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Time to Make a Change

Writer-at-large William Martin on investigating a needle program for drug users in Dallas.

By April 2007Comments

texasmonthly.com: You’ve mostly written pieces about religion for Texas Monthly, like the Faith Bases columns or the feature on T.D. Jakes last August. Why did you want to write about this, now?

William Martin: It is true that I have written about religion more than any other topic, but I taught criminology at Rice for 35 years and have long been interested in ways to reduce the harms associated with drug abuse and drug policy. In my position as a senior fellow at the James A. Baker III Institute for Public Policy at Rice, I lead programs in religion and public policy and also in drug policy. In 2003, I organized and led a two-day international conference regarding ways to reform our drug policies, which often do more harm than the drugs themselves, though no one denies that drugs can have serious negative consequences.

I chose to write about increasing access to sterile syringes because it is one of the simplest issues. The science is clear: Needle-exchange programs have worked throughout the world and in many states and cities in this country to cause significant reduction in the transmission of blood-borne diseases such as HIV/AIDS and hepatitis C. In 2005, I wrote a scholarly paper on the subject, entitled “Needle Exchange Programs: Sending the Right Message.” It can be accessed at http://bakerinstitute.org/Publication_List.cfm , in the list of publications for 2005. I plan to update it soon, to include new data that I have gathered for the current article in Texas Monthly.

I wrote the current article at this time because the Texas Legislature is seriously considering bills that would remove barriers to providing sterile syringes to injecting drug users. I hope that, by providing solid factual information to legislators and their constituents, the bills will pass, making it possible to establish programs with a proven ability to reduce the spread of dangerous diseases, save the state (and cities and counties) millions of dollars, and serve as a bridge to treatment for a significant number of participants.

texasmonthly.com: Do you think the Legislature is going to change its stance anytime soon?

WM: I certainly hope so. No one that I know of even tries to argue with the evidence, since it is so clear. Some are so opposed to anything having to do with drugs that they find it difficult to support such a measure until they come to understand that needle-exchange programs have been repeatedly shown to reduce disease without increasing or encouraging drug abuse. Some recognize the worth of such programs but fear that their constituents may not.

texasmonthly.com: How did you find DANSE? Where had you first heard about them?

WM: I honestly don’t remember where I first heard about needle-exchange efforts in Dallas, but it was some time around 2003. In 2005, I met Marty Krepcho, DANSE’s founder, when we both testified at a hearing of the Senate Health and Human Services committee in support of a bill sponsored by Republican Senator Jon Lindsay. During my efforts to support that bill at that time, I met other people with similar interests and a couple of them recommended that I get in touch with Jack Taylor, who assumed the leading role with DANSE after Marty Krepcho moved to Arizona.

texasmonthly.com: Besides some senators’ holding on to old notions about drug users and transmitted diseases, what are some other reasons why Texas is falling behind other states in programs like these?

WM: Needle-exchange programs have seldom been an easy sell. Almost no one, including most injecting drug users, think drug addiction is a good idea, so it requires some open-minded thinking and exposure to the overwhelming worldwide evidence that these programs actually work before many people will change their minds. As for Texas—and we are by no means unique in this regard—the legislators and, presumably, their constituencies, have long shown a strong inclination to believe that many social problems can best be solved by increased punishment. That model is conspicuously inadequate when dealing with drug abuse.

texasmonthly.com: What can people do to help if the state still refuses to fund these programs or allow them to receive private funding?

WM: First, we need to make clear that the bills in question at this time do not authorize use of state funds for needle-exchange programs. The results would probably be much better and the return on investment significantly greater with stable funding, but programs funded by private entities or by local governments will have to prove their worth before legislators would consider state funding. If these bills fail, existing programs will still have to rely on contributions from individuals, churches, and foundations for their money and, for the most part, on volunteers to do the work. That places continued hardship on existing programs and makes it more difficult for new programs to begin. Foundations and churches that believe in these programs are still reluctant to contribute to them as long as they are illegal, even when local officials agreed to let them operate without hindrance. There is always the fear that an individual police officer or politician or zealous anti-drug crusader will make a public fuss and create embarrassment and possibly even legal difficulties for people who are trying to provide a valuable service.

texasmonthly.com: You include a lot of numbers and facts in your story. How long did you spend researching this?

WM: As I mentioned, I wrote a scholarly article on the topic in 2005. That’s when I developed the basic understanding that went into this story. Still, I did a great deal of work for this piece, updating statistics, examining new research, and interviewing people involved in syringe exchange and other efforts to stem the spread of blood-borne diseases. As it happens, I can be fairly specific in answering your question. Since retiring from teaching at the end of 2004, I have kept a rough record of how much time I spend on various projects. According to these records, I spent 176 hours, spread over several months, working on this story.

texasmonthly.com: What advice or input did you get from editors here before you started?

WM: Not much before I started, since editor Evan Smith had read my 2005 Baker Institute article and knew that I had a good grasp of the subject. As we went along, articles editor Brian Sweany, who also works with me on my Faith Bases column, gave me some typically valuable advice about how to organize the story to achieve greatest readability and impact. Apart from that, Evan and Brian offered another bit of standard instruction: use fewer words. I cut the original draft by two thousand words. I’m confident readers would have found everything we cut to be absolutely compelling, but I acceded to their wishes.

texasmonthly.com: Anything else you want to say?

WM: There is one thing and, as it happens, it’s one of the things we had to cut, for reasons of space only. Several legislators or their aides have told me they would like to support these bills but are afraid their constituents might not understand their reasons for doing so. I had suspected that the resistance might not be nearly as strong as they fear. In the spring of 2006, Rice sociology student Emery Gullickson conducted an ambitious study of potential support for needle-exchange programs and found evidence to support that hunch. In the process of her research, she learned that Representative Dianne Delisi, who chairs the House Public Health committee, felt that her opposition to syringe-exchange bills in 2005 was reflecting the sentiment of her constituents. Emery decided to try to find out if that was true. She didn’t have the resources to conduct a full-scale survey, so she interviewed 27 clergy from fourteen denominations in Representative Delisi’s Temple district, presuming they would serve as a reasonable gauge of the moral and ethical views of the community. When provided with the fact that extensive research has shown that needle-exchange programs reduce the spread of blood-borne diseases without increasing drug abuse and also serve as a bridge to treatment for a significant percentage of participants, 19 of the 27 (70 percent) declared themselves in favor of needle-exchange programs; 6 had no opinion, usually because it was not an issue in their part of town; and only 2 opposed them. Several mentioned that, because numerous members of their churches were associated with Scott and White Hospital, they would be aware of the scientific and medical data and would likely also be supportive. That indicates to me that the fear some legislators have is probably unfounded. I hope that will give them courage to make what ought to be an easy choice.

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