Advocacy

Taking a systems approach, we work with legislators and community leaders to advocate for public and institutional policy changes that reduce health inequities and health disparities faced by people who use drugs.

Our current legislative priority is advocating for the legalization of syringe service programs in Iowa through revision of Iowa’s drug paraphernalia law.

124.414 Drug paraphernalia.

1. a. As used in this section, “drug paraphernalia” means all equipment, products, or materials of any kind used or attempted to be used in combination with a controlled substance, except those items used in combination with the lawful use of a controlled substance, to knowingly or intentionally and primarily do any of the following:

(1) Manufacture a controlled substance.

(2) Inject, ingest, inhale, or otherwise introduce into the human body a controlled substance.

(3) Test the strength, effectiveness, or purity of a controlled substance.

(4) Enhance the effect of a controlled substance.

b. “Drug paraphernalia” does not include hypodermic needles or syringes if
manufactured, delivered, sold, or possessed for a lawful purpose.

2. It is unlawful for any person to knowingly or intentionally manufacture, deliver, sell, orpossess drug paraphernalia.

3. A person who violates this section commits a simple misdemeanor.

About Syringe Service Programs

No, needle and syringe exchange is not legal in Iowa, but is also not illegal in the state. Under Iowa law

Pharmacies in the state of Iowa do not require a prescription to purchase new syringes or needles. However, some pharmacists chose not to sell syringes to individuals who do not have a prescription with their pharmacy for a medication that must be administered intra-venously.

Syringe exchange programs are one of the most effective public health interventions for decreasing the transmission rates of HIV and other blood borne diseases such as hepatitis C, as well as connect users to treatment and other important needs such as housing or food assistance.

In states with legalized syringe exchange programs, people who use injection drugs turn in their used or “dirty” needles in exchange for unused, clean needles.

By expanding access to clean syringes and ensuring a safe way to dispose of bio-hazardous materials, syringe exchange programs create safer environments for the community at large. Additionally, syringe exchange programs are shown to lead to a 66% reduction in needle-stick injury to law enforcement.

35 states (plus the District of Columbia) operate successful syringe exchange programs, in which people who inject drugs may obtain new needles for free, and turn in needles they have previously used. These simple programs can make a big impact. Running for over twenty years in some states, they are well known to reduce the risk of disease transmission among drug users. Some critics suggest that needle exchanges encourage drug use. However, the Surgeon General and reports in several major medical journals (including the New England Journal of Medicine) tell us that there are no data to support this claim. In fact, new syringe exchange program participants are five times more likely to enter into drug treatment than non-syringe exchange program participants. Former participants in syringe exchange programs are more likely to report significant reduction in drug use or to stop using all together, and to remain in drug treatment programs. For people who are struggling with addiction, needle exchanges can be a way to keep them healthy until they potentially choose to seek treatment.

No. While syringe distribution programs have operated in the U.S. for over thirty years, there is no data that these programs lead to increased drug use. In fact, studies from syringe distribution programs show that needle exchange participants are more likely to reduce their drug use than community members who do not receive services through needle exchange programs.

While it is a common myth that syringe exchange programs encourage, enable or increase drug use, as well as crime, decades of research from organizations including the World Health Organization and the American Medical Association, show that syringe exchange programs do none of those. In fact, many studies demonstrate that syringe exchange programs decrease drug use by connecting otherwise marginalized people to treatment. It is estimated that syringe exchange program participants are five times more likely to enter drug treatment than non-participants.

Yes! Syringe exchange programs are supported by extensive medical and public health research and endorsed by the former U.S. Surgeon General Dr. Vivek Murthy, the National Academy of Sciences, and the CDC. A few great places to start learning more about the evidence for syringe exchange include:

    • Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health
    • Integrated Prevention Services for HIV Infection, Viral Hepatitis, Sexually Transmitted Diseases, and Tuberculosis for Persons Who Use Drugs Illicitly: Summary Guidance from CDC and the U.S. Department of Health and Human
    • The Centers for Disease Control and Prevention has more information on the effectiveness of syringe exchange programs as a comprehensive public health approach. Click here to read more from the CDC.

Needle sharing among people who inject drugs can lead to a number of illnesses, including HIV, hepatitis C, and endocarditis. Of these, hepatitis C (HCV) is currently the most common in the state of Iowa.

In Iowa, there are over 20,000 people living with HCV (as of March 2016). The Iowa Department of Public Health reports that this number is likely a gross underestimate. Many cases are currently undiagnosed, and as many as 110,00 Iowans may have the virus without being aware. Between 2000 and 2015, there was a 300% increase in HCV diagnosis among people 18-30 years old. Of these new HCV diagnoses, at least 55% occurred among people who inject opioids. This high rate of hepatitis among drug users is due to sharing needles and materials used to prepare drugs for injection (eg. cottons, cookers, wipes, ties).

HCV is a viral infection that causes severe liver inflammation and increases the risk of developing liver cancer. Currently, HCV is the leading reason for liver transplantation, and directly causes a number of non-liver related illnesses which are estimated to amount to $1.5 billion in direct medical costs at the national-level. Until recently, HCV was incurable – but even now curative treatments for HCV remain out of reach for many people, as treatments can cost over $100,000 per course of medication.

Syringe service programs are the only proven way to reduce the risk of transmitting HIV, HCV, and other infectious organisms among people who inject drugs. Further, syringe service programs provide community members with many other benefits, including naloxone, HIV/HCV testing, case management, and connections to other health and social services.

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