolden legislators to give syringe reform a veto-proof majority in both the House and Senate. Obviously, any celebration should be deferred until a law is actually passed; after all, politicians can do strange things heading into election season. But for the time being, there seems to be ample reason for optimism.

Adam Reilly can be reached at areilly[a]phx.com.

Issue Date: November 11 - 17, 2005
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