I realize that needle-exchange programs can be controversial, but to see a conservative Middle Eastern theocracy take a more progressive approach to the issue than the United States is just embarrassing.
Fearing an AIDS epidemic, Iran’s theocratic government has dropped a zero-tolerance policy against increasingly common heroin use and now offers addicts low-cost needles, methadone and a measure of social acceptance.
For two decades, Iran largely avoided the global AIDS crisis. But today, officials are alarmed by a 25 percent HIV infection rate that one survey has found among hard-core heroin users and worry that addicts may channel the virus into the population of 68 million.
Supporters of the government’s new approach laud it as practical and devoid of the wishful thinking and moralism that they contend hampers policies on drug abuse and AIDS in some other countries, including the United States. “I have to pay tribute to Iran on this,” said Roberto Arbitrio, head of the U.N. Office on Drugs and Crime in Tehran.
Bijan Nasirimanesh, who heads a drop-in clinic that dispenses needles, bleach and methadone in a hard-hit area of south Tehran, said, “It’s ironic that Iran, very fundamentalist, very religious — very religious — has been able to convince itself” to embrace such policies.
That’s right, America, when it comes to adopting a forward-thinking, progressive attitude towards AIDS prevention and methadone treatments, Iran is taking the lead, and making us look regressive.
Azarakhsh Mokri, who works at Iran’s National Center for Addiction Studies, noted that the U.S. Congress is considering a bill to imprison Americans who fail to report marijuana dealers, while Iranian clerics are endorsing needle-exchange programs. “Sometimes I think the ayatollahs are more liberal,” Mokri said.
When Iranians mock the United States for not being liberal enough, you know there’s a real problem.
And as long as we’re on the subject of the Bush administration and needle-exchange, I thought I’d remind readers that the Bush gang supports its policies in this area by pointing to scientific evidence that doesn’t exist.
The administration’s error is to oppose the distribution of uncontaminated needles to drug addicts. A large body of scientific evidence suggests that the free provision of clean needles curbs the spread of AIDS among drug users without increasing rates of addiction. Given that addicts are at the center of many of the AIDS epidemics in Eastern Europe and Asia, ignoring this science could cost millions of lives. In Russia, as of 2004, 80 percent of all HIV cases involved drug injectors, and many of these infections occurred because addicts share contaminated needles. In Malaysia, China, Vietnam and Ukraine, drug injectors also account for more than half of all HIV cases. Once a critical mass of drug users carries the virus, the epidemic spreads via unprotected sex to non-drug users.
The administration claims that the evidence for the effectiveness of needle exchange is shaky. An official who requested anonymity directed us to a number of researchers who have allegedly cast doubt on the pro-exchange consensus. One of them is Steffanie A. Strathdee of the University of California at San Diego; when we contacted her, she responded that her research “supports the expansion of needle exchange programs, not the opposite.” Another researcher cited by the administration is Martin T. Schechter of the University of British Columbia; he wrote us that “Our research here in Vancouver has been repeatedly used to cast doubt on needle exchange programs. I believe this is a clear misinterpretation of the facts.” Yet a third researcher cited by the administration is Julie Bruneau at the University of Montreal; she told us that “in the vast majority of cases needle exchange programs drive HIV incidence lower.” We asked Dr. Bruneau whether she favored needle exchanges in countries such as Russia or Thailand. “Yes, sure,” she responded.
When the Washington Post questioned the administration’s conclusions, a Bush official directed the paper to three researchers — all of whom believe the administration is pursuing the wrong course.