Congressional Record, Volume 144 Issue 50 (Wednesday, April 29, 1998)

[Congressional Record Volume 144, Number 50 (Wednesday, April 29, 1998)]
[House]
[Pages H2445-H2478]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

PROHIBITING THE EXPENDITURE OF FEDERAL FUNDS FOR DISTRIBUTION OF
NEEDLES OR SYRINGES FOR HYPODERMIC INJECTION OF ILLEGAL DRUGS

Mr. SOLOMON. Mr. Speaker, by direction of the Committee on Rules, I
call up House Resolution 409 and ask for its immediate consideration.
The Clerk read the resolution, as follows:

H. Res. 409

Resolved, That upon the adoption of this resolution it
shall be in order to consider in the House the bill (H.R.
3717) to prohibit the expenditure of Federal funds for the
distribution of needles or syringes for the hypodermic
injection of illegal drugs. The bill shall be considered as
read for amendment. The previous question shall be considered
as ordered on the bill to final passage without intervening
motion except: (1) two hours of debate on the bill equally
divided and controlled by Representative Wicker of
Mississippi or his designee and a Member opposed to the bill;
and (2) one motion to recommit.

The SPEAKER pro tempore (Mr. Blunt). The gentleman from New York (Mr.
Solomon) is recognized for 1 hour.
Mr. SOLOMON. Mr. Speaker, I would ask for every Member to turn on and
watch this debate, because it affects every child in this country and
every future child in the next generations to come.
Mr. Speaker, for the purposes of debate only, I yield half of our
time to the gentlewoman from Rochester, New York (Ms. Slaughter),
pending which I yield myself such time as I may consume. During
consideration of this resolution, Mr. Speaker, all time yielded is for
the purposes of debate only.
Mr. Speaker, I mentioned just a few minutes ago that I would wish
that every Member would either come to the floor or would listen to
this debate that is about to take place, because it does affect all of
my children, my grandchildren, all of your children, your
grandchildren, and future generations to come.
Mr. Speaker, this bill provides for consideration of H.R. 3717. It is
a bill to prohibit the expenditure of Federal funds for the
distribution of needles or syringes for the hypodermic injection of
illegal drugs under a closed rule. The rule provides 2 hours of debate
in the House, equally divided and controlled by the gentleman from
Mississippi (Mr. Wicker) and an opponent; and finally, the rule
provides one motion to recommit.
Now, Mr. Speaker, I say to my colleagues, this bill was introduced on
April 23 by myself, by the gentleman from Mississippi (Mr. Wicker), the
gentleman from Illinois (Mr. Hastert), the gentleman from Georgia (Mr.
Barr), and our majority whip, the gentleman from Texas (Mr. DeLay).
This legislation initiative and its counterpart in the Senate is a
proactive response to recent disturbing events in the Clinton
administration with respect to the needle exchange policy of the United
States.
In recent weeks, it was reported that the Department of Health and
Human Services Secretary Donna Shalala was going to ask the use of
Federal funds in a needle exchange program as an effort to halt the
spread of AIDS.
Now, Mr. Speaker, last Monday President Clinton, after I had
contacted Erskine Bowles, the Chief of Staff of the President,
President Clinton did not go along with that policy and changed his
mind. He endorsed the use of needle exchange programs while refusing to
allow Federal funds to be spent to subsidize it, and that is what this
bill does here today.
Mr. Speaker, the point is, illegal drug use in this country is of
critical importance to the health and to the safety of our entire
Nation, but especially our children. The Clinton administration's
endorsement of needle exchange programs is part of an intolerable
message to our Nation's children sent by the White House that drug use
is a way of life. Mr. Speaker, we cannot let that happen. This
legislation says once and for all that there is no way that this
government will take taxpayers' money and spend one penny of it to
support a deadly drug habit.
We have heard a lot of rhetoric recently about saving lives and
treating drug addiction by handing out free needles. Well, it is time
for this Congress to stand up once again and to deliver a resounding
message that drug use kills, and that the best way to deal with the
addiction is to never use drugs in the first place, just like Nancy
Reagan used to say when she was here, just say no. That is the message
we ought to be sending, not handing out needles to these people.
Hundreds of our children are falling prey to these killer drugs every
single day, and thousands of them are killing themselves.
According to studies by the President's own, this is President
Clinton's own Office of National Drug Control Policy, listen to this:
352 new young people try heroin every day, 352 more children, these are
children, not adults; with more than 4,000 deaths attributed to
overdoses every year. My gosh, what are we doing here?
Other studies have shown that drug use, and this is something I think
that all of my colleagues ought to listen to, drug use is the common
denominator in 75 percent of violent crime against women and children.
That means that 75 percent of all of the crime against our children and
our wives are drug-related.
Mr. Speaker, the bottom line is that needle exchange programs
increase illegal drug use, and that is what we have to pay attention to
in this debate. The evidence is absolutely clear. In 1986, in
Switzerland, the Swiss began experimenting with needle exchange
programs in an attempt to counter their drug problem. Within months, I
say to my colleagues, the distribution stations turned into chaos
centers. Needle exchanges grew to 15,000 per day in the major city in
Switzerland. One park opened for needle distribution became a war zone
between rival drug-dealing gangs, and that is true up in Montreal, it
is true in Vancouver, it is true in Amsterdam, Holland, and it is true
in the United States where there are needle programs.
Furthermore, the largest supporters of the Swiss needle exchange
program are vocal proponents, that means they are supporters of, a
nationwide heroin distribution program in Switzerland. In other words,
this is giving away free heroin. And what has this great experiment
given to this once wonderful country of Switzerland? Switzerland now
has the highest heroin addiction rate and the second highest HIV
infection rate in all of Europe.
And just across our border, as I just mentioned a minute ago,
Vancouver, Canada has one of the largest needle exchange programs in
the world. It has distributed over 1 million needles annually for the
last 10 years, 1 million needles annually.
According to a study by the Office of National Drug Control Policy
earlier this month, and this again is the President's own drug control
policy, the HIV rates among participants in this program are higher
than the HIV rates among injected drug users who do not participate in
the programs. There is proof positive if we are going to give away
these needles, we are going to increase heroin drug use. The death rate
due to illegal drugs in Vancouver has skyrocketed since 1988 when this
policy was first instituted, and during the month of March, the death
rate in Vancouver was averaging 10 deaths due to drugs per week, 10 a
week, deaths of a human being.
Furthermore, and this is, I think, so important, too, because some
people will probably come to this floor and say that they want to help
their neighborhoods by establishing these programs. Listen to this: The
highest rate of property crime in Vancouver are within two blocks of
these needle exchange distribution centers. In other words, they
attract the drug sellers, they attract the criminals. As the number of
needles exchanges grow, drug use rises, violent crime increases, and
more people died in Vancouver. These are absolute facts.
Mr. Speaker, needle exchange programs do not save lives, they destroy
lives. They destroy hope, they destroy opportunity, they ruin families,
and they ruin communities, and in some cases they are actually
destroying a Nation, like the Netherlands and like Switzerland. We
cannot let that happen in this country.

I urge all of my colleagues to stand with General Barry McCaffrey,
the President's drug czar, even though the President does not agree,
the Director

[[Page H2446]]

of the Office of National Drug Control Policy is, in his opposition to
these needle exchange programs, says it would be a disaster.
Mr. Speaker, what is even worse is the President, even though he took
our advice and said no Federal funds, but still supports the program,
he is opposing this bill simply by having Mrs. Donna Shalala out here
right now. I will bet that there are Members that are receiving phone
calls from her; even worse, they are receiving phone calls from the
Surgeon General Satcher, and he is making calls rights today in
Members' offices asking them to oppose this bill. Now, which way is it?
Is the President supporting our bill, or is he not, because of the
people that have worked for him who are out here trying to defeat him.
I urge all of my colleagues to reject the culture of heroin, which
brings only despair and destruction, and embrace hope and opportunity.
As elected officials we have a crucial responsibility right here in
this House to tell our children that drugs are not hip, they are not
cool, and I told my granddaughter that up at Saint Lawrence University
up on the Canadian border where they are subject to so many drugs
coming across that border every day now, it is turning into another
Mexico with drugs coming across.
We need to provide leadership on this issue where the White House is
missing. Drugs and crime kill and destroy families. Needle exchange
programs exacerbate these problems, and we can prevent that by
supporting this rule today which will bring to this floor the bill
which, when signed into law by the President, will prevent Federal
funds from funding these programs that are going to kill our children.
Mr. Speaker, I would ask Members who are interested in this debate to
come over to this floor. It is vital to our children.
Mr. Speaker, I reserve the balance of my time.
Ms. SLAUGHTER. Mr. Speaker, I thank the gentleman from New York for
yielding me the customary 30 minutes, and I yield myself such time as I
may consume.
(Ms. SLAUGHTER asked and was given permission to revise and extend
her remarks.)
Ms. SLAUGHTER. Mr. Speaker, I want to talk about process this
morning, because I think it is important. During my tenure here as a
Member of the House of Representatives, I chaired an organization
called the Organization on Study and Review, which set the rules of the
House. And since the beginning, the inception of this Republic, this
House has followed the rules. We set up the committee process because
we wanted a full and thorough airing of every bill that came to the
floor.
As the gentleman from New York (Mr. Solomon) has said, this bill was
filed last Friday. It has had no process at all. It has simply gone to
the Committee on Rules and directly to the floor, and, Mr. Speaker, it
is going on a closed rule. No hearings have been held. As I mentioned,
no committee action has been taken.

{time} 1045

Now, the unfortunate thing here is that the Committee on Rules
ignored the committee of jurisdiction. The ranking members of the
committee and the subcommittee of jurisdiction asked for an opportunity
to review, to amend, and to state their views on the legislation
through hearings, markup, and committee reports; the process, Mr.
Speaker, by which we operate. They were not allowed to have their
wishes heard.
Mr. Speaker, one may ask what new, unanticipated crisis has caused
the House to abandon its usual legislative process. Why do we have to
deal with this immediately without the opportunity for the Committee on
Commerce to examine the scientific and epidemiological facts that would
enable the House to make an informed decision? It may simply be that,
as usual, the House has nothing else to do. But in any case, these
questions remain unanswered.
This bill would merely continue the existing administration policy.
The rule is unusual in several other ways as well. The vast majority,
almost all of our rules allow for only one hour of general debate which
is controlled by the Chair and the ranking member of the committee or
subcommittee of jurisdiction. That is our process, again.
This rule allows two hours of debate controlled for the majority by a
Member who is not even on the committee of jurisdiction. The control of
the minority time is left to a Member ``opposed to the bill.'' The lack
of due process, the closed rule, its unusual provisions, and the haste
simply to confirm what is already current policy might lead a cynic to
believe that this debate is not designed to help Members make a
difficult choice about the best public health policy. No, this process
and this rule do not foster deliberation, but are more conducive to a
2-hour campaign sound bite designed to label political opponents as
less than vigorous in opposing illegal drug abuse.
Mr. Speaker, the Committee on Commerce and the full House should be
thoroughly considering how best to stop the spread of HIV infection,
not reaffirming a circumstance that already exists. The spread of HIV
continues to rise in this Nation.
But in addition to opposing this procedure, I have concerns about the
bill made in order by this rule. H.R. 3717 would place a permanent ban
on the use of Federal funding for needle exchange programs.
Last week, Health and Human Services Secretary Donna Shalala
announced that the administration would not, would not use Federal
funds for these programs. This decision was made in spite of the fact
that studies have demonstrated conclusively that needle exchange
programs reduce AIDS transmission and do not, do not encourage illegal
drug use.
This bill, Mr. Speaker, is a solution in search of a problem. The
Secretary has stated in no uncertain terms that the administration will
not use Federal funds for needle exchange programs, but here we are
today on the House floor taking up a bill that offers a ``me too''
response an already announced decision. With our budget resolution
already 2 weeks overdue, the House of Representatives should be using
Members' valuable time to consider pressing new business, rather than
reaffirming the status quo.
Mr. Speaker, I oppose this closed rule because it circumvents
thoughtful consideration on an important public health issue.
Mr. Speaker, I reserve the balance of my time.
Mr. SOLOMON. Mr. Speaker, I reserve the balance of my time.
Ms. SLAUGHTER. Mr. Speaker, I yield 2 minutes to the gentleman from
Ohio (Mr. Brown).
Mr. BROWN of Ohio. Mr. Speaker, I thank the gentlewoman from New York
(Ms. Slaughter) for yielding me this time.
Mr. Speaker, I rise to oppose the rule and to express my strong
opposition to the manner in which this legislation was reported to the
floor of the House for today's vote.
This legislation was referred to the Committee on Commerce. The
members of this committee, the Committee on Commerce, are entitled to
review, to amend, to express their views on legislation referred to the
committee through hearings, through markup, and through committee
reports. Unfortunately, the Committee on Commerce members, Republicans
and Democrats alike, Committee on Commerce members on both sides of the
aisle were denied this opportunity.
As the ranking member of the Subcommittee on Health and Environment
of the Committee on Commerce, I believe rushing this complicated and
controversial legislation to the House floor without proper review is
clearly at odds with the best interests of the House and ultimately the
American people. This body does not produce the best public policy in
the best interests of this Nation when we rush legislation to the floor
in this manner.
Mr. Speaker, the issue of needle exchange programs and whether they
help control the spread of HIV and AIDS or promote illegal drug use is
highly controversial. Experts from across the country are deeply
divided over this issue. Historically, needle exchange programs have
been the subject of deliberations by the Committee on Commerce and the
Subcommittee on Health and Environment.
In the 105th Congress, Mr. Speaker, neither H.R. 3717 nor comparable
legislation has been subject to any such review. For these reasons I
urge my colleagues, Republicans and Democrats

[[Page H2447]]

alike, because Republicans and Democrats alike were denied the
opportunity to discuss and amend and to talk about this legislation, I
urge my colleagues to oppose this rule and respect the regular order of
the House of Representatives.
Mr. SOLOMON. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I would say to the gentleman from Ohio (Mr. Brown), the
previous speaker for whom I have a great deal of respect, he is a fine
Member, but I do not think anybody knows more about the regular rules
of the House than this Member who has been here for 20 years. I can
almost recite this Bible, and perhaps some time the gentleman would
like to sit down and talk about it.
But let me tell the gentleman what regular rules are. This bill was
brought to the floor under regular rules. But what is even more
important is that the bill must be on the floor today because tomorrow
another life might be lost. Another life might be lost.
As far as public hearings on this, as far as the committee
jurisdiction is concerned, this bill was debated last year at length
with all kinds of hearings. A vote came on this floor and it passed 266
to 158. This is not a new issue coming to this floor. This is the same
issue. And over the last year we have had more and more children ages
12 and 13 who have now taken up a drug habit; 12 and 13 years old, and
there are even those that are 10 and 11 years old. And when we go a
little bit higher in the 14 and 15-year-olds, I urge Members to go into
their schools. Have they not done that? Do they not see what is
happening?
Mr. Speaker, I had a very prominent businessman come to me, and he
traveled a lot. He is a CEO of a company. Has a daughter who is an
eleventh grader, and now she is hooked and he did not even know it. And
we want to stand here and let needles be passed out to that girl? She
will not live another 6 months.
Mr. Speaker, that is what this debate is all about.
Mr. Speaker, I reserve the balance of my time, before I say some
things I should not, which I can do once in a while.
Ms. SLAUGHTER. Mr. Speaker, I yield myself such time as I may
consume, just to ask the gentleman from New York (Mr. Solomon), my
friend, what part of his book and Bible over there says we file them on
Friday and go to the floor on Wednesday. I would like to see it, if the
gentleman could cite that for me.
Mr. Speaker, I yield 3\1/2\ minutes to the gentlewoman from Texas
(Ms. Jackson-Lee).
(Ms. JACKSON-LEE of Texas asked and was given permission to revise
and extend her remarks.)
Ms. JACKSON-LEE of Texas. Mr. Speaker, I thank the gentlewoman from
New York (Ms. Slaughter) for yielding me this time.
Mr. Speaker, for the very reason that the gentleman from New York
(Mr. Solomon), my good friend, rises to the floor, I likewise rise in
opposition both to the rule and the complete unreal proposition that
this legislation offers. I also apologize to the American people for 3
hours of political infighting that this legislation suggests.
Mr. Speaker, I agree with both of my friends who have spoken before
me that, one, this is a bad rule, and in fact it is a bad rule because
it has not had a public hearing, it has not been considered before any
committee in the House, and it is being rushed to the floor under a
procedure which completely shuts out any amendments. That we can say is
true. It is a closed rule for a very vital and crucial discussion.
I think it is important when we discuss issues of importance to the
American people that we tell the truth as to what they want. I think
the American people want a Patient's Bill of Rights. They want the
ability to select their own physician, and yet that legislation is far
from coming to the floor of the House. They want, most of all, for us
to do a job that responds to their concerns.
Republicans and Democrats alike abhor the illegal use of drugs. All
of us have come to the floor of the House and regularly voted or
offered legislation to stem the tide of the devastation of drug use. We
cry with our constituents, we attend funerals we would like not to
attend, and we hope to God that some day we will be victorious.
This legislation is a travesty and a blight upon true medical
science, and it plays into the hands of those who would use the lives
of our children and those addicted for political purposes.
Mr. Speaker, this needle exchange program is not a program directed
toward children using drugs. It is directed toward known addicted
heroin addicts who through their use of dirty needles perpetrate, pass
on the devastation of HIV.
These programs are programs that are orderly and conducted under
medical precisions and medical procedures. These programs are combined
with telling and teaching these heroin addicts about stopping and
finding other ways and being treated. These programs are combined with
intervention and prevention. These programs are combined with health
care.
What are we saying to the HIV community? That we can pass funds on
one hand to say that we support the Ryan White bill, but we cannot face
reality? The Clinton administration's policy is a policy that I may not
agree with, but it is a policy that allows for existing and viable
programs to continue.
Mr. Speaker, this is legislation that is unneeded, redundant,
repetitious, political. It is not about saving lives. It is wrongly
here on the floor of the House. It is here without hearings. It is here
without assessment of the medical science.
Mr. Speaker, this is a bad rule. This is a bad piece of legislation.
I am going to err on the side of supporting saving lives, adult lives
who engage in this terrible dastardly use of illegal drugs. Support the
idea of using clean needles with supportive programs as well as
funding, but most importantly, let us vote down this devastating piece
of legislation that does nothing but kill Americans.
Mr. SOLOMON. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, let me respond to the previous speaker. The gentlewoman
from Texas (Ms. Jackson-Lee) is one of the most respected Members of
this body on the other side of the aisle. Certainly I know she speaks
from the heart, and reasonable people can disagree.
Mr. Speaker, the gentlewoman from the District of Columbia (Ms.
Norton) came to me and said, ``Jerry, I am going to have to oppose you
and I am going to be very, very emphatic about it.'' But she feels just
as the gentlewoman from Texas does, and I respect those feelings.
But let me just say that I do not believe we should be pitting one
constituency against another. I know we are all sincere in trying to do
something about this terrible, terrible problem. And let me give an
example of even why my constituency is at fault, a lot of them.
I mentioned before that 75 percent of all the crime against women and
children is drug-related. But what props up the price and what makes
this so terrible is that 75 percent of all the drug use in America
today does not come from the inner cities, it does not come from the
constituency of the gentlewoman from Texas. It comes from suburbia.
I am so ashamed to say that the upper middle-class people who use
drugs recreationally on the weekend, this is where 75 percent of the
drug use is. They are what causes these territories to be developed in
the inner cities, because they drive their Pontiac Firebirds that cost
more money than I can afford into the inner cities and buy these drugs,
and take them back out and say it is okay to sniff a little cocaine on
the weekend. We do not do it all the time, so we are not addicted. We
are going to smoke a little marijuana. So my constituency is at fault
the same as that of the gentlewoman from Texas, and maybe mine even
more so.
Ms. JACKSON-LEE of Texas. Mr. Speaker, will the gentleman yield?
Mr. SOLOMON. I yield to the gentlewoman from Texas.
Ms. JACKSON-LEE of Texas. Mr. Speaker, first of all I know that I
have already acknowledged my sadness in the exciting retirement
announcement made by the gentleman from New York (Mr. Solomon)
yesterday. We have worked together, and I do appreciate the point that
the gentleman made about pitting constituencies against each other.

[[Page H2448]]

I will just close with this. We have both, Republicans and Democrats,
risen at any different time to fight against illegal drugs.
Mr. SOLOMON. Yes.
Ms. JACKSON-LEE of Texas. Mr. Speaker, I would raise the concern, the
gentleman mentioned cocaine and marijuana. The needle exchange
specifically focuses on the dastardly use of heroin by addicted
persons. My concern is on this legislation, that I have, and maybe also
in suburbia, many individuals who, and let me just say in the inner
city, who would benefit from the program. We are specifically talking
about a clean needle which ultimately may result in the passage or the
transmitting of HIV.
Mr. Speaker, I do welcome the gentleman's point about not pitting
constituencies against each other. I hope we do not. And I look forward
to working with the gentleman.

{time} 1100

Mr. SOLOMON. Mr. Speaker, I thank the gentlewoman. Again I have great
respect for her.
Mr. Speaker, I am using up all of our time over here, but let me
yield such time as he might consume, and I hope it is not more than 4
or 5 minutes, to one of the outstanding orators of this body, the
gentleman from Ohio (Mr. Traficant).
Mr. TRAFICANT. Mr. Speaker, I thank the chairman for yielding to me.
And I, too, as the gentlewoman from Texas (Ms. Jackson-Lee) has stated,
am sad to hear about the gentleman from New York leaving us and shocked
a little bit.
America is overrun with narcotics, and I am trying to figure Congress
out. I was a sheriff, and I ran the drug treatment program for 11
years. So help me, God, if there is any common sense left, I cannot
find it.
Well, 70 percent of our narcotics, heroin, cocaine, come across the
Mexican border, and Congress allows the Mexican border to be
technically wide open. And out of frustration to stop all of this, now
there are those that want free needles to stop the spread of AIDS.
Unbelievable.
Every study shows that free needles produce and perpetuate more
dependence, more overdose, more violence, more despair, but out of
frustration, Congress is willing to try anything but some common sense.
Tons and tons of heroin and cocaine are coming across the border, and
we are debating free needles.
But it takes me back to something else here. Over the years, if
anybody is watching this debate or really cares, and they do, we allow
Communists to work in our defense factories. The Constitution, they
say, ensures that mass murderers shall have law libraries, free condoms
to protect us from all this elicit sex, and now free needles to combat
this great problem.
But after all of this, many people say the Constitution says no
school prayer is allowed. Condoms, drugs, needles, Communists, that is
all okay when stretched under some code of the Constitution, but school
prayer is not. Is it any wonder we are so screwed up in America and we
are so overrun with narcotics?
I believe we have so many do-gooders around here that they have
abused the Constitution to the point where our country is limping into
the next century, literally. I believe these do-gooders mean well, but,
in my opinion, they have no common sense, and they are so dumb, if they
throw themselves on the ground, they will miss the floor.
I say America would be better off with school prayer and without
condoms and needles. And if we do not get back to a little common
sense, I do not know what is left. But if we want more addiction, more
violence, more dependence, then go ahead with free needles, because
those addicts that are out there now will not even be responsible to
return the needles they are using now. They will continue to
irresponsibly share needles provided by the government.
I do not normally support closed rules, but I support the rule. I
support the bill. I would like to stand up for a little bit of common
sense if there is anything left under such guise in our country.
Ms. SLAUGHTER. Mr. Speaker, I want to comfort my friend, the
gentleman from Ohio (Mr. Traficant), to remind him that there will be
no Federal money being used for needle exchange. What we are doing this
morning is simply restating the obvious.
Mr. Speaker, I yield 5 minutes to the gentlewoman from the Virgin
Islands (Ms. Christian-Green).
Ms. CHRISTIAN-GREEN. Mr. Speaker, I would like to thank the
gentlewoman from New York for yielding me this time.
Mr. Speaker, I rise to oppose the rule and bill, H.R. 3717. I
consider it a privilege to be a Member of this august body, as I
represent the Virgin Islands. It is truly a pleasure to serve with you
and my colleagues.
I must admit, however, to one recurring frustration, and that is that
too often research findings, even scientific or social, do not dictate
or influence our policies or our legislation.
Mr. Speaker, this is unacceptable, which brings me to H.R. 3717. The
time has come to stop fighting the war against AIDS on the altar of
political correctness and treat this disease as the public health
crisis that it is. The reality is that our people are dying, and they
are dying in epidemic numbers.
Among women and children with AIDS, African Americans and Hispanics
have especially been affected, representing approximately 75 percent of
cases reported among women and more than 80 percent of cases reported
in children. And 63 percent of all AIDS cases among women are related
to sharing needles and syringes for the injection of drugs or through
sex with an intravenous drug user.
Mr. Speaker, we know that needle exchange programs can reduce HIV
infection by more than 30 percent, and that making available clean
needles is an important part of a broader-based strategy to reduce HIV
infection and deaths from AIDS. Other important factors which also must
be addressed are improved and effective prevention strategies and
increased access to treatment.
While it has never been shown that providing clean needles encourages
drug abuse, what we do know is that drug addicts or drug-addicted
individuals who are not under treatment will not stop using drugs just
because sterile needles are unavailable. They will simply continue to
use contaminated and often infected needles, continuing to infect
innocent women and children.
In 1995, the cost of treating the 25,000 cases of needle- or syringe-
sharing related AIDS cases was more than $3 billion. Hundreds of
millions of dollars are spent on mindless ads against drugs and AIDS,
which will be ineffective, while, by comparison, a fraction of those
dollars will support a program that has been unequivocally proven
effective at preventing HIV/AIDS transmission.
Mr. Speaker, we represent all of the American people and are sent
here to protect and serve their best interest. We have an obligation to
do what we know can save lives when we know that those women and
children are at risk.
As a physician and former public health official, I am compelled to
support the use of Federal programs for needle exchange, and I would
urge all of us to do so. But if we do not fully understand the issue or
have concerns about these programs, or even if we disagree, there is
one thing we should all be able to agree on, and that is amending the
Public Health Service Act is a serious matter and must not be done
hastily without having been given due consideration by the committee of
jurisdiction.
My colleagues, I plead with you to be guided by sound scientific
research and the thinking of our best public health minds, not
politics. Let us value the lives of all Americans, oppose the rule, and
vote no on H.R. 3717.
Ms. SLAUGHTER. Mr. Speaker, I yield 5\1/2\ minutes to the gentleman
from New York (Mr. Rangel).
(Mr. RANGEL asked and was given permission to revise and extend his
remarks.)
Mr. RANGEL. Mr. Speaker, first let me join those who regretted to
hear the leaving of this battlefield from one of our great warriors,
someone that speaks his mind and has very strong convictions.
Mr. Speaker, I was interested in identifying to the gentlewoman from
Texas (Ms. Jackson-Lee) where we are finding so much abuse in the white
middle-class suburban area. I remember, over

[[Page H2449]]

35 years ago, I was trying to convince people in America that drugs
would not be confined to the inner city, that we cannot just identify a
minority group because they are poor and hopeless and think that the
profiteer people would not enlarge their market.
For those who want to say that this Nation has not done enough to
deal with this devastating problem, which I think is a threat to our
national security, I am certainly prepared to join hands with those
Republicans and Democrats to do just that.
We cannot go into this next century having a million and a half
people locked up in jail where 80 percent are there because it is a
drug-related crime. I think I share in the sentiments of most people to
believe that we have to resort to the distribution of sterile needles
to deal with a health crisis that we have in this country.
The gentleman from New York (Mr. Solomon) and I may agree that we are
not tackling this problem the way that we should, but just saying no,
just saying no is not even looking for a solution to this problem. If
we wanted to find out whether or not the support of Federal-supported
needle exchange is going to increase the problem, if we wanted to find
out does it really decrease the spread of HIV, if we want to find out
whether lives could be saved, whether Federal dollars could be saved,
whether this terrible and tragic disease could be held back, we do not
do this with a resolution, we do these things with hearings. We search
for the truth. We do not ask Members just to say no.
There are a lot of answers that we are searching for, but to ask
Members to come to this floor just to direct that our Federal
Government defy all scientific evidence before we have had an
opportunity to weigh it, and when we know that we are talking about the
saving of lives, if we are wrong, how many lives will be lost? They are
doing this anyway. Our soul would not be any more cleansed if this
thing passes than if we waited to see what the results are going to be.
But what I am afraid is happening is that this is not a legislative
body that we are dealing with anymore. This is a campaign committee. It
is how many issues can we vote on to determine how we stand on
something.
One of the major issues that we are facing today is getting rid of
the IRS, pulling up the Code by its roots. But when it comes to
legislation, what we vote on is a supermajority in order to increase
taxes.
One of the major issues we have today is whether or not the Social
Security system is going to be strong enough for our children and our
children's children. What are we voting on today? To have some horse
and pony show run around the country and discuss the issue.
One of the serious issues we have today is whether or not drug
addiction is going to expand, whether or not we can control AIDS,
whether or not people can live, whether or not people can die, and
whether or not the distribution of needles can save lives. Are we going
to study this? Are we going to have hearings? Are we going to have the
experts in? Are we going to have the scientists in? Or do we just say
no?
I wish this issue had not come before this floor in this present
body, because what we are saying is that we do not trust the United
States Congress. We do not trust Democrats. We do not trust
Republicans. We do not trust committees. We do not trust subcommittees.
Why? Because the Committee on Rules knows best.
Did the Committee on Rules have hearings? Did the Committee on Rules
bring in experts? Did the Committee on Rules know that we are not
talking politics? The people that have taken to this floor trained in
medicine are talking about lives and not talking about drug policy.
We say we do not want to divide groups. The only way that we can
avoid this, and I believe the gentleman from New York is sincere, is
that we say that the appropriate committees study this issue and report
back to the House of Representatives. With all due respect to the
Committee on Rules, it is not a legislative body. It has not had
hearings. This issue is too serious just for us to say no.
Mr. SOLOMON. Mr. Speaker, would you identify the amount of time
remaining for each side.
The SPEAKER pro tempore (Mr. Blunt). The gentleman from New York (Mr.
Solomon) has 12 minutes remaining. The gentlewoman from New York (Ms.
Slaughter) has 11 minutes remaining.
Mr. SOLOMON. Mr. Speaker, I yield myself such time as I might
consume.
Mr. Speaker, I do say to my good friend, the gentleman from New York
City, New York (Mr. Rangel), I mentioned earlier that I have great
respect for the gentlewoman from Texas (Ms. Jackson-Lee) and the
gentlewoman from the District of Columbia (Ms. Norton). If it is
possible, I have even greater respect for that gentleman. The gentleman
from New York knows it.
The gentleman from New York and I disagree on many things, but we
listen to each other. I listened to him back in 1990 when I read the
U.S.A. Today on November 8 when my good friend the gentleman from New
York (Mr. Rangel) said our goals should be to eliminate drug abuse, not
to find a cleaner, safer way to do it.

{time} 1115

Sure, IV drug abusers put themselves at risk of AIDS through sharing
needles, and certainly we want to slow its spread, but there are better
ways than giving addicts needles to do their drugs.
And the gentleman, I know times change and I know he still feels that
way, but, again, there are probably reasons why he might feel a little
differently today. But he is absolutely right. We cannot just say no.
That does not accomplish it all. We still have to have a Federal policy
of interdiction to stop these drugs from coming across the borders
wherever, and he has been a leader on this, Mr. Speaker. We have to
have an education program, and we have to have a treatment program.
So it is not, just say no. The gentleman is so right. It takes a lot.
But at least we ought to be focusing and setting the example here in
this Congress and not using the Federal dollars, as he stated back in
1990.
Mr. Speaker, I yield 3 minutes to the distinguished gentleman from
Athens, Georgia (Mr. Kingston).
Mr. KINGSTON. Mr. Speaker, I thank the chairman of the Committee on
Rules, the gentleman from New York (Mr. Solomon) for yielding me this
time; and I rise in support of the rule.
I really and truly believe that needle exchange programs are an
unintended, very cruel thing to do to addicts. I believe it is the
equivalent of giving an anvil to a drowning man and saying, well, here
is something to stand on; maybe you can get your head above the water.
I think the Democrats basically feel this way, despite the rhetoric
we hear today. Because they really do not want to fund needle exchange
programs. And, as they know, President Clinton does not want to either.
So to say that needle exchange programs have a consensus among the
Democrats is probably wrong, too.
There is a lot to be discussed here. Let us look at the Vancouver
case. Now, the Vancouver needle exchange program started 10 years ago.
They have given out, since that time, millions and millions of needles,
in fact, two-and-a-half million needles last year alone. During that
period of time, HIV, among participants, is higher than the HIV rate of
those who do not participate. The death rate has skyrocketed.
In 1988, in Vancouver, there were about 18 drug-related deaths. In
1993, there were 200 drug-related deaths. In terms of property crime,
in the two-block area around the needle exchange program, Vancouver has
the highest property crime rate in the whole city.
Does it work? I would say, well, maybe we cannot just prove
everything because of the dismal Vancouver results, but the fact is
that surely this scares people and gives us cause for alarm.
The administration is very obsessed with tobacco. There are a lot of
good ways, and there is the bill of the gentleman from Georgia (Mr.
Sanford Bishop) that I think would greatly reduce teen tobacco usage.
But the administration and the Democrats are not talking about the
Bishop Democrat bill because it does not raise money.
What the tobacco debate still seems to be about is putting a tax on
America's working poor and creating 17 new

[[Page H2450]]

Federal Government agencies with hundreds of Washington bureaucrats who
can run our lives. That is why the Democrats seem to be obsessed with
tobacco.
And while I am very concerned about it and while I think the Bishop
bill has a lot to offer and I do plan to support it to crack down on
teen smoking, what is interesting is that the Democrats really are not
interested in that. They are just interested in growing the government
and raising taxes, and because of that they have ignored the drug
problem.
During the Clinton administration, albeit teen smoking rates have
gone up, drug usage rates have gone up a lot more. During that period
of time, convictions have gone down. We need, as we crack down on the
drug use and get active in the drug war, we need more convictions, we
need more interdiction, and we need more treatment.
Let me close with this sentence from the head of the Vancouver-
Richmond Health Board who said, ``I can have all the needles I want,
but they won't give me a single drug treatment bed.'' If we want to
help people who are addicted to these horrible drugs, we need to give
them treatment, not free needles.
Ms. SLAUGHTER. Mr. Speaker, I yield myself such time as I may consume
to add to the litany of things mentioned by the gentleman from New York
(Mr. Rangel) that we wish we were doing on the floor of the House.
I have a piece of legislation to protect every American from loss or
exorbitant costs of health insurance because of their genetic makeup.
It has almost 200 sponsors in this House, bipartisan, over 100 outside
groups that collectively represent a third of the American population,
yet I cannot even get an answer from the committee chair to give us a
hearing. But, nonetheless, the process has gone by the way; and today
we are doing what we are doing.
Mr. Speaker, I yield 3 minutes to the gentlewoman from California
(Ms. Eshoo).
Ms. ESHOO. Mr. Speaker, I rise in opposition to the rule and to the
Solomon bill which would permanently prohibit Federal funding for
needle exchange programs.
First, let me say that I am deeply disappointed with the
administration's recent decision not to restore Federal funding for the
program, and I hope in the future the administration will listen to the
scientific community, the public health experts that have spoken so
eloquently because of the studies that have clearly demonstrated that
lives are being saved and more lives can be saved by funding the
program.
This legislation that we are debating today would end any hope that
this decision could ever be corrected. As the AIDS epidemic continues,
we have to continue to support efforts by local authorities. There has
been so much talk in this Congress that we should pay attention to what
is going on in the States and in local government. Well, they have
demonstrated by the implementation of the needle exchange programs that
they use all the prevention methods that are available and that this is
prevention. It helps to prevent the spread of this dreaded disease and
save lives.
Numerous scientific studies demonstrate that needle exchange is
effective in preventing HIV infection amongst drug users, their spouses
and their children. And this group today now represents nearly 50
percent of new HIV infections. In more than 50 cities, needle exchange
programs operate on shoestring budgets, and many are run by volunteers.
Despite these difficulties, the programs have been largely effective in
reducing the spread of AIDS.
Now, what has not happened, what has not happened, and I think this
is very important for us to state this, because it has been documented,
it has not demonstrated a use of more drugs. That is not the case. Very
easy to come to this floor and use inflammatory language and say that
this is going to increase the use of drugs. It is not what has been
demonstrated at all.
But there are those that would come to the floor under the guise of
being tough on drugs and crime and state that that is the case. It is
not.
The studies demonstrate that needle exchange does not lead to
increased drug use among participants in the programs, does not
increase crime, and does not encourage first-time drug use.
One of my colleagues came to the floor and said that all common sense
has been lost. I was taught that the most uncommon of the senses is
common sense. It is very easy to come here and rail. It is another
thing to have read the studies by some of the leading scientific
experts in our country.
So I come to the floor today, really, on an issue that I know can be
used against some Members of Congress that would have the courage to
come here and say that needle exchange does work. We can indeed save
lives. It is the right thing to do.
Do not allow politics to come before science. I ask my colleagues to
vote against the rule and the bill.
Mr. SOLOMON. Mr. Speaker, I yield myself such time as I may consume
to note that the gentlewoman from California's comment that the Solomon
bill prohibiting Federal funds being used for needle exchange programs
is permanent is true. It sends the very strongest message that we can
that we do not want to encourage the use of drugs.
However, any law is only as permanent as this Congress wants it to
be. Day after tomorrow, this Congress could change its mind and pass
another law making it legal. So I wanted to make that point.
Mr. Speaker, I yield 3 minutes to the gentleman from Kentucky (Mr.
Whitfield).
Mr. WHITFIELD. Mr. Speaker, I want to thank the chairman of the
Committee on Rules for bringing this bill to the House floor and
particularly for this rule, because I think it is important that we
have an opportunity to debate one of the leading causes of crime in
America today and that is the use of illegal drugs. We have seldom an
opportunity to debate this, and I am delighted that the gentleman has
this measure on the floor today.
I find it ironic that the Clinton administration and many on the
other side of the aisle spend most of their time talking about reducing
teenage smoking, and that is very important, but that is not the
immediate threat to young people today as is the use of illegal drugs.
As far as scientific studies and experts, I would just like to read
an article from the New York Times which is quoting Dr. James Curtis, a
professor of psychiatry at Columbia University's medical school,
relating to needle exchange, which many people on the other side of the
aisle want to advocate.
He says,

For the past 10 years, as a black psychiatrist specializing
in addiction, I have warned about the dangers of needle-
exchange policies, which hurt not only individual addicts but
also poor and minority communities. There is no evidence that
such programs work. An addict is enrolled anonymously,
without being given an HIV test to determine whether he or
she is already infected. The addict is given a coded
identification card exempting him or her from arrest for
carrying drug paraphernalia. There is no strict accounting of
how many needles are given out or returned. And the studies
found that those addicts who took part in such exchanges were
two or three times more likely to become infected with HIV
than those who did not participate.

So I would send a challenge to this administration and our friends on
the other side of the aisle. Let us get serious about the real problem
facing the youth of today. It is not so much teenage smoking as it is
the use of illegal drugs.
Once again, I commend the chairman for bringing this issue to the
floor.
Ms. SLAUGHTER. Mr. Speaker, I yield 5 minutes to the gentleman from
California (Mr. Waxman).
Mr. WAXMAN. Mr. Speaker, as I listen to the debate, I wondered why do
we have this bill up at this moment? There is no urgency, except for
the fact that we read last week that the number of HIV infections is
going up, even as more people with AIDS are living longer because of
drug therapy. Today, we are not spending Federal dollars for needle
exchange programs, although some people think it might be a good public
health strategy to reduce the spread of AIDS.
Ordinarily, when we get people saying a policy is worthwhile and
others saying it is not, we would hold hearings and we try to find out
the truth. But this bill is being brought up without the committee that
has jurisdiction holding any hearings, without hearing from the Surgeon
General, the American Medical Association, and the

[[Page H2451]]

public health community to learn the truth. This bill is being brought
up now, it seems to me, for political reasons.
What would be the political reasons involved? Well, it is always
great politics for someone to say they are against drug addiction. We
can all say that. We are all against drug addiction. But there is
another political reason. It seems to me that if I were part of the
Republican leadership and my party had received millions of dollars
from the tobacco companies, I would want to change the subject. I would
want to talk about drugs. It is an important issue, but it is not being
handled in a responsible way that an important issue should be handled.
I would want to talk about how the Administration is trying to go
after kids and tobacco and also want to talk about drug abuse. Of
course, today's debate is not about drug abuse and kids. This is about
HIV and drug abuse prevention programs that work, not with Federal
funds but at the local level.
So I think that the American people ought to understand what is going
on here today. If I were going to try to take people's minds off the
fact that over 450,000 people die each year in this country from
smoking-related diseases, while only a fraction of that number of
people die from illicit drug use. Tobacco is such an enormous problem,
that I would try to minimize that problem by trying to change the
subject.
If we are going to do a scientific evaluation of needle exchange, we
ought to ask the people who know about it to give us some guidance. The
Secretary of Health and Human Services has done that, and she concluded
that needle exchange programs lead IV drug users into drug treatment
programs to rid themselves of drug addiction.

{time} 1130

This is a very worthwhile result. But she also said that the National
Institutes of Health that have looked at needle exchange and determined
that it has reduced not only the incidence of illicit drug use, but
reduced the spread of HIV infection.
Congress wrote a law that was responsible for this evaluation. We
said we do not want any Federal funds to be used for needle exchange
programs unless we can be clear that it is not only a good strategy to
stop the spread of HIV, but it is also going to discourage, or at least
not encourage, the use of illegal drugs. And if there were a positive
finding on both of those areas, Federal funds could be then available.
The Secretary made a finding that both circumstances apply to these
needle exchange programs; yet the administration's position is no
Federal funds still would be permitted.
So why do we have this bill up today? This bill says no matter what
we learn from experiments, we will never allow federal funding of
needle exchange programs. Why should we take that kind of position? Why
should we determine forever what the policy will be, especially in the
face of so much evidence that is extremely effective in stopping the
spread of HIV and also in discouraging people from using illegal drugs?
The regular order of Congress should be to permit the committees that
have jurisdiction and Members that have knowledge, to hold hearings and
evaluate these issues. What we are being told today is to pass a rule,
to take it away from the committee, to have no hearings, to not think
about the issue beyond a few slogans and cliches, and to immediately
pass a bill so we can go home and claim we have done something, when in
fact no real-world result will come from our efforts.
The SPEAKER pro tempore (Mr. Blunt). The gentlewoman from New York
(Ms. Slaughter) has 2\1/2\ minutes remaining, and the gentleman from
New York (Mr. Solomon) has 5 minutes remaining.
Mr. SOLOMON. Mr. Speaker, before I yield, let me just say to my good
friend, the gentleman from California (Mr. Waxman) that I have great
respect for him. I am surprised, though, that he brought the politics
into the debate. We have tried to keep this on the highest plane, and I
commend all the Members for having done so.
Mr. Speaker, I yield 2 minutes to the very distinguished gentleman
from New Jersey (Mr. Pappas), a new Member of this body.
Mr. PAPPAS. Mr. Speaker, I thank my friend the gentleman from New
York for yielding me the time.
My colleagues, America is watching. This debate is probably one of
the most significant debates that we will be having, because the future
of our young people are so dependent upon the drug culture in our
country.
Members of this body meet with children. I do. Just as I was walking
into this building just a few moments ago, there were four or five
Members speaking with young people from their districts. When I
interact with the young people from my district, I ask them a question:
``What are the issues that you are most concerned about?''
Nine out of ten speak to me about their concern for drugs and the
drug culture that they are facing and that we all are exposed to of the
illegal drugs. They talk about how quickly they can purchase it if they
choose to. They talk about how they do not understand how the system
does not seem to support efforts to cut down on drug usage and to
punish those that are using drugs. They are frustrated that their
teachers and school administrators do not seem to have the support of
the system, as they put it, to discipline those young people who are
undertaking drug usage and dealing with it.
Today there are 10 young people who are members of the 4-H program
from my district that I am going to have lunch with in just less than
half an hour, and I am going to speak to them about this debate and
encourage them to be a part of it, as so many young people are.
Mr. Speaker, this is a mixed message that we are sending to our
country, and I applaud the efforts of my colleagues in this House to
bring this resolution forward. We owe it to our young people.
Ms. SLAUGHTER. Mr. Speaker, I yield 1\1/4\ minutes to the gentleman
from Washington (Mr. McDermott).
Mr. McDERMOTT. Mr. Speaker, the issue here today is whether or not we
are going to make decisions on the basis of science, or are we going to
have the politics of gesture.
Now, there is clear evidence that the program that has been operating
in the Northwest for the last few years has been very effective. And,
in fact, the article by the authors from British Columbia that is
widely quoted as saying the needle exchange does not work contains the
sentence that says, ``The authors must point out that the officials who
have used this information have misrepresented our research.''
The fact is that in the Northwest, it is operating in nine counties.
The AIDS infection rate in Seattle and Tacoma is 3 percent among drug
addicts; whereas, in the South and in the East, in New York City and in
other places, it is between 20 and 30 percent. There is clear evidence
that this is effective in reducing the infection rate.
Mr. Speaker, I include for the Record the following article that
appeared in the New York Times today called ``The Politics of Needles
and AIDS'' and also an article in the Seattle Post Intelligencer by the
Superintendent of Public Instruction, Judith Billings:

[From the New York Times, Apr. 9, 1998]

The Politics of Needles and AIDS

(By Julie Bruneau and Martin T. Schechter)

Debate has started up again in Washington about whether the
Government should renew its ban on subsidies for needle-
exchange programs, which advocates say can help stop the
spread of AIDS. In a letter to Congress, Barry McCaffrey, who
is in charge of national drug policy, cited two Canadian
studies to show that needle-exchange plans have failed to
reduce the spread of H.I.V., the virus that causes AIDS, and
may even have worsened the problem. Congressional leaders
have cited these studies to make the same argument.
As the authors of the Canadian studies, we must point out
that these officials have misinterpreted our research. True,
we found that addicts who took part in needle exchange
programs in Vancouver and Montreal had higher H.I.V.
infection rates than addicts who did not. That's not
surprising. Because these programs are in inner-city
neighborhoods, they serve users who are at greatest risk of
infection. Those who didn't accept free needles often didn't
need them since they could afford to buy syringes in
drugstores. They also were less likely to engage in the
riskiest activities.
Also, needle-exchange programs must be tailored to local
conditions. For example, in Montreal and Vancouver, cocaine
injection is a major source of H.I.V. transmission. Some
users inject the drug up to 40 times a day. At that rate, we
have calculated that the two cities we studied would each
need 10

[[Page H2452]]

million clean needles a year to prevent the re-use of
syringes. Currently, the Vancouver program exchanges two
million syringes annually, and Montreal, half a million.
A study conducted last year and published in The Lancet,
the British medical journal, found that in 29 cities
worldwide where programs are in place, H.I.V. infection
dropped by an average of 5.8 percent a year among drug users.
In 51 cities that had no needle-exchange plans, drug-related
infection rose by 5.9 percent a year. Clearly these efforts
can work.
But clean needles are only part of the solution. A
comprehensive approach that includes needle exchange, health
care, treatment, social support and counseling is also
needed. In Canada, local governments acted on our research by
expanding needle exchanges and adding related services. We
hope the Clinton Administration and Congress will provide the
same kind of leadership in the United States.
____

[From the Seattle Post-Intelligencer]

Needle Exchanges Help Stem Flow of AIDS/HIV

(By Judith A. Billings)

As a woman living with AIDS, I am angry that our
government's silence on needle exchange programs has led to
new HIV infections and needless human suffering. I am angry
because politics, not sound public policy, continue to block
needle exchange programs that could save thousands of lives.
The statistics are too grim to ignore. Every day, 33
Americans contract HIV through injection drug use. More than
half of all new HIV infections occur among injection drug
users, their partners and their children. According to the
Centers for Disease Control, an estimated 85 percent of new
AIDS cases among heterosexuals, and 66 percent of the cases
among women, were linked to injection drug use. The
overwhelming majority of children born with HIV infection
have a parent who injected drugs.
Across the nation, communities of color bear an
overwhelming share of the burden, with injection drug use
representing nearly half of all new HIV infections among
African Americans and Latinos. We cannot allow that to
continue.
As a member of the President's Advisory Council on HIV/AIDS
and as chairwoman of our state's Governor's Advisory Council
on HIV/AIDS, I join other advocates in calling for the
removal of federal restrictions on funding for needle
exchange programs. Scientific evidence, backed by the
American Medical Association and the American Public Health
Association, demonstrates that needle exchange programs
prevent the spread of HIV without contributing to drug use.
President Clinton and Health and Human Services Secretary
Donna Shalala have the ability to advance the policy debate
by publicly supporting needle exchange programs. Shalala
should exercise her authority to declare that the programs
meet congressional eligibility requirements for federal
funding: Needle exchange helps prevent HIV infections and
does not increase drug use. Five federally funded studies
have recommended removing the ban on federal funding for
needle exchange programs. The scientific evidence mandates
such a move.
Yet the Clinton administration is divided from within on
the issue. A public battle has developed, pitting two of
Clinton's respected advisers. Sandra Thurman, the White House
director of national AIDS policy, is the first person in her
position to publicly call for the removal of the ban on
federal funding for all needle exchange programs. She knows
that thousand of injection drug users, their partners and
their children have died unnecessarily as a result of current
policy.
On the other side, Gen. Barry McCaffrey, director of
national drug policy, maintains that needle exchange
programs send a message of tolerance to young people and
are contrary to our nation's war on drugs. That is refuted
by a National Institutes of Health research panel,
convened at the request of Shalala, who found that needle
exchange programs do not increase and may, in fact,
decrease drug use. The misguided belief that exchanging
sterile needles for contaminated ones will encourage young
people to use drugs continues to drive the spread of HIV.
Needle exchange also reduces the financial cost of the AIDS
epidemic. Health officials estimate that by preventing just
one HIV infection, a needle exchange program saves taxpayers
$119,000 in medical costs. The programs saves lives and
financial resources. But needle exchange programs are not
available everywhere, with the consequence of placing
thousands at risk for HIV infection.
Washington state has led by example. Our state is home to
the first needle exchange program in North America. Local
public health authorities, working with community-based
organizations, embraced needle exchange programs as one tool
in a comprehensive HIV-prevention strategy. Needle exchange
programs now operate in eight Washington counties, serving
most metropolitan areas. The programs are credited with
keeping the percentage of HIV-positive injection drug users
in Washington lower than in regions that waited to establish
needle exchange programs. In Seattle and Tacoma, less than 3
percent of injection drug users are estimated to be HIV-
positive, compared to 20 percent to 30 percent in some East
Coast and Southern cities.
I applaud local public health authorities and community-
based organizations for allowing science, rather than
political rhetoric to dictate policy on needle exchange. Our
state has saved thousands of lives and has helped hundreds of
addicts seek drug treatment. Given this success, our state's
congressional delegation should lead the effort to ensure a
full federal-state partnership in the fight against AIDS.
Other states and communities deserve the opportunity to
prevent new infections through needle exchange programs. Our
communities need to send one clear message to Congress and
the Clinton administration: Immediately remove federal
restrictions on funding for local needle exchange programs.
Today, 33 of our friends, neighbors, co-workers and
children will wish we had done so earlier.

Ms. SLAUGHTER. Mr. Speaker, I yield 1\1/4\ minutes to the gentlewoman
from the District of Columbia (Ms. Norton).
Ms. NORTON. Mr. Chairman, I thank the gentlewoman for yielding me the
time.
I ask fervently for the defeat of this provision based on its
wording: ``Directly or indirectly,'' it says. That is a virtual death
sentence, especially for black and Hispanic men, women, and children,
who, in hugely disproportionate numbers, are dying of AIDS, and the
science tells us now that this is needless.
A third of all AIDS cases come through needles. We are setting a
terribly dangerous precedent here. The Committee on Appropriations
said, let us not do something dumb. Let us ask the world-class
scientific investigators.
Now they have asked, and they have heard the answers. Three criteria
we said had to be met: No spread of drugs, no spread of AIDS, and save
lives. They tell us, dramatic saving of lives. NIH, NAS, GAO. And the
most that Mr. McCaffrey, who should resign, can think to do is try to
pick off members of the Black Caucus, who rise, almost all of us, to
say that indeed this disease which is spreading (and it is the leading
killer in our community) can, in fact, be eradicated if we can get to
the hard-core addicts, clean needle for dirty needle, until we finally
lure them into treatment.
Do not vote for death in our communities. Vote for the science. Do
not say, look, give us the facts, and then say, we do not want to be
confused by the facts, we choose death.
The SPEAKER pro tempore. The gentleman from New York (Mr. Solomon)
has 3 minutes remaining.
Mr. SOLOMON. Mr. Speaker, I yield myself the balance of my time.
Again, the gentlewoman from the District of Columbia (Ms. Norton) was
not on the floor when I heaped praise on her and told the body how much
I thought of her; and I really do.
But Mr. Speaker, Members have come to this floor, I guess, all from
that side of the aisle, and I do not try to play politics in saying
that, but like Mr. Waxman before, he has asked for a delay of this
bill, and he asked what is the urgency; and my colleagues, the urgency
is that one more child should not be hooked on drugs. It is so, so
pathetic.
Let me just read the bill. It is a one-paragraph, simple bill. It
does not require a lot of hearings. Everyone knows how they are going
to vote on this bill. It says, ``Notwithstanding any other provision of
law, none of the amounts made available under any Federal law for any
fiscal year may be expended directly or indirectly to carry out any
program of distributing sterile needles or syringes for the hypodermic
injection of any illegal drug.''
Mr. Speaker, first of all, it is a fact, the exchange needle programs
increase drug use. Go with me to any city, any area in any city in the
United States or in this world, in Amsterdam, in Switzerland, in
Montreal just above my district.
This Federal Government should be doing everything that it possibly
can, not to just say no, but we need to, in fact, direct all of our
attention to interdiction to try to keep these drugs out of the hands
of our children. We ought to do all we can to treat those that are
unfortunate enough to have already been taken over by these illegal
drugs. And then we should do all that we can to educate our children.
It is their lives we are talking about. And by creating a program that
is encouraging the use of illegal drugs, we just cannot do it.
Ms. NORTON. Mr. Speaker, will the gentleman yield?
Mr. SOLOMON. Mr. Speaker, I do not have any time, or I would. But
there is going to be 2 hours of general debate

[[Page H2453]]

coming up, and I will be glad to enter into a colloquy with the
gentlewoman.
But I just hope that Members come over here and vote for the rule,
and then let us have the dialogue between us. Let us talk about the
problems. But let us try to keep the politics out of it because we are
not talking politics. We are talking about the lives of our children,
and that means so much to all of us. I urge support of the rule.
Mr. Speaker, I yield back the balance of my time, and I move the
previous question on the resolution.
The previous question was ordered.
The resolution was agreed to.
A motion to reconsider was laid upon the table.
Mr. WICKER. Mr. Speaker, pursuant to House Resolution 409, I call up
the bill (H.R. 3717) to prohibit the expenditure of Federal funds for
the distribution of needles or syringes for the hypodermic injection of
illegal drugs, and ask for its immediate consideration.
The SPEAKER pro tempore. The Clerk will report the resolution.
The Clerk read as follows:

H.R. 3717

Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,

SECTION 1. PROHIBITION REGARDING ILLEGAL DRUGS AND
DISTRIBUTION OF HYPODERMIC NEEDLES.

Part B of title II of the Public Health Service Act (42
U.S.C. 238 et seq.) is amended by adding at the end the
following section:

``prohibition regarding illegal drugs and distribution of hypodermic
needles

``Sec. 247. Notwithstanding any other provision of law,
none of the amounts made available under any Federal law for
any fiscal year may be expended, directly or indirectly, to
carry out any program of distributing sterile needles or
syringes for the hypodermic injection of any illegal drug.''.

SEC. 2. CONFORMING AMENDMENT.

Section 506 of Public Law 105-78 is repealed.

The SPEAKER pro tempore. Pursuant to House Resolution 409, the
gentleman from Mississippi (Mr. Wicker) and the gentlewoman from
California (Ms. Pelosi) each will control 1 hour.
The Chair recognizes the gentleman from Mississippi (Mr. Wicker).
Mr. WICKER. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, let me first take this opportunity to commend and thank
the gentleman from New York (Mr. Solomon) for the legislation which is
before us today. Although my colleague still has several more months
remaining in this Congress and a lot more work to do, let me be among
the many to express my gratitude to him for his service to his
community, to the military, to this institution, and to his State and
Nation.
I also at this point want to note the leadership and tireless efforts
of the gentleman from Georgia (Mr. Gingrich) in leading the war on
drugs and the significant contribution of the gentleman from Illinois
(Mr. Hastert), chairman of the Task Force for a Drug-Free America, who
is working with Members of Congress and communities across the country
in an effort to stem the tide of illegal drug use.
I rise today in strong support of this legislation, which has at its
center a very simple premise: The Federal Government should not be in
the business of supplying IV needles or syringes to drug addicts.
Let me point to this graphic. Mr. Speaker, this photograph very
vividly points out the sad, regrettable, dangerous, and even deadly
issue that we are talking about today.

{time} 1145

Under a needle exchange program, an individual such as the one
depicted here uses a hypodermic needle to inject an illegal and harmful
and deadly drug, such as cocaine or heroin, then hands over that
contaminated needle at a facility in exchange for a clean needle which
can then be used in further illegal activity. In many cases, the
illegal drug user will be given a permission slip which would authorize
him or her to carry the otherwise illegal drug paraphernalia. A needle
exchange program facilitates an act which is in fact illegal, which is
in fact a felony in most of the United States of America.
The festering disease of illegal drugs is eating away at our society.
We have witnessed a dramatic rise in drug use during the last several
years, particularly among our young people. The failure of our country
to have a coherent drug policy which emphasizes education, prevention
and a strong anti-use theme is having a disastrous effect.
This very day, more than 8,000 young people across America will use
an illegal drug for the first time. Illegal drug use is tearing at our
social fabric, ripping apart families and corrupting our children.
Fifty-four percent of high school children have used illegal drugs. The
use of heroin, a drug which is almost exclusively injected
intravenously, has quadrupled, has increased fourfold, just since 1994.
According to a University of California study last year, the social
cost of drug abuse amounts to $67 billion per year.
Clearly we must act. It is our duty, our obligation to society and to
our children to act promptly, to act responsibly and to eliminate the
scourge of illegal drugs. The government does indeed have an important
role in winning the war on drugs in America. But using tax dollars to
hand out free needles to drug addicts is not the right way to go about
addressing the crisis of drugs in our communities. In fact, it is
exactly the wrong way.
To begin winning the war on drugs, we should instead be emphasizing
an approach which gets tough on the supply side of illegal drugs by
dramatically stepping up interdiction. Then on the demand side we must
concentrate our efforts on education and prevention to fight the
devastating effects illegal drugs have on our society.
Unfortunately, last week, President Clinton announced to the American
people that his administration endorses the use of needle exchange
programs for drug users. But he stopped short of funding such programs.
In effect, the President tried to have it both ways. This headline is
devastating: ``Clinton Supports Needle Exchanges But Not Funding.''
That is the message which the President of the United States, the
highest elected official in our land, sent out across this land to the
young people, that needle exchange programs are a good thing.
Mr. Speaker, the President could hardly have sent a more destructive
and harmful and confusing message to the American people. The President
argues forcefully that we must protect our children from tobacco, and I
agree. But in his next breath, he endorses needle exchange programs,
the exchange of one piece of illegal drug paraphernalia for the other.
Thankfully the administration's own national drug policy adviser,
General Barry McCaffrey, courageously took the opposite view and stated
just last week, and I quote General McCaffrey, ``Needle exchange
programs are magnets for social ills, pulling in crime, violence,
addicts, prostitution, dealers and gangs and driving out hope and
opportunity.''
If the President will not listen to his own drug czar, who will he
listen to? Perhaps he will listen to this body. It is time for this
body once again to stand up for what is right. We have debated this
issue on the floor before. Last September a bipartisan majority of this
House said ``No'' to Federal funding for needle exchanges during the
Labor-HHS appropriation bill for FY 1998. The moratorium which banned
funding for these programs has now expired and it is time for us to put
into place a permanent ban on funding for needle exchanges.
Mr. Speaker, the underlying assumption of a needle exchange program
is that we can somehow encourage ``responsible drug users.'' That is an
oxymoron if ever I have heard one. Advocates of needle exchange
programs hope that drug users will not share their needles with other
drug users. But let's consider the kind of clientele that we are hoping
will act ``responsibly.'' We are talking about drug addicts who often
commit violent crime to support their habits, who often sell their own
bodies just to get high or to sustain their drug habits. Do we really
believe that individuals engaged in this type of harmful, illegal and
even deadly activity are going to be worried about whether their
needles are clean?
On the floor today we will hear, as we have already heard, proponents
of needle exchanges talk about the alleged benefits of these programs
in reducing the spread of HIV and AIDS. But there are no reliable
scientific studies to back up that charge. In fact, the opposite is
true.
The 1996 Montreal Study demonstrated that intravenous drug addicts
who used needle exchange programs were more than twice as likely

[[Page H2454]]

to become infected with HIV as addicts who did not take part in
exchange programs. Needle exchange programs are simply based on a
flawed theory, and they will not work to solve the problem of AIDS.
I wish we could find a cure for AIDS. I hope that we will. This
Congress is funding research to do just that. But I am opposed to
spending more taxpayer dollars on programs that do not work and which
send the wrong message to the children of America.
H.R. 3717 will prevent the administration from moving ahead on a
risky program of handing out free needles. This bill is brief and goes
straight to the point by amending title II of the Public Health Service
Act to prevent any funds from being expended, either directly or
indirectly, to carry out any program of distributing sterile needles or
syringes for the hypodermic injection of any illegal drug.
Mr. Speaker, I urge my colleagues to join me in supporting this
straightforward bill to ban Federal funding for needle exchange
programs. In so doing, we will be sending the right message to
America's young people, that the Federal Government does not condone
and will not be a party to illegal drug use in any form.
Mr. Speaker, I reserve the balance of my time.
Ms. PELOSI. Mr. Speaker, I yield myself such time as I may consume. I
too want to join my colleagues in commending the distinguished
gentleman from New York (Mr. Solomon) for his fine service in this
House of Representatives. I consider him a friend and I have fought
with him on his side on many battles in this Congress. He will be
sorely missed by all of us. I thank the gentleman from New York for his
service. He has served his constituents well. I know they are very
proud of him.
So it is with great regret that I rise today to oppose the Solomon
amendment. But I do so, Mr. Speaker, with the confidence that in
standing here I stand with the great scientists of our country in
stating that needle exchange programs help reduce the spread of HIV and
AIDS and do not contribute to increasing substance abuse, indeed in
many instances reduce substance abuse. There are many issues that will
be raised during this debate on this bill, but there is one clear
message that is irrefutable now and will be equally irrefutable at the
close of business. That message is, the leading scientists in this
country have examined the evidence and determined that needle exchange
programs, again, help stop the spread of HIV infection and do not
encourage drug use.
We give the National Institutes of Health, we appropriate for FY
1998, the year we are in, $13.6 billion. What does this Congress want
to do? Ignore the recommendations of the NIH. There are special orders
and Dear Colleagues around here to double the funding in 5 years for
the National Institutes of Health. But what does this body want to do
today? Ignore the findings of the National Institutes of Health. Mr.
Speaker, I want to not have my colleagues take my word for it but
listen to the words of the scientists themselves:

After reviewing all of the research, we have unanimously
agreed that there is conclusive scientific evidence that
needle exchange programs, as part of a comprehensive HIV
prevention strategy, are an effective public health
intervention that reduces the transmission of HIV and does
not encourage the use of illegal drugs.

Signed, Dr. Harold Varmus, Director, National Institutes of Health,
and I might add, a winner of the Nobel prize himself; Dr. Anthony
Fauci, Director, National Institute of Allergy and Infectious Diseases,
the institute that does the research on HIV and AIDS; Dr. Alan Leshner,
Director, National Institute on Drug Abuse; and Dr. David Satcher, the
Surgeon General. This memorandum is dated April 1998. That is the
determination of the Nation's leading scientists.
In 2 hours we will see how this House of Representatives will side
with the scientists or side with the politics. I would not think of
asking my colleagues in this body to vote for an item that would
increase drug abuse in this country.
I have heard others on the other side of this issue question the
motivation of those of us who support the needle exchange program. I do
not question their motivation. I say that every single person in this
body is fully committed to ridding our country of this terrible scourge
of substance abuse, and also of the spread of HIV and AIDS.
H.R. 3717 would impose a permanent ban on Federal funding for needle
exchange programs, a position which contradicts the enormous body of
scientific research. For that reason, I urge my colleagues to vote
``no'' on the bill.
It is cruelly ironic, as I said earlier, in a year when there seems
to be consensus to increase the funding at NIH, that we are at this
time considering throwing out the science and basing public policy on
politics. I will speak to the science and the role of needle exchange
in fighting the AIDS epidemic. I have said what the scientists have
said, and I will say that this statement by Dr. Varmus and others
clearly states what the facts are.
I would say to the gentleman from Ohio who said a word about common
sense, is it common sense to ignore the opinion of the leading
scientists in the country? Is that common sense, when we ourselves fund
their scientific research? Something is not right here.
The NIH panel also concluded that individuals in areas with needle
exchange programs have increased likelihood of entering drug treatment
programs. In the fight to reduce drug abuse, we need to understand that
needle exchange is a valuable opportunity to help drug abusers into
treatment.
Leading private organizations see the value of needle exchange as
well. They include the American Medical Association, the American
Public Health Association, the National Academy of Sciences, American
Nurses Association, the American Academy of Pediatrics, the U.S.
Conference of Mayors, and the American Bar Association.
Something is wrong with this picture. When I hear this debate in this
body that the science is so conclusive, one would think we were having
a meeting of the Flat Earth Society. How can we turn our back to the
science?
In making our decision on needle exchange, we need to ask, who is
affected negatively if we use political expediency rather than science
to fight a public health emergency? The answer to that question is also
clear. Among women of childbearing age, more than 70 percent of HIV
infections are related either directly or indirectly to injection drug
use. Of babies diagnosed with HIV infection, more than 75 percent were
infected as a direct or indirect result of injection drug use by a
parent.

{time} 1200

When we fail to fund needle exchange, we are foregoing a proven
intervention that can save the lives of women and children. We are
giving up the opportunities to help the drug users get treatment.
I have more to say on this subject, Mr. Speaker, but my colleagues
are very eager to get into this debate. I will just close by saying by
ignoring the science, that ignoring, that ignorance, is not bliss. That
ignorance equals death. And I say without any fear of contradiction to
my colleagues that a vote against the Solomon amendment, which I am
requesting of them, is a vote to save lives.
Mr. Speaker, I reserve the balance of my time.
Mr. WICKER. Mr. Speaker, I yield 2 minutes to the distinguished
gentleman from Virginia (Mr. Davis).
Mr. DAVIS of Virginia. Mr. Speaker, I appreciate my friend yielding
this time to me.
Let me just say here I do not think there is a wrong and right on
this issue. I think there are two competing public policy objectives.
One objective just focuses on the AIDS epidemic, on getting people who
are using bad needles good needles so they can continue their habit,
but at the same time at least have them use a needle that will not
infect them with a virus. And I understand that. And under this
amendment State and local governments in the private sector who already
fund these programs can continue to do that. We are not wiping that
out.
But the other policy objective, and I think we have to look at this,
each day over 8,000 young people are going to try an illegal drug for
the first time. Heroin use rates are up among youth. And while perhaps
eight persons contract HIV directly or indirectly from dirty

[[Page H2455]]

needles, 352 start using heroin each day, and more than 4,000 die each
year from heroin- and morphine-related causes.
We send a wrong signal when we tell people it is illegal but we are
going to give out a clean needle for people to pursue this illegal
habit, and I think it looks terrible from a public policy objective to
have the government really funding these programs and encouraging the
use of illegal drugs.
Mr. Speaker, I think that is where we get into the mix on this. And
although if our only objective were AIDS, that would be fine, but we
have the competing objective here of getting people, the government is
saying it is all right to use it, and here is a clean needle by the
way. And we are going to fund this even though, if they are a veteran
in a VA hospital, they may have, or someone who is in a hospital on
Medicare, they may have to pay for their own needles, and we may charge
them for it.
That is how this gets so ridiculous, and that is why I support the
Wicker amendment. Even assuming the needle exchange programs can
further accelerate the declining rate of HIV transmission, I think the
risks of these programs encourage a high ratio of heroin, and they
outweigh the potential benefits. So that is where I come down on this,
with all due respect to folks who I think are very narrowly focused and
I think admirably so on the other side.
The President's own drug czar has spoken very eloquently on this. He
knows that the use of taxpayer dollars could, in fact, be better
diverted in areas of drug prevention.
Ms. PELOSI. Mr. Speaker, I yield 3 minutes to the gentleman from
Washington (Mr. McDermott) who is also a doctor.
Mr. McDERMOTT. Mr. Speaker, the reason we are having this debate is
clearly because the Republicans cannot get a budget together. We have
not had one single minute of debate in the Committee on the Budget on a
budget for this country and not a single minute out here on the budget,
but we have 2 hours on this issue, which is basically a matter of
science.
Now, there is very clear and convincing evidence that this is a
matter of saving lives through a program that some people want to make
it, people are either for needle exchange and therefore they are soft
on drugs or people are against needle exchange and they are strong
against drugs.
There could not be anything further from the truth. The fact is,
these programs have been used in the Northwest. They have reduced the
infection rate from 30 percent in New York and the South to 3 percent
in the Northwest among HIV-infected people.
Now people say it encourages drug use. The Secretary of HHS, Donna
Shalala, convened a panel of experts at the National Institutes of
Health. They came back with the fact that needle exchange programs do
not increase and, in fact, may decrease the use of drugs.
The fact is, if we just want to be money-wise, one case of prevented
HIV infection is estimated to save $119,000.
Now how do these programs work? In Tacoma and Seattle, they have a
table where somebody sits and somebody has to bring a needle and they
get a clean needle. Now I do not know how that is going to encourage
the use of drugs. Are my colleagues suggesting that high school kids
are going to come and say, well, I got a needle; give me a clean one so
I can go find some drugs to use?
We are talking about a population that is infecting 33 people per day
in this country with HIV, and 85 percent of the new cases in this
country are among heterosexual people, and 66 percent of the cases
among women are linked to drug use. Every single case of a child today
being infected by HIV is linked to drugs and drug usage.
Now if my colleagues want to prevent those cases, if they are worried
about kids, if they are worried about women getting the disease, then
they want to have the needle exchange program. It has worked in the
Northwest for a bill like the one that the gentleman from New York (Mr.
Solomon) has put out here on the floor that has a broad, sweeping
nature to it. Any direct or indirect; does that mean that Seattle and
Tacoma cannot have their program? Do we have to continue a program or
discontinue a program because of that?
I say that is wrong. My colleagues ought to vote against this bill.
Mr. WICKER. Mr. Speaker, I yield 3 minutes to the distinguished
gentleman from Texas (Mr. Paul).
(Mr. PAUL asked and was given permission to revise and extend his
remarks.)
Mr. PAUL. Mr. Speaker, I rise in support of this legislation. It
makes no sense to pay somebody, pay for free needles to do something
that is currently illegal. It is very questionable whether it will do
any good.
As a physician, I would have to agree with the opposition that a
clean needle certainly is better than a dirty needle. I do not think
there is a question about that. But I do believe that there is a
message sent that if we provide free needles to do something that we
are condoning or encouraging it. But there is also a strong moral as
well as an economic argument against this.
What we are talking about here is lowering costs of risky behavior.
We are saying that we will pay for the needles to perform this risky
behavior. But there is another much larger element that has not been
discussed so far, and that has to do with the concept that all risky
behavior be socialized; that is, through the medical system, it is
assumed that those who do not participate in risky behavior must pay
for the costs of the risky behavior, whether it has to do with
cigarettes or whether it has to do with drugs or whether it has to do
with any kind of safety.
So, therefore, the argument is that we have to save money in medical
care costs by providing free needles. But there is another position,
and that is that we might suggest that we do not pay for free needles
and we might even challenge the concept that we should not be paying
people and taking care of them for risky behavior, whether it is risky
sexual behavior or risky behavior with drugs.
I think this is very clearly the problem, and I do not believe we
should be socializing this behavior because, if we do, we actually
increase it. If we lower the cost of anything, we increase the
incidence of its use. So if the responsibility does not fall on the
individual performing dangerous behavior, they are more likely to, and
this is just part of it, the idea that we would give them a free
needle.
But there is a moral argument against this as well. Why should people
who do not use drugs or do not participate in dangerous sexual
procedures and activities have to pay for those who do? And this is
really the question, and there is no correct moral argument for this.
And the economic argument is very powerful. It says that if we lower
the cost, we will increase this behavior.
But this is not only true when we are dealing with drugs. It has to
do with cigarettes. I mean, the whole tobacco argument is dealing with
the same issue, that we have to pay for the costs of people who get
sick from dangerous behavior with cigarettes and, therefore, we have to
come in and regulate the tobacco companies and nobody can assume
responsibility for themselves.
Same thing with alcohol and safety. This is the reason we have so
much government regulation dealing with helmet laws and seat belts and
buzzers and beepers and air bags. So this concept has to be dealt with
if we are ever to get to the bottom of this.
So, Mr. Speaker, I strongly support this legislation.
Ms. PELOSI. Mr. Speaker, I yield 4 minutes to the gentleman from Ohio
(Mr. Stokes) the distinguished ranking member on the Subcommittee on
VA, HUD and Independent Agencies of the Committee on Appropriations,
who also is leaving the Congress after a very, very distinguished
career.
Mr. STOKES. Mr. Speaker, I thank the distinguished gentlewoman from
California (Ms. Pelosi) for yielding this time to me. I also want to
thank her for her outstanding and steadfast leadership in legislation
and funding which has helped to fight the spread of HIV/AIDS.
Mr. Speaker, I rise in opposition to H.R. 3717. This bill would
prohibit the expenditure of Federal funds for needle exchange programs.
More specifically, the measure would help to ensure the continuing
spread of the deadly HIV/AIDS virus.
Extensive scientific evidence and the Nation's leading health
experts, including the National Institutes of Health,

[[Page H2456]]

Centers For Disease Control, the American Medical Association, the
American Public Health Association, National Academy of Sciences, the
American Nurses Association, the American Academy of Pediatrics, all
unanimously agree that there is conclusive scientific evidence that
needle exchange programs as a part of a comprehensive HIV/AIDS
prevention strategy that makes needles available on a replacement basis
only and that refers participants to drug counseling and treatment and
other medical services are effective in public health intervention in
reducing the transmission of HIV/AIDS and that it does not encourage
the use of illegal drugs.
Mr. Speaker, over the years, the House has provided enhanced Federal
spending for AIDS treatment and outreach services and for the
biomedical which continues further advances in the development of
effective treatment for AIDS. Now we must also do what is necessary to
help further reduce the spread of this epidemic.
Since AIDS was first identified, it has been known that injection
drug use plays an increasing role in the spread of this disease. These
two deadly health epidemics, AIDS and substance abuse, devastate
families all across this Nation and from all walks of life.
Mr. Speaker, prohibition and silence on the use of Federal funds for
needle exchange programs to prevent and control the spread of HIV/AIDS
are no longer options. Nationwide, IV drug use accounts for more than
60 percent of the AIDS cases, more than 70 percent of the HIV
infections among women of child-bearing age and more than 75 percent of
babies diagnosed with HIV/AIDS. These babies, through no fault of their
own, were injected as a direct or indirect result of IV drug use by a
parent.
And while I am encouraged by the decline in AIDS deaths in the
general population, I am extremely discouraged by the devastating
situation in the African American community where AIDS is now the
leading cause of death among those that are 25 to 44 years of age.
According to the Centers For Disease Control, the rate of HIV/AIDS in
the African American community is seven times that of the general
population. Seventy-two people that are African American are infected
every day. This is a state of emergency. We must do what is necessary
to address the Nation's devastating public health problem in HIV/AIDS.
The fact that the greatest number of AIDS cases are due to
intravenous drug use forces the Congress to have to carefully,
seriously consider the value of needle exchange programs in the control
and prevention of this deadly disease.
The National Institutes of Health March, 1997, consensus development
statement on interventions to prevent HIV risk behaviors reported that
needle exchange programs have shown a reduction in risk behaviors as
high as 80 percent in injecting drug users, with estimates of 30
percent or greater reduction of HIV.
We must not continue to ignore solid scientific evidence. Now is the
time to support Federal funding, and I urge the defeat of this bill.

{time} 1215

Mr. WICKER. Mr. Speaker, I yield 5 minutes to the distinguished
gentleman from Oklahoma (Mr. Coburn).
Mr. COBURN. Mr. Speaker, I would first like to address the
gentlewoman from California (Ms. Pelosi) and say I admire her efforts
in HIV prevention and the work that she has put forward in trying to
solve this epidemic.
I probably find myself in a unique category because I have read all
the studies on needle exchange; I have actually read the studies, and I
find it ironic that the report that was issued, even though we have a
statement from April of 1998, the NIH consensus statement was made
prior to the release of the Montreal data.
I want to quote from the Montreal study, and I also want to educate
the Members a little bit on the studies, because there have only been
two studies done on all needle exchange programs that have the same
group of individuals in the beginning of the study as they had at the
end of the study. All of the others had unidentified needle users and
unidentified needle users at the end and took averages of numbers,
which scientifically is meaningless when we want to try to show
something as a cause and effect or a reduction of risk.
The Montreal study and the Vancouver study were both excellent
studies. They had the same people looked at when they began the study
as when they ended the study. I want to read to my colleagues the
conclusion as printed in the American Journal of Epidemiology by
Doctors Bruneau and others as to what their conclusion is. They were
not anticipating the debate in the U.S. Congress when they wrote this
conclusion: ``In summary, Montreal needle exchange program users have a
higher HIV seroconversion rate than needle exchange program nonusers.''
What does that say? That says that if one is in their program and one
is getting free needles, one is more likely to get HIV than if one is
not in their program using needles.
Now, we can distort that, but that is the science of the two studies,
and the Vancouver study supports the same claim.
We should be concerned about drug injection in this country. We
should be concerned about drug addiction. The way to solve that is
mandatory treatment programs for people who are addicted.
I will pledge to those on the other side of the aisle who differ with
me on this issue that I will support any program that comes forward for
funding for mandatory drug treatment centers and promotion of lifestyle
change to decrease the risk associated with this horrendous infection.
Remember, we are not just talking about HIV. We are talking about
hepatitis B now that is a major epidemic in this group of people; we
are talking about hepatitis C, we are talking about probably hepatitis
D as well. So there are large areas besides HIV that these people are
subjected to.
Mr. Speaker, I think that we can have disagreements, and we know the
scientific community has disagreements. There is no question. But we
cannot ignore the two largest studies that have ever been done on this,
both of which come to the same conclusion, that if one is in a needle
exchange program, one is more likely to seroconvert than less likely.
That is completely opposite of what we have heard here so far today. I
would recommend that everybody read the study so that they actually
know what the scientists have said in terms of their conclusions.
Finally, there are other things that are associated with needle
exchange programs that we ought to be concerned about. There is
multiple reports that the needle traffickers there, what they do is
they draw drug traffickers to the needle exchange program; that the
crime rates in the areas where we have needle exchange programs
actually go up, they do not go down. So there are all of these other
consequences associated with needle exchange programs that have, in
fact, not been addressed by any argument today. We have a problem with
drug addiction, injection drug addiction in this country. This is
fixing the wrong problem. We need to be fixing drug addiction, not
enabling drug addicters and drug-addicted people to more easily use
their illegal drug.
Ms. PELOSI. Mr. Speaker, I yield myself such time as I may consume to
respond to the gentleman.
I appreciate his offer of supporting mandated treatment programs, and
I do believe that treatment on demand is the answer to reducing
substance abuse in our country. But he spent a good deal of his time
talking about the Montreal study, and Julie Bruneau and others who
worked on that. I want to call to the attention of my colleagues the
op-ed by Julie Bruneau and Martin Schechter, her colleague in making
the Montreal study. In this op-ed, in their own words, they say, As the
author of the study, we must point out that these officials have
misinterpreted our results. A study conducted last year and published
in the Lancet, the British medical journal, found that 29 cities
worldwide where programs were in place, HIV infection dropped by an
average of 5.8 percent a year among drug users. In 51 cities that had
no needle exchange plans, where they had no exchange programs, 5.9
percent a year was the increase in HIV spread.
In Canada, as a result of these studies, the same study that our
colleague is citing in opposition to our position, the authors of the
study he cites, the Montreal study says, in Canada, local

[[Page H2457]]

governments acted on our research by expanding needle exchanges and
adding related services.
So I say to my colleagues that this Montreal study, which the
gentleman is correct, it did come since our vote last year, but it does
not support the argument. The fact is, it supports the fact that needle
exchange programs reduce the spread of HIV.
Mr. COBURN. Mr. Speaker, will the gentlewoman yield?
Ms. PELOSI. Mr. Speaker, the gentleman has plenty of time on that
side, and I am pleased to answer any questions the gentleman has on his
own time.
Mr. Speaker, I yield 3 minutes to the gentleman from Rhode Island
(Mr. Kennedy), a leader in this fight to reduce substance abuse and
stop the spread of HIV in this country.
Mr. KENNEDY of Rhode Island. Mr. Speaker, I would like to thank the
gentlewoman for yielding, and I want to commend her for the good work
that she is doing to save lives in this country.
That is what we should be about in this debate, saving lives. And the
idea that we are going to talk about a moral argument here, that we
should somehow not support needle exchanges because it helps promote
risky behavior, is just absurd. I cannot even believe I am hearing this
said, because the people who are making this argument must not know
that AIDS is not a disease that talks about people who have risky
behavior. When we look at the fact that 40 percent of cases of those
with AIDS are babies, do my colleagues mean to tell me those infants
are having risky behavior?
I would like everyone to keep in mind here, we are talking about
children, children in this country who have HIV. Let me remind everyone
that dying of AIDS is a slow and painful death, and if we pass this
legislation, we will be sentencing children in this country to a slow
and painful death that could otherwise have been prevented. How could
it have been prevented? Because we would have cut back on the
incidences of AIDS because we would have allowed those people who do
insist to use drugs the opportunity to use clean needles so that they
are not spreading this deadly disease.
Let me repeat for my colleagues, the needle exchange program reduces
HIV. After reviewing all of the available evidence and science, the
Directors of the National Institutes of Health are saying conclusively
that the needle exchange programs reduce HIV. I think it is a moral
obligation for our colleagues to vote against this legislation, because
if we save any lives, that will be our job here in this Congress.
We cannot, I repeat, we cannot ignore the scientific evidence for
political expediency purposes. I know it is easy for my colleagues to
go back to their districts and say, hey, I do not want to support these
needles. That is an easy cop-out. That is a cop-out when we have the
science that says we are preventing AIDS from being spread; we ought to
follow our evidence. I thought that is the reason we came to the
Congress is because we know the evidence, we have been up here, we have
been studying the facts.
The Congress has been advised by the National Institutes of Health,
which advised the Congress what to do in the public's health interest
to say needle exchange programs reduce the incidences of AIDS. I do not
think there is any debate about this whatsoever. Let us do what the
scientists tell us to do. Let us reduce AIDS, let us support needle
exchange programs, let us oppose this bill.
Mr. WICKER. Mr. Speaker, I yield 6 minutes to the distinguished
gentleman from Illinois (Mr. Hastert), the leader of the Speaker's Task
Force For a Drug-Free America.
Mr. HASTERT. Mr. Speaker, I thank the gentleman for yielding me this
time.
First of all, I want to acknowledge the gentlewoman from California
(Ms. Pelosi) in her earnestness in this fight. We have stood and
debated issues and like issues many times, and I certainly believe that
she is sincere in her efforts. I also commend my colleague from
Baltimore in the State of Maryland. I know he is sincere in what his
views are and what he is trying to do, and we have had testimony in
committee on what he is trying to do. But I listened to the speech of
the gentleman, the previous gentleman, and I am amazed.
First of all, we are talking about drug use in this country, and we
are talking about trying to stop drug use in this country. I will tell
my colleagues, I feel sorry for the 40 percent of the AIDS victims who
are children, but those 40 percent of the victims who are children are
not using needles, so the whole needle issue does not affect those
folks at all.
Mr. KENNEDY of Rhode Island. Mr. Speaker, will the gentleman yield?
Mr. HASTERT. Mr. Speaker, I did not interrupt the gentleman, and I
would appreciate it if he would not interrupt me.
What we are talking about are 20,000 people who die on our street
corners every year. They are dying in our emergency rooms, OD-ing, they
are dying in the darkest parts of our cities, and they are also dying
in the wealthiest of our suburbs. They are young people. Most of those
20,000 folks are children. Some of us know members of our family or
friends who have had drug problems, who have had very, very serious
situations with drugs.
What we are saying, if drugs are illegal in this country, if it is
illegal to use cocaine or heroin or anything that is injectable, then
we should not be handing out free utensils to be able to inject that
substance in our arms. I think that is a common-sense proposal.
Mr. Speaker, we wave around a lot of studies, and we talk about the
Montreal study, and we talk about the Vancouver study, we talk about
the Chicago study, and we go back and forth on what somebody said. I
understand, I read the op-ed that the two folks that did the Canadian
studies talked about. Mr. Speaker, the reality is the study did not
prove what they believed. They do not like the results of the science.
The science did not prove their theory.
Now, that is too bad. We talk about unintended consequences around
here, but I will tell my colleagues, the unintended consequences of
handing out free needles in our cities and in our suburbs and on our
street corners is that in the study in Montreal we found, and in
Vancouver, we found out that we had more kids using drugs when we
handed out free needles. We found out that the incidence of exchanging
needles, trading needles around when we handed out free needles, was 39
percent. Thirty-nine percent more people or people still traded
needles. Do my colleagues know what the percentage was when we did not
have free needles? It was 38 percent. So the problem of exchanging and
trading needles, this is just a false argument. It does not exist.
So the whole issue here is--excuse me, sir. I did not mean to
interrupt the gentleman.
So the whole issue here is we are talking about something in passing
out needles in HIV that exacerbates the problem, it does not solve the
problem. I do not care what the arguments are on the other side. That
is what the facts prove. It also proves, and I have talked to people
who work in these areas, but quite frankly, a person who gets a buy of
heroin or a buy of cocaine--
The SPEAKER pro tempore (Mr. Blunt). The gentleman will suspend.
The gentleman will be reminded that the rules prohibit passing in
front of the member speaking.
Mr. KINGSTON. Mr. Speaker, regular order. There is a chart up.
The SPEAKER pro tempore. Would the minority please remove the chart?
Would the gentlewoman from California please assure that this chart be
removed since it is not currently being utilized in debate?
Ms. PELOSI. Mr. Speaker, is someone objecting to the chart, the list
of scientists that are the head of the National Institutes of Health?
Mr. KINGSTON. Regular order, Mr. Speaker. Regular order.
Ms. PELOSI. Are we to ignore the list of scientists at the National
Institutes of Health?
Mr. HASTERT. Mr. Speaker, the chart is not being used.
Ms. PELOSI. The Flat Earth Society lives.
Mr. HASTERT. Mr. Speaker, I am sorry for the comments of the
gentlewoman from California and the interruptions that we have seen in
here, but I think everybody ought to be heard on this, and I think
everybody ought to have the opportunity to make their arguments.

[[Page H2458]]

{time} 1230

What we have seen when somebody gets a buy of cocaine or heroin to be
able to inject, they really do not care. They need that narcotic. They
do not care whether they are going to go out and be able to buy a
needle or trade a needle or steal a needle. They are going to get a
needle to get their fix, and that is the consequences.
So when we really get back to what we are talking about in the use of
drugs, I think the first premise is we should not be handing out a
utensil or tool to allow people to break a law. That is pretty simple.
The second issue is commitment. If we are talking about trying to
show that we are going to reduce demand in this country on drug use,
and we are going to try and also persuade countries south of our border
to stop and try to reduce the supply, we have to be honest and genuine
about trying to stop demand.
I think it certainly is a wrong message to say that, oh, by the way,
we are going to try to stop demand in our country, but here we are
handing out free needles to drug users. What happens when you hand out
free needles to drug users, the incidence of drug use goes up. It was
proved in the Montreal study and proved in the Vancouver study. It was
also proved in the Chicago study.
As a matter of fact, the Chicago study showed that HIV increased 8.4
percent per 100 people when there are free needles, and there was a
drop without free needles of 71 percent of HIV in that community when
there were no free needles.
Mr. Speaker, we need to have a commitment to stopping drugs in this
country. Giving away free needles is not part of that. We also have to
have local solutions to national problems. And the best way to start
those local solutions is to help people clean up their neighborhoods.
Handing away free needles or giving away free needles in people's
neighborhoods does not stop the drug problem, it exacerbates the drug
problem.
Mr. Speaker, this is a good piece of legislation and a needed piece
of legislation. It is a piece of legislation that we debated last year
and was passed overwhelmingly in the House, and it is a shame that we
have to retread this argument and go over it again.
Ms. PELOSI. Mr. Speaker, I agree with the gentleman from Illinois
(Mr. Hastert), this resolution is a shame.
Mr. Speaker, I yield 2 minutes to the gentlewoman from California
(Ms. Waters), a champion in the fight against drug abuse in our
country.
Ms. WATERS. Mr. Speaker, if passed, H.R. 3717 would needlessly impose
a permanent ban on the use of Federal funds for needle exchange
programs even though they are scientifically proven to save lives and
do not increase drug use.
The research speaks for itself. Three comprehensive reviews of the
scientific literature done by the United States General Accounting
Office, the National Research Council, the Institute of Medicine and
the University of California at San Francisco all found that needle
exchange programs are an effective component of comprehensive
community-based HIV prevention programs.
In March 1997 the National Institutes of Health published a report
which concluded that needle exchange programs did not cause an increase
in drug use. In fact, needle exchange programs linked to drug treatment
and other services actually led to a decrease in drug use.
Mr. Speaker, we have got to get our heads out of the sand. The
statistics speak for themselves. Thirty-three Americans are infected
each day with HIV because of injection drug use. Nationwide, IV drug
use accounts for more than 60 percent of the AIDS cases, over 70
percent of HIV infections among women of childbearing age, and more
than 75 percent of babies diagnosed with HIV/AIDS. Every hour seven
Americans are infected with HIV. Three of these seven are African-
American.
As many of us know, minorities are disproportionately affected by
HIV/AIDS. While overall AIDS deaths have declined, AIDS is still the
number one killer of African-Americans and Latinos between the ages of
25 and 44. The Congressional Black Caucus is committed to fighting the
scourge of HIV/AIDS and drugs. We absolutely see no contradiction
between supporting needle exchange and working to rid drugs from our
communities.
Let me say to my Republican friends, the Congressional Black Caucus
made the fight of illegal drugs the number one priority for the 105th
session. We have not been joined by those who claim they care about
this issue. They better get on board and do something about the deaths
that are occurring in this Nation. They ought to be ashamed of
themselves.
Ms. PELOSI. Mr. Speaker, I yield 2 minutes to the gentleman from
Missouri (Mr. Gephardt), the Democratic leader of the House who has
made fighting substance abuse a hallmark of his service in the
Congress.
(Mr. GEPHARDT asked and was given permission to revise and extend his
remarks.)
Mr. GEPHARDT. Mr. Speaker, this is, to put it simply, a public health
issue. If we are to fight against drugs and drug use and against
further cases of HIV, we have to ask local governments and scientists
to help us with the best way to bring about the prevention of both of
those occurrences. And what the best scientists have told us and what
some local and private agencies tell us, is that this kind of program
gives us the best chance to both prevent further cases of HIV and to
prevent further drug use.
What we know from experience in many local jurisdictions is that if
people are brought into a drug prevention and drug treatment program,
they can be gotten off of their addiction. We know that drug use is an
addictive disease and the way to get people to not be addicted is to
get them into drug treatment, and we know that these programs are the
way in many, many cases we can get people into drug treatment.
Mr. Speaker, this is a doubleheader victory. We can prevent drug use,
stop drug use, and prevent HIV, both of which have huge costs for our
society. This is a matter of common sense and good judgment.
Mr. Speaker, I say to the Members today, why should the Federal
Government be telling local governments and jurisdictions and private
agencies that they should not do something that they feel is working?
This is a case where we might even use good Republican arguments that
the Federal Government should not be dictating to local jurisdictions,
we ought to be following their good judgment and practice and
experience.
Mr. Speaker, I say to Members: Vote against this bill. Let us prevent
drug use. Let us stop drug use. Let us prevent HIV. Let us follow the
science, follow the facts and do the right thing for the American
people. I urge Members to vote against this bill.
Mr. WICKER. Mr. Speaker, I yield 3 minutes to the distinguished
gentleman from Indiana (Mr. Souder) who has been a leader in the fight
against drugs.
(Mr. SOUDER asked and was given permission to revise and extend his
remarks.)
Mr. SOUDER. Mr. Speaker, the problem with the science that is being
argued on the other side is that it is just not there. The fact is that
at the very best, at the very best, there are mixed studies.
It is clear that in Vancouver, that in spite of providing 2 million
needles a year, they now have the highest incidence of AIDS and it is
increasing. Vancouver has the highest heroin death rate in North
America and is referred in The Washington Post as the ``drugs and crime
capital of Canada.''
In Montreal we have seen the HIV-positive at twice the rate of
addicts not in the program. Nearly 1,600 injection drug users found
that those participating in the needle exchange programs had a 33
percent cumulative probability of HIV seroconversion compared to 13
percent of injection drug users who had not participated in the
program.
In the British medical journal ``The Lancet'' they said that
injection drug users who participated in the Montreal needle exchange
programs were two times more, not less, likely. The science at best is
mixed here, and we need more research. But what is clear is that heroin
is illegal, and we do not need the Government of the United States and
the taxpayers of the United States to become needle traffickers in this
country.

[[Page H2459]]

Mr. Speaker, what kind of message are we trying to send when we are
trying to work together on the drug war? Do we really want this to
happen? A woman gets raped in the street by a heroin addict. What are
we going to tell her when she finds out that the needle that enabled
that addict to get heroin and then get him on the street to rape her
came from her tax dollars and the tax dollars of America? When we have
a heroin addict, a father, go home to his house and he beats his little
child and the child, sobbing, asks his mom, ``How does daddy get this
stuff?'' And the taxpayers are providing the needles for the heroin
addict. What kind of debate are we having here?
I know that there is a deep concern about HIV. But we cannot enable,
we cannot become a Dr. Kevorkian because we think the cause is right to
violate the law and enable people to violate the law, when that is also
leading to death and murder and rape and pillaging and the abuse of
children.
Just because giving low-tar cigarettes to people who smoke would
reduce the incidence of cancer does not mean that we should start
distributing in our schools low-tar cigarettes. Hey, the kids are going
to smoke anyway. Why do we not make it a little less risky for them?
Why do we not make it so that the secondhand smoke does not damage the
other kids as much, so let us give them free low-tar cigarettes to
reduce the incidence. We cannot get rid of the problem anyway, so let
us enable this bad habit to continue because maybe we can save a few
people.
And what about the violence in the streets, where little kids are
gunning down other people on the streets with machine guns? If we made
sure that they had safety locks on those, a few people where there are
accidental deaths would be saved. We cannot get rid of those guns
anyway. Why not get the government in the business of giving new guns
to these kids, new machine guns with safety locks on them, because a
few lives would be saved? We would be enabling the deaths to continue.
We would be giving the sanction of the government for an illegal
behavior and trafficking in guns in this case ourselves, but at least
we would save a few lives.
Mr. Speaker, we have to have a clear moral message coming out of this
Congress that drugs are wrong.
Ms. PELOSI. Mr. Speaker, I yield 3\1/2\ minutes to the gentleman from
Massachusetts (Mr. Delahunt), a former prosecutor and a fighter against
substance abuse in our country.
(Mr. DELAHUNT asked and was given permission to revise and extend his
remarks.)
Mr. DELAHUNT. Mr. Speaker, I rise in opposition to the bill. I am
really surprised to hear that the science is divided, because
everything that I have read and examined indicates that the science is
rather clear.
I just cannot imagine if the science was divided that the American
Medical Association would give support to needle exchange programs. I
cannot imagine the American Public Health Association would give
support to needle exchange programs. I cannot imagine that the American
Nurses Association would give support to needle exchange programs. I
cannot imagine that the American Academy of Pediatrics would give
support to needle exchange programs if there was not clear and
convincing proof, clear and convincing proof that these programs work.
And they do work, Mr. Speaker. And I hear many here talk about their
experience as fighters in the war on drugs. Well, let me assure my
colleagues, I stand second to none when it comes to that war. I dare
say that I put more people in jail for drug distribution and narcotic
abuse than all of the Members in this body combined.
But also let me tell my colleagues this. This program works. I heard
the minority leader speak to the issue of local option. I know it works
because it works in Massachusetts. It has worked in Massachusetts. It
has prevented clearly the spread of HIV. There is no doubt about that
whatsoever.
And, again, according to the study that was just released, it does
encourage the addict to seek treatment. And guess what that translates
into?

{time} 1245

That translates into a reduction of people on the streets dealing in
drugs. Massachusetts has once more proven they are right. We had a
debate on juvenile justice here, and I kept advocating that that
approach was wrong and looked to Massachusetts. The statistics were
there then, and they are there now.
If we believe in States' rights, if we believe in States' rights, and
I know Members on the other side advocate constantly for States rights,
leave this local option available because it does work. I am not
surprised by the results of the HHS study. I could have told my
colleagues what it was going to show, because it has been my
experience.
Let me just conclude by saying the minority leader was absolutely
right. This is a win/win. It is a win against the spread of HIV, and it
also is a win against the war against drugs. Defeat this bill, I
implore everybody, all my colleagues on both sides of the aisle.
Mr. WICKER. Mr. Speaker, I am pleased to yield 2\1/2\ minutes to the
gentleman from Georgia (Mr. Kingston), a gentleman who is not only a
leader on the Committee on Appropriations but one of the great leaders
in the drug task force.
Mr. KINGSTON. Mr. Speaker, I thank the gentleman for yielding time to
me.
Mr. Speaker, since Clinton has become President, the use of tobacco
and drugs in our country has skyrocketed. I wanted to get this straight
with my Democrat friends: What they want to do is penalize tobacco
users by making them pay more for tobacco, but they want to subsidize
drug users by having my middle-class taxpayers pay for their syringes.
Think about this a minute. The hard-working folks back in Savannah,
Georgia that I represent and all coastal Georgia wake up every morning
at 5, 6 o'clock in the morning, bust their tail getting ready to get to
work, kiss their kids good-bye, take them to school. The mom, the dad,
they go back to their own offices. Meanwhile, back in Vancouver or
other places outside of America, the Canadian taxpayers, their
counterparts, are having to pay for drugs and syringes. Is this not
great?
Let us think about this for a minute. The days of moonshine, would we
have fought moonshine by giving out clean and sterile jugs for
moonshiners to put their products in? And what would Elliot Ness have
said to Al Capone? ``We are going to bust you, but do it with clean
jugs.''
Then what about gamblers? Should we start giving them clean playing
cards, because certainly compulsive gamblers are subjected to germs on
cards. What about compulsive eaters? Should we give them free but low-
fat French fries?
What has all this needle exchange done for people? Two and a half
million needles were given out in Vancouver last year. What did it do?
The HIV rate among participants is higher than those who do not
participate. The death rate in the 10 years that the program has been
in effect has skyrocketed. In 1988 there were 18 deaths that were drug
related. In 1993, 200. What else happens? The highest crime rate in
Vancouver is within the 2-block area of the needle exchange program.
What did the drug czar, General McCaffrey, say? He said no needle
exchange programs are going to be located in exclusive neighborhoods. I
ask the Democrats, how many of them want a needle exchange program in
their backyard? Is this really something that they want to say to their
taxpayers? ``Look, right next door to my office is a needle exchange
program, and this is good for you.''
Do my colleagues really want these things being handed out right next
to them? No. We know they are going to go to some inner city area where
disadvantaged people are already living in crime-infested, drug-
infested areas. All this does is make the problem worse.
I say it is a cruel joke. It is like giving a drowning man an anvil
and saying, ``Here, stand on this. Maybe you could get your head above
water.''
Ms. PELOSI. Mr. Speaker, I yield myself 30 seconds to say to the
gentleman, if he really believes what he says, and I trust that he
does, that he ought not to support the next appropriations for the
National Institutes of Health, which has scientifically conclusive
evidence that needle exchange programs work.
I do have a needle exchange program right next to my office. In
answering the gentleman's question about his

[[Page H2460]]

own constituents and their tax dollar, this syringe costs 10 cents.
Taking care of a person for HIV/AIDS costs $130,000. I do not
understand why our colleagues do not want to spend a dime to save a
life.
Mr. Speaker, I yield 1\1/2\ minutes to the distinguished gentlewoman
from New York (Ms. Velazquez).
Ms. VELAZQUEZ. Mr. Speaker, I rise in strong opposition to H.R. 3717.
If my colleagues are serious about stopping the spread of AIDS, they
will oppose this bill.
The fact is the needle exchange programs save lives. Since 1993,
universities, the National Commission on AIDS, the CDC, and even the
General Accounting Office have determined that these programs work.
These programs can reduce HIV infections by at least one-third and
reduce risk behavior by as much as 80 percent. Furthermore, they
provide a unique opportunity for those currently using drugs to access
health care services, including drug treatment.
There are three publicly funded needle exchange programs in my
district in New York. Their services are helping to reduce the number
of new AIDS cases and providing intravenous drug users with
rehabilitation. As a result, Medicaid costs are reduced. More
important, lives have been saved.
My colleagues, needle exchange programs prevent the spread of AIDS
and help turn people's lives around. This bill is a tragic step in the
wrong direction, and I urge all of my colleagues to vote ``no''.
Mr. WICKER. Mr. Speaker, I yield 2\1/2\ minutes to the gentleman from
Washington (Mr. Nethercutt), not only a leader in the fight against
drugs but also a leader in the effort to fund research for the disease
of diabetes.
Mr. NETHERCUTT. Mr. Speaker, I thank the gentleman from Mississippi
for the yielding me this time and for the introduction.
It has been interesting to listen to this debate today and hear the
advocacy on the left, and people who are opposing this legislation
today advocating so strenuously for people who use needles and drugs
illegally. I want to submit to my colleagues that there is a moral
outrage that is misplaced there; that we do not hear any moral outrage
asked for and stressed by the other side for people who are the only
legitimate users, one of the only legitimate groups of users in the
country of needles legally and for health purposes, and that is the
diabetics in our society.
Sixteen million people in our country have diabetes. A million
children have diabetes. It requires that they inject themselves with a
lifesaving product called insulin three times, four times a day,
legitimately, at a great cost to them. But we do not hear that.
We do not hear our friends who are opposing this legislation
advocating strenuously for the diabetic, for people who are, through no
fault of their own, through no illegal activity, through no misbehavior
in their life-style, contracting this disease. So where is that moral
outrage?
I think we have to look at this as a cost-benefit analysis. Diabetes
consumes billions of dollars a year; 27 cents out of every Medicare
dollar goes to the cost of consequences of diabetes. We do not hear
anybody saying give free needles or have a needle exchange for
diabetics.
Where is the moral outrage? The moral outrage is in favor of the drug
user. In my judgment, I think it is clear that this needle exchange
program, although some may work well in some communities for some
purposes, they perpetuate illegal drug use, not drug use of insulin
injections or diabetes prevention but illegal drug use.
I suggest to my friends, if we are going to have the moral outrage
that I question here in favor of people who are drug users, drug
abusers and injectors of illegal substances that cause tremendous pain
in our society, stand up and fight for the diabetic, the people who use
needles, who use needles legally to live. Do not have this perpetual
constituency that my colleagues seem to want to defend time and time
again. I support this measure and I hope the House will pass it.
Ms. PELOSI. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, if the gentleman cares to know, I am a member of the
Subcommittee on Labor, Health and Human Services, and Education of the
Committee on Appropriations, as is the gentlewoman from New York (Mrs.
Lowey), and all of us fight for funding for diabetes. So it may be good
news to the gentleman from Washington, or maybe he chooses not to know.
Mr. NETHERCUTT. Mr. Speaker, will the gentlewoman yield?
Ms. PELOSI. The gentleman has plenty of time. I will answer any
questions he wants on his time.
Mr. NETHERCUTT. Great.
Ms. PELOSI. I object to the gentleman saying that we do not fight for
funding for diabetes. He does not know what he is talking about.
Mr. NETHERCUTT. Not needle exchange programs.
Ms. PELOSI. Mr. Speaker, I yield 2\1/2\ minutes to the gentlewoman
from New York (Mrs. Lowey), a champion in the fight against substance
abuse and funding for diabetes.
Mrs. LOWEY. Mr. Speaker, I thank my colleague, the gentlewoman from
California, for yielding to me.
I would also like to add before making some other comments, that I
hope the gentleman and all the Members on that side would join us in
doubling the investment at the National Institutes of Health for those
of us who care passionately about diabetes and cancer and the whole
range of illnesses that cause such pain in our society. I hope my
colleagues will join us.
I want to proceed in making comments.
Mr. Speaker, drug use is one of the fastest growing causes of HIV
infection and AIDS. Nearly three-quarters of all AIDS cases in women
are related to IV drug use. This is the tragic and unfortunate reality
of the AIDS epidemic.
Let me be very clear that those of us that oppose this amendment do
not condone the use of illegal drugs. In fact, I believe we have to do
more on the war on drugs. But this amendment is part of a phony war.
Instead, we need to spend more on prevention, treatment programs, and
we need to get much tougher on drug pushers.
If I thought that needle exchange programs promoted drug use, I would
support this amendment. But the fact is that since 1991, six federally
funded studies have reported that needle exchange programs reduce HIV
transmission but do not increase drug use, and that is the fact.
After reviewing the research, an NIH panel concluded that needle
exchange programs will not increase the number of drug users or the
amount of drugs used by addicts. In fact, individuals with access to
needle exchange programs are more likely to enter drug treatment.
A study conducted in New York found that HIV infections decreased by
two-thirds among participants in needle exchange programs. It is
estimated that needle exchange could save between 5,000 to 11,000 lives
over the next few years alone. That is why the AMA, the National
Academy of Sciences, the Nurses Association, the American Public Health
Association, and many other mainstream medical and scientific groups
support needle exchange. This is why the U.S. Conference of Mayors also
supports needle exchange as part of a comprehensive AIDS-fighting
effort.
Let us be clear, this amendment is not fighting drug use. It is about
partisan politics, pure and simple. Let us listen to our Nation's
health experts instead of playing politics with people's lives. Let us
not oppose a proven method of preventing the spread of the deadly AIDS
epidemic.
Mr. WICKER. Mr. Speaker, might I inquire about the time remaining?
The SPEAKER pro tempore (Mr. Blunt). The gentleman from Mississippi
(Mr. Wicker) has 26 minutes remaining. The gentlewoman from California
(Ms. Pelosi) has 9 minutes remaining.
Ms. PELOSI. Mr. Speaker, I am pleased to yield 1 minute to the
gentlewoman from Connecticut (Ms. DeLauro), who is a member of the
Subcommittee on Labor, Health and Human Services, and Education, and a
fighter for increased funding at the NIH for all of the diseases that
challenge the health of American people.
(Ms. DeLAURO asked and was given permission to revise and extend her
remarks and include therein extraneous material.)
Ms. DeLAURO. Mr. Speaker, I believe that public health policy ought
to be driven by science, by concern by human life, not by ideology and
politics. Extensive studies of needle exchange programs, such as the
one in

[[Page H2461]]

the City of New Haven which I represent, have documented that needle
exchange programs do not increase drug use. They do save lives.
Do not take my word for it. Yale University's study of the New Haven
needle exchange program found that it reduced transmission of HIV per
capita by 33 percent each year. In fact, New Haven Chief of Police
Melvin Waring and New Haven Mayor John DeStefano believe that the
needle exchange program has made New Haven, Connecticut a safer
community.
I have a letter from the chief of police and from the mayor which I
will include in the Record, where they write, ``Needle exchange has
contributed greatly to public health and public safety. Our police
officers are grateful for the needle exchange programs.''
I understand the concerns of many here in the House. We should never
condone drugs. Needle exchange programs have a clear purpose, to save
lives.
The text of the letter referred to is as follows:

Office of the Mayor,

New Haven, CT, March 3, 1998.
The President,
The White House
Washington, DC.
Dear President Clinton: As the Mayor and Chief of Police,
we write to convey our strong support for needle exchange
programs operating in the City of New Haven. We urge your
Administration's leadership on HIV prevention by supporting
the local communities who use needle exchange as an effective
HIV/AIDS prevention tactic by allowing federal resources to
be allocated for this purpose in a community deems it
appropriate.
Our programs have served as a national model for innovative
approaches to the twin epidemics of HIV and substance abuse
since 1990. We are proud of the success that our program has
had. In fact, a landmark study by Yale University shows a
reduction of HIV transmission annually per capita of 33
percent in New Haven. We are proud of our innovative efforts
to reduce HIV infection and stand ready to continue to
strengthen and maintain our program locally.
Working in partnership, the Mayor's Office, the health
department and the police department have been able to
develop a needle exchange program that works for New Haven.
The primary goal of our program is to prevent the spread of
HIV among our drug using population keeping them safe from
this deadly disease. Our programs also offer referrals to
medical care drug treatment and other social services, such
as food, housing and support groups.
Needle exchange has contributed greatly to public health
and public safety. Our police officers are grateful for the
exchange programs because the risk of accidental needle
sticks is reduced due to regular capping of needles. Needle
exchange itself encourages users to discard of needles
properly through the exchange sites and not to leave those
needles on the streets. New Haven is a safer place today
because of the community partnership developed through the
use of needle exchange.
We know that this compensive approach to HIV prevention is
effective and hope that your Administration will support our
lifesaving methods by allowing federal resources to be used
in New Haven and nationally for needle exchange. We urge you
to act quickly because lives hang in the balance. A strong
public health message supporting needle exchange and the
necessary resources will demonstrate the courageous, strong
commitment that this Administration has for public health and
public safety and for its most vulnerable citizens.
Many thanks for your consideration of this matter.
Very truly yours,
John DeStefano, Jr.,
Mayor.
Melvin H. Wearing,
Chief of Police.

Mr. WICKER. Mr. Speaker, I yield 2\1/4\ minutes to the distinguished
gentleman from New York (Mr. Fossella).
(Mr. FOSSELLA asked and was given permission to revise and extend his
remarks.)
Mr. FOSSELLA. Mr. Speaker, let me acknowledge at the outset that we
all share, I think, the goal of stopping the spread of AIDS and
sexually transmitted diseases, as well as diabetes and cancer, and
clearly acknowledge that the intention of those who oppose this
legislation is not controverted by our position and our goal to stop
the spread of AIDS.

{time} 1300

But I think it is appropriate as well to apply a little useful
distinction here.
Let me just put a human face on this. Needle giveaway programs should
not be supported with taxpayer dollars. The people back home in Staten
Island and Brooklyn, who get up every morning for work, who go to work
and see a big chunk of their paycheck taken out and given to the
Federal Government, should not expect to see the Federal Government, in
turn, buying needles and giving them away to drug addicts on our
streets and our communities.
Indeed, as we speak here today, there is a group on Staten Island
that is seeking a waiver to start a needle giveaway program. At the
outset, what they wanted to do was to open up a storefront and provide
needle exchanges. Well, the community went a little nuts, as well they
should, because these people invest their life savings in their
American dream, having their children walking around the streets, and
why should they be confronted with looking at a needle giveaway program
with drug addicts coming into their neighborhoods? Because that is all
that is going to happen, with these needle giveaway centers becoming
drug hubs, drug magnets for drug addicts.
So, instead, this group said, well, instead of having the storefront
in one location, we will have a van. We will have a van drive around
the streets of Staten Island dispensing free needles.
Well, what kind of message are we sending to children? Is that the
Good Humor van coming down the block? No, that is the needle giveaway
van coming down the block. They are going to give needles away to drug
addicts.
And, colleagues, let me just point to one needle program in New York
City on the lower east side of Manhattan, not necessarily, I would
argue, the conservative bastion of politics, whereby a local resident
became a little concerned.
Clearly, what is going to happen here on moral grounds, if anything,
is to support this measure. To do anything else would be morally wrong.
And maybe politically right for some, but politically right and morally
wrong just does not fly in this country.
Ms. PELOSI. Mr. Speaker, I wish to inquire about the time.
The SPEAKER pro tempore (Mr. Blunt). The gentlewoman from California
(Ms. Pelosi) has 28 minutes, and the gentleman from Mississippi (Mr.
Wicker) has 24\3/4\ minutes.
Ms. PELOSI. Mr. Speaker, I yield myself 30 seconds.
I wanted to make a statement following the gentleman who just spoke
and welcome him to the Congress, our new Member, as well as the
gentlewoman from Connecticut (Ms. DeLauro), who talked about the
experiences in their own communities.
I want to call to the attention of my colleagues a motion to recommit
which I intend to offer which says that there would be a ban on Federal
funds on needle exchange unless the governor, State health officer, or
local municipal health authority determines that the use of Federal
funds for such a program would reduce the rate of transmission of HIV
and would not encourage the use of illegal drugs and is acceptable to
the State, city or other unit of local government or community.
I think this fits well within the objections that my colleagues have
put forth, and I hope they could support the motion to recommit.
Mr. Speaker, I yield 1 minute to the gentleman from Guam (Mr.
Underwood), who has been a leader in the fight against drug abuse in
that country.
(Mr. UNDERWOOD asked and was given permission to revise and extend
his remarks.)
Mr. UNDERWOOD. Mr. Speaker, the current epidemiology of HIV/AIDS is
clear. Women, children and minorities are affected disproportionately
by heterosexuals' HIV infection associated with transmission from
injectable drug users.
Understand this: We are not just talking about drug users but those
of whom they come into contact with. Certainly, minority communities
are disproportionately affected by AIDS injection drug use.
In 1996, of the Latinos diagnosed with AIDS, injection drug use
accounted for 39 percent of the total cases in men and 51 percent of
the total cases in women. Of particular concern is the fact that nearly
50 percent of new HIV infections can be attributed to injecting drug
use, which disproportionately affects minority communities.
We are not reducing drug use through this legislation. We are talking
about denying protection to families, women and children who come into
contact with drug users, compounding their misery and risking their
lives for an

[[Page H2462]]

empty political symbol. The war on drug use is not the same as a war on
drug users nor a war on their families.
Mr. WICKER. Mr. Speaker, I yield myself 30 seconds.
I appreciate the gentlewoman from California telling us what the
motion to recommit with instructions will be about. I think Members on
both sides of the aisle are smiling about my friends on the left and
their new-found dedication to States' rights and local decision-making.
The fact is, this is Federal money. This Congress has a stewardship
over the use of funds paid into the Federal Treasury by the taxpayers,
and we have a right to make sure they are not used for a
counterproductive purpose.
Mr. Speaker, I yield 3 minutes to the gentleman from Virginia (Mr.
Goodlatte).
Mr. GOODLATTE. Mr. Speaker, I thank the gentleman for yielding me
this time; and I also want to commend him and the gentleman from New
York (Mr. Solomon) for introducing this important legislation; and I
rise in strong support of H.R. 3717, which would prohibit the Federal
Government from subsidizing the distribution of hypodermic needles or
syringes for the injection of illegal drugs.
The argument behind needle exchange programs is fundamentally flawed.
Needle exchanges facilitate and even encourage illegal activity. Is
this really what we want our Federal Government to stand for?
While some in the administration may be able to tell our children,
``Don't do drugs'' on one hand, while giving our other children clean
needles to shoot up with in the other hand, Mr. Speaker, I cannot do
that.
Not only are needle exchange programs inconsistent with Federal law,
the results of community-based needle exchange programs have been
disastrous. Needle exchange programs have resulted in communities with
higher crime, communities that are littered with used drug
paraphernalia and communities that are magnets for drug addicts and the
high-risk behavior that accompany them.
David Murray, Director of Research for the nonpartisan, nonprofit
Statistical Assessment Service here in Washington, has pointed out the
weakness in the methodology of many of the studies cited by the other
side and pointed out the strong evidence in two Canadian studies in
Montreal and Vancouver.
In the Vancouver study, where two-and-a-half million clean needles
were handed out last year, death caused by illegal drug skyrocketed.
Needle exchange programs result in higher drug use. They result in
communities that have serious criminal problems. And the answer to this
problem is twofold: combined strict enforcement of our anti-drug laws
with education of our young people about the dangers of illegal drug
use. And there we have seen real reduction in communities that have
followed that approach.
I urge my colleagues to support this legislation, oppose the use of
needle exchange programs, and make sure that we continue the fight on
drugs in a sensible way by cracking down on drug traffickers and
educating people in this country about the dangers of using illegal
drugs.
Ms. PELOSI. Mr. Speaker, I yield 2 minutes to the gentlewoman from
California (Ms. Woolsey), who has been a leader on this issue of needle
exchange, not needle giveaway, needle exchange, to reduce the number of
contaminated needles in circulation.
(Ms. WOOLSEY asked and was given permission to revise and extend her
remarks.)
Ms. WOOLSEY. Mr. Speaker, I thank my colleague, the gentlewoman from
California (Ms. Pelosi), for her leadership in this effort.
When we talk about AIDS, we are talking about an epidemic, not
someone's narrow-minded cultural war. Maintaining the ban will not help
save our children or anyone else. In fact, the ban on needle exchange
actually threatens lives.
More than half of all children with AIDS contracted the virus from
mothers who are injection drug users or the partners of injection drug
users. That is right. We are talking about our children. Do not forget
that.
In 1995, needle exchange programs were found to reduce the spread of
AIDS and not to lead to increased drug use.
I want to at this point note that my district, Marin and Sonoma
Counties in California, not the inner cities that my colleague, the
gentleman from New York (Mr. King), referred to, provides free needles
through the public health system. This is not just a problem for poor
inner city districts. This is a problem, AIDS is a problem for every
single district in this country.
This bill would ignore the science by denying public health experts a
tool in the fight against AIDS, a tool that has been proven to slow the
spread of this deadly disease. And those of my colleagues who are
worried that free needles increase drug usage have to stop and think.
We have to be reassured that knowing that the positive step by a drug
user to choose clean needles is actually a first step in a very
positive way towards their recovery. Just think about it. This is an
opportunity to begin the healing process.
I urge my colleagues to vote against this flawed piece of
legislation. Support needle exchange and stop the spread of AIDS.
Mr. WICKER. Mr. Speaker, I yield 1 minute to the gentleman from Iowa
(Mr. Latham).
Mr. LATHAM. Mr. Speaker, I thank the gentleman for yielding me this
time, and I just wanted to make a couple of points.
I serve on the Speaker's drug task force. Anyone who has looked for a
moment about drug usage with children and how they start, there are two
key components: Number one, the risk, the risk of what is going to
happen to them. They are going to get sick or it is going to kill them.
Number two is the peer pressure or the moral authority that drug use is
wrong.
Now, if we, as a Federal Government, use taxpayer dollars to say to
kids it is okay if they use drugs as long as they use a clean needle
and we are going to pay for it, what message does that send to our kids
who are facing very difficult decisions today? If we tell kids that,
hey, it might not be good, mom and dad do not like it, but the peer
pressure is not there because the Federal Government says it is okay,
we are going to subsidize their drug use, it is wrong. And I support
this bill 100 percent.
Ms. PELOSI. Mr. Speaker, I yield 1\1/2\ minutes to the gentleman from
Michigan (Mr. Dingell), the ranking member on the Committee on Commerce
and a strong leader in this House with unquestioned credentials in the
fight against drugs.
(Mr. DINGELL asked and was given permission to revise and extend his
remarks and to include extraneous material.)
Mr. DINGELL. Mr. Speaker, what happened to the regular order around
here? What is the reason for bypassing the committee? What is the
reason we are putting this bill on the floor without ever having it
considered by the Committee on Commerce?
This is an authorization bill. It is put on the floor by the
Committee on Rules. No consultation with the Committee on Commerce,
which has jurisdiction over these matters.
I do not intend to talk about the substance. I intend to talk about
outrageous procedure. Without any consideration of the views of the
Committee on Commerce, all of a sudden this legislation is on the
floor; introduced and moved here with blinding speed. A majority which
is incapable of moving ordinary legislation at even ordinary speed is
not capable of withholding from themselves the opportunity to move with
blinding haste on a piece of legislation which is unnecessary. The
Secretary has already said we are not going to have needle exchanges.
If we are going to have a debate on it, let us have an intelligent
debate. Let us let the committees work on these matters, as they
properly should.
Woodrow Wilson, over a half a century ago, observed that the Congress
works in its committees. Let the committees function. Let this body
work its will in an ordinary and intelligent way.
There is no reason for this unseemly haste. If the House needs to
work its will on this and if we should pass this legislation, let us do
it, but in the ordinary, intelligent way, after allowing the committees
to do their work.
There are public health experts who have strong feelings on this.
They

[[Page H2463]]

know vastly more about the public health aspects of this than do we.
Let us hear from them. If there are theologians or experts on crime or
narcotics use or control of narcotics, let us hear from them.
Let us not have this matter laid upon our lap by the Committee on
Rules without the slightest consideration of public interest questions
that should be considered in the ordinary fashion.
Vote this matter down.

Congress of the United States,

Washington, DC, April 28, 1998.
Hon. Gerald B.H. Solomon,
Committee on Rules, U.S. House of Representatives,
Washington, DC.
Dear Chairman Solomon: We are writing to object to the
highly irregular and unfortunate effort to force House
consideration of H.R. 3717, a bill to prohibit Federal
funding of needle exchange programs, without any
consideration by the Commerce Committee, the committee of
jurisdiction.
H.R. 3717 has been referred to the Commerce Committee. Its
members are fully entitled to an opportunity to review,
amend, and state their views on the legislation through
hearings, markup, and committee reports. Allowing H.R. 3717
or any comparable legislation to reach the House floor
without adequate research and reflection is inconsistent with
the best interests of the House.
In past Congresses, needle exchange programs have been the
subject of deliberations by the Commerce Committee and the
Subcommittee on Health and the Environment. In the 105th
Congress, neither H.R. 3717 nor comparable legislation has
been subject to any such review. Consequently, we urge you to
ensure that the regular order is observed and an opportunity
for appropriate scrutiny of the legislation is made available
to the Commerce Committee.
Sincerely,
John D. Dingell,
Ranking Member, Committee on Commerce.
Sherrod Brown,
Ranking Member, Subcommittee on Health and Environment.
Henry A. Waxman,
Ranking Member, Committee on Government Reform and
Oversight.

Mr. WICKER. Mr. Speaker, I yield 3\1/2\ minutes to the gentleman from
Florida (Mr. Weldon), a physician in his own right and a passionate
advocate on behalf of drug control.

{time} 1315

Mr. WELDON of Florida. Mr. Speaker, I thank the gentleman for
yielding me the time.
I am a physician. I did my internship and residency in San Francisco
in the early 1980s. I remember when I got there as a young intern being
told that there were people coming in with strange conditions. And I
remember the first article that was published in the New England
Journal of Medicine and came out of the Veterans' Administration
Hospital in Los Angeles that initially described AIDS.
After serving some time with the Army in Georgia, I went into private
practice in Florida, and I did indeed practice infectious disease with
the only infectious disease specialist in the county, a county of about
400,000 people, who saw AIDS patients. I had the opportunity to treat
lots of AIDS patients and get up in the middle of the night, go into
the emergency room, admit them to the hospital. And I have to say, I
had the sad experience of seeing a lot of young people in the prime of
their life die from complications of AIDS. So, needless to say, I am
very interested in any effort that we can pursue to help control the
spread of AIDS.
Now, there have been a lot of studies that have been quoted by a lot
people that assert that needle exchange programs cut down on the
transmission of infectious disease, and there have been quite a few
studies quoted by people on our side of the aisle that there are other
studies that confound that. So we have a situation where we have some
studies that contend that there is a benefit from needle exchange, and
then there are some studies that show that needle exchange programs do
not work or indeed may actually make matters worse.
I can quote from some of those studies, but I believe some of my
colleagues who have preceded me have already quoted from some of those
studies, so I choose not to do so again, but to simply point out that
one of the confounding problems with some of the studies that contend
that there is a benefit is that they frequently do not control for
other aspects that go along with the needle exchange program, like
counseling, like education that is incorporated into the needle
exchange program. And indeed there are studies that actually suggest
that those things, when we actually go into a community and engage in
counseling and intervention with the drug abuse community exclusive of
needle exchange, we can actually see a dramatic reduction in the
instance of AIDS.
I am specifically thinking about a study that came out of Chicago
which showed the seroconversion rate, that is when people convert from
being without AIDS to having AIDS in their bloodstream, amongst the IV
drug-abusing community fell from 8.4 percent to 2.4 percent. That is
the conversion rate, a dramatic 71 percent reduction.
So, in conclusion, I think this is a very controversial issue, and I
think it is extremely appropriate that the Federal Government not get
involved in promoting this. And if they want to have one in Hartford or
other places, I think certainly we should not prohibit them from doing
that. But this is good legislation. It keeps the Federal Government out
of an issue that I think on a scientific basis is very controversial.
Ms. PELOSI. Mr. Speaker, I yield 2 minutes to the gentleman from
Maryland (Mr. Cummings), who has been a leader on this issue in the
State Legislature of Maryland and in the Congress of the United States
and he is an authority on the needle exchange programs as a means of
reducing substance abuse.
Mr. CUMMINGS. Mr. Speaker, I thank the gentlewoman for yielding.
Mr. Speaker and my colleagues, as I listened to all of the
discussions, I must say that I became a bit upset. I live in a drug-
infested area. I live about 45 miles away from here. And we have a
needle exchange program.
A few years ago, when the Maryland Legislature considered needle
exchange, we had a lot of people who were very much opposed to it, but
it passed for Baltimore City. And 4 years later, after working with the
needle exchange program, our legislature came back and, by a wide
margin, approved it again.
The reason why they have approved it was several reasons. Number one:
Johns Hopkins University conducted a study of our needle exchange
program and found that there was indeed a reduction in AIDS cases, and
they also found that there was no increase in crime. They found that
there was a reduction in crime, as a matter of fact; and they also
found that there was no increase in drug addiction. And that is very,
very significant. As a matter of fact, in Baltimore communities are
asking that needle exchange come to their communities because of the
fact that they have noted that there has been a reduction in crime.
I do not know how many Members of this House have ever seen anyone
dying from AIDS. It is a very, very painful disease, and it is a slow
and debilitating disease. The fact still remains that the science is on
this side. And so, it is very important that we address this issue and
not go for this particular piece of legislation. This piece of
legislation stops the Federal Government from preventing AIDS.
So I say to my colleagues, I ask the Members of this House to look at
Baltimore City. They do not have to go to Vancouver. Baltimore is 45
miles away. The number one research institution in the world has
already studied this issue and says that needle exchange works.
Mr. WICKER. Mr. Speaker, I yield 3 minutes to the gentleman from
Florida (Mr. Mica), one of the most tireless warriors in the fight
against drugs.
Mr. MICA. Mr. Speaker, this administration averted a disaster last
week. Even after an avalanche of opposition from Congress and
opposition from our national drug czar General McCaffrey did President
Clinton weigh in to prevent Federal funding for drug needle exchange.
Today, the House of Representatives, with this resolution, will make
clear that this Congress does not intend to pay for free needles for
drug addicts. This message needs to be heard by our Health and Human
Services Secretary Shalala.
This message needs to be heard by President Clinton's new Surgeon
General Satcher. How inconceivable it is that our new Surgeon General,
as his

[[Page H2464]]

first and premier action in that position, has recommended and promoted
this free drug needle exchange. We as a Nation have not yet recovered
from the damage of President Clinton's former Surgeon General Jocelyn
Elders. Remember, if you will, her advocacy of a drug use policy that
said to this Nation and our children, just say maybe. That policy was
combined with our President's statement to our youth that, ``If I had
it to do all over again, I'd inhale.''
Between the former Surgeon General and the President, drug use among
our teens has soared through the ceiling since 1993. I am pleased that
Congress today is cutting off this new Surgeon General at the pass. His
proposal to give free needles to drug addicts with taxpayer dollars is
absurd. It is like providing free cigarette holders to our
schoolchildren.
I am saddened that the Congressional Black Caucus has called for the
resignation of our national drug czar, who has sided with us on this
issue. He only gave his opinion. The President reversed the other
decision. Why are they not calling on the President to resign? How
tragic that those Representatives whose constituents have been
slaughtered in incredible numbers would support Federal funds for more
drug abuse.
Where is the most dramatic increase taking place with heroin which
will be used by these needles? By our teens. So this program will get
those needles right where they need to be, to our teens. ``Long Out of
Sight, Heroin is Back Killing Our Teens.'' This is the headline from my
local paper. This is absurd. This is crazy.
I challenge Members to come with me and ask my constituents if they
want their tax dollars to pay to supply free needles for drug addicts
in my district, and I guarantee them the answer will be no.
Ms. PELOSI. Mr. Speaker, I yield 2\1/2\ minutes to the gentlewoman
from California (Ms. Millender-McDonald), who came to Congress to
challenge each of our Members to lead their constituents not down the
easy path, but the real path to reduce substance abuse in our
communities.
Ms. MILLENDER-McDONALD. Mr. Speaker, I rise today in opposition to
H.R. 3717.
As a Member of this House, representing a region of this country with
an astronomical high rate of HIV transmission and AIDS, I cannot
support this bill. I cannot support legislation that is brashly written
to resolve hot tempers and not to resolve the real problems here.
HIV and AIDS continue to plague this country. We have not and will
not see the rate of HIV transmission fall if we continue to let
politics rule the legislative process. We have conclusive scientific
evidence that needle exchange programs mitigate the spread of HIV and
are an essential catalyst in getting people off the streets and into
the life-saving substance abuse programs.
Nationwide, injection drug use accounts for more than 60 percent of
the AIDS cases, more than 70 percent of the HIV infections among women
of child-bearing age, and more than 75 percent of babies diagnosed with
HIV AIDS.
Among African Americans, 48 percent of AIDS cases are related to
injection drug use. The rate of HIV AIDS transmission in the African
American community is 7 times that of the general population, and AIDS
continues to be the number one killer of African American women age 25
to 44 years.
Needle exchange programs have shown a reduction in risk behavior as
high as 80 percent in injecting drug users, with estimates of 30
percent of greater reduction of HIV. Perhaps the most critical of all,
these needle exchange programs help individuals stabilize their health
and gain more control over the dangerous environment in which they live
so that they can benefit from HIV medications and drug treatment.
The needle exchange programs that have been implemented in inner
cities throughout the country are playing a critical role in reducing
HIV transmission, assisting HIV-positive drug users in obtaining
necessary care and drug treatment, and providing essential information
on AIDS. This is critical not only for those who are IV drug users, but
for the hundreds of thousands of adults who do not know that their
partners are using drugs and for the innocent children who are born
with this fatal disease.
The American Medical Association, the American Public Health
Association, American Academy of Pediatrics, and many more national
health organizations support needle exchange programs. I encourage my
colleagues to join me in voting against this bill, which is full of
politics and void of reason.
Mr. WICKER. Mr. Speaker, I yield 3 minutes to the gentleman from
Arizona (Mr. Shadegg).
Mr. SHADEGG. Mr. Speaker, I thank the gentleman from Mississippi for
yielding.
As I listen to this debate, I find one particular part of it rather
fascinating. I heard a colleague early on in the debate say clearly
that the evidence was all on one side; that, in fact, there was clear
and convincing evidence that these programs indisputably work, that
they lower HIV conversion, and that they do not increase drug abuse.
And he said, I cannot believe that that is not true. It is absolutely
true. And speaker after speaker has come to this floor and cited
scientific studies.
But do my colleagues know what? There are studies on both sides of
the aisle. Quite frankly, one thing is very obvious from this debate.
The science is, in fact, divided on this issue. No one can maintain
that it is absolutely clear.
I want to cite James L. Curtis, a medical doctor and a clinical
professor of psychiatry at Harlem Hospital Center, a black American
himself. He says point blank, ``There is no evidence that such programs
work.'' He says, citing the Montreal and Vancouver studies, that they
show that those addicts who took part in the program were two to three
times more likely to become infected with AIDS than those who did not.
And he also found that almost half the addicts frequently shared their
needles.
I also want to cite Dr. Janet D. Lapey, M.D., president of Drug Watch
International. She cites the same two studies, but she points out
another important fact that is being ignored. She points out that in
Montreal, deaths from overdose have increased over fivefold since the
program started. That is an historic increase. And Vancouver has now
the highest heroin death rate in all of North America.
One thing we have to concludes from this is that science is divided,
but practicality is not. Let me give my colleagues a real-life
situation.
A woman appeared before our subcommittee and testified on this issue.
Her name was Nancy Sossman. We heard my colleague on the other side.
She said that she made a personal visit. We heard my colleague say this
is an exchange program. In the real world, it is not an exchange
program. Without presenting a single needle, she was given 40 clean
needles. Asked if she had to return them, she was told no, she did not
have to return them, she simply had to dispose of them in an opaque
container. In the practical world this program spreads needles among
people who need them the least and will do the most damage. As for
cleaning up the problem, she specifically told them that she had only
been using drugs for 6 months in hopes that they would encourage her to
get treatment. They did not do that.
Across America, there is no debate about this issue. If we want to
win the fight against drugs, if we care about our children as much as
we care about HIV, we cannot send the mixed signal of handing out free
needles, encouraging people to break the law, encouraging them to
engage in destructive conduct that will destroy their lives. In the
real world, this program is simply dumb. It encourages people to break
the law, destroy their lives, and it at best under the science does not
work.
Ms. PELOSI. Mr. Speaker, I agree with the gentleman that the program
that he described is not one that fits the standards set by the
Committee on Appropriations which is a needle exchange program, not as
described by him. I would agree with him that that is not appropriate.
Mr. Speaker, I yield such time as she may consume to the gentlewoman
from Texas (Ms. Jackson-Lee), a very strong advocate against substance
abuse in our country.
(Ms. JACKSON-LEE of Texas asked and was given permission to revise
and extend her remarks.)

[[Page H2465]]

Ms. JACKSON-LEE of Texas. Mr. Speaker, the gentlewoman is right.
Because of the fact that children do not use needles and this is a
lifesaving legislation that helps prevent the transmission of HIV, I am
rising to oppose this legislation because I want to save lives.
Mr. Speaker, I rise today to urge my colleagues to vote no on H.R.
3717, which will prohibit Federal funds for needle distribution
programs.
Extensive scientific evidence shows that the needle exchange program
reduces the spread of HIV and AIDS and does not increase drug use.
What the needle exchange program does, is saves lives. And if we can
save one life, that makes the needle exchange program a resounding
success.
I applaud President Clinton's steadfast leadership in the Nation's
fight against HIV/AIDS. But the combination of AIDS and substance abuse
remain a complex public health epidemic that must be dealt with in the
most effective manner.
Nationwide, IV-Drug use accounts for about 60 percent of the AIDS
cases and more than 70 percent of the HIV infections among women of
child bearing age. And more than 75 percent of babies diagnosed with
HIV/AIDS were infected as a result of IV-drug use by one of their
parents.
The numbers in the African-American community are even more shocking.
A recent study shows that AIDS is the leading death of African-American
men between 25 and 44 years of age.
The fact that the largest number of AIDS cases in the general
population and in the African American community are due to intravenous
drug use clearly illustrates the necessity of the needle exchange
program in the control and prevention of HIV/AIDS.
According to a recent study, the number of HIV infections that could
have been prevented between 1987 and 1995 if the needle exchange
programs were established is between 4,400 and 9,700. In addition, up
to a half billion dollars in health care expenditures could have been
avoided.
We can not continue to ignore solid evidence that needle exchange
programs that make needles available on a replacement basis only, is
extremely effective in controlling and preventing the spread of HIV/
AIDS, and it helps to reduces drug use through effective referrals to
drug treatment and counseling.
Federal funds must be used to support effective needle exchange
programs. We must put politics aside and support the needle exchange
program, for the sake of our children and the young men and women who
are contracting HIV/AIDS through intravenous drug use.
Clean needles are only a part of the solution, but it is an important
part. I urge my colleagues to vote no on H.R. 3717 and help me to save
a life today.
Ms. PELOSI. Mr. Speaker, I yield 1 minute to the gentlewoman from
California (Ms. Lee), one of the newest Members of the House of
Representatives, a champion in the State legislature in the fight
against substance abuse and now in the Congress.
Ms. LEE. Mr. Speaker, I thank the gentlewoman from California for
yielding time and for her leadership in this effort to save lives.
Mr. Speaker, for years I have been supportive of needle exchange
funding legislation as a member of the California legislature. Studies
conclusively show that needle exchange programs, while dramatically
reducing the spread of HIV, do not encourage drug use. On the contrary.
Needle exchange programs can provide a bridge to treatment. They have
been shown to have a positive impact on identifying intravenous drug
users, a very hard to reach population, and bringing these individuals
out of crime and into medical care treatment and prevention programs.
IV drug use accounts for 75 percent of all new HIV infections among
women and children, and for 40 percent of new HIV infections overall.
The passage of this bill would be dramatically damaging to people of
color and communities which I represent. The disproportionate number of
African-American and Latino individuals who are infected with HIV is
astounding: Minorities make up 64% of HIV infections. Even more
shocking, while African-Americans make up 16% of the U.S. population,
they comprise 45% of those infected with HIV. These statistics
demonstrate a state of emergency for people of color.
Two-thirds of Americans support needle exchange programs, which are a
lifesaving event in the right direction. I urge a ``no'' vote on H.R.
3717.
Ms. PELOSI. Mr. Speaker, I yield 1\3/4\ minutes to the gentleman from
New York (Mr. Nadler), an expert on the subject of reducing substance
abuse in our country and stopping the spread of HIV.
(Mr. NADLER asked and was given permission to revise and extend his
remarks.)
Mr. NADLER. Mr. Speaker, I represent New York City, the epicenter of
the AIDS epidemic in this country. We have seen dramatic reductions in
the rate of transmission of AIDS in those areas where we have needle
exchange programs. Our experience has changed the minds of many former
opponents as a result of what they have seen.
This bill we have today is a death sentence for many people in this
country. The evidence is clear and convincing and irrefutable, needle
exchange programs save lives. The Federal Government's top scientists
at the National Academy of Sciences, the National Commission on AIDS,
the American Medical Association, the National Institutes of Health,
the General Accounting Office all tell us there is conclusive proof
that needle exchange programs save lives, prevent the spread of AIDS
and do not encourage drug use. With scientific proof in hand that
needle exchange saves lives, the question before us today is does this
House wish to cause people to suffer and die rather than to let science
and medicine slow the spread of this deadly disease?
The numbers are shocking. Every day 33 people, including drug users,
their sex partners and their children, become infected with the AIDS
virus because of intravenous drug use. Forty percent of all new
infections in the U.S. result from the use of contaminated needles. For
women and children, 75 percent. But needle exchange programs prevent
the spread and without any increase in IV drug use. In fact, studies
show that IV drug use declines as a result of needle exchange because
needle exchange programs encourage drug users to seek treatment.
If we have the ability to help those who want and need this
assistance, why would we not? Because it sends a message? Dead and
dying children send a worse message. Defeat this deadly, deadly bill.
Mr. Speaker, I represent N.Y.C., the epicenter of the AIDS epidemic
in this country. We have seen dramatic reductions in the rate of
transmission of AIDS in those areas where we have needle exchange
programs. Our experience has changed the minds of many former
opponents, of needle exchange programs.
Mr. Speaker, this bill is a death sentence for many people, in this
country. The evidence is clear and convincing, needle exchange programs
save lives!
The federal government's top scientists, as well as the National
Academy of Sciences, the National Commission on AIDS, AMA, Nat'l Acad.
of Sciences, the National Institutes of Health, and the General
Accounting Office, all tell us there is conclusive proof that needle
exchange programs prevent the spread of AIDS, and do not encourage drug
use. With scientific proof in hand that needle exchange saves lives--
the question before us is does this House wish to cause people to
suffer and die rather than to let science and medicine slow down the
spread of this deadly disease.
Mr. Speaker, the numbers are shocking. Every day, 33 people--
including drug users, their sex partners and their children--children
become infected with the AIDS virus as a result of intravenous drug
use. Forty percent of all new infections in the U.S. result from the
use of contaminated needles; for women and children, that figure is 75
percent.
But needle exchange programs prevent this spread--and without any
increase in IV drug use. In fact, studies show that IV drug use
declines as a result of needle exchange, because needle exchange
programs encourage drug users to seek treatment.
If we have the ability and resources to help those who want and need
assistance and save them and their children from a slow and painful
death then why not do so? Because it sends a message? Dead and dying
children send a worse message.
Mr. Speaker, I do not believe that any member of this House would
wish greater spread of the AIDS epidemic. There is no real controversy
here--it is a fact that needle exchange saves lives. To ban federal
funds for these programs would bring certain death to thousands.
Mr. Speaker, we have to face reality. People are using drugs
intravenously already. If by providing clean needles, we reduce their
use of infected needles, then we reduce the transmission of AIDS. We
know this. Study after study shows this.
I urge my colleagues to choose life! Choose life over death! Choose
life over demagoguery! Reject this deadly bill.

[[Page H2466]]

Ms. PELOSI. Mr. Speaker, I yield 3 minutes to the gentleman from
California (Mr. Waxman), a champion in this House in the effort to stop
the spread of HIV and AIDS and an expert on the issue of substance
abuse.
Mr. WAXMAN. Mr. Speaker, I thank the gentlewoman very much for
yielding time to me. I want to give a reality check for this
institution. There is no Federal funding of the needle exchange program
anywhere in this country. There is no mandate or requirement that a
State, city or community use needle exchange. This bill is simply
unnecessary. Today States and localities are free to determine with
their best scientific judgment whether needle exchange makes sense for
their own citizens. They can fund them themselves. But this bill would
slam the door now and forever on any possibility of getting Federal
funding provided in the future. Even if the State of California wanted
to do it, a city like Boston or New York thought it was appropriate,
they would, even in the best interest of their citizens, be blocked
from using Federal funds. The cold, hard reality is that all of the
science shows that needle exchange programs prevent AIDS and save
lives. This is a fact. This is the conclusion of the Surgeon General.
That is the conclusion of the National Academy of Sciences. That is the
conclusion of the National Institutes of Health. If that is not enough
for you, it is also the conclusion of the American Medical Association,
the American Public Health Association, the American Nurses Association
and the American Academy of Pediatrics.
It is not, however, the conclusion of the Republican leadership.
Needle exchange programs prevent AIDS and save lives. Period. The proof
is overwhelming.
Mr. Speaker, I want to emphasize the real purpose of this
legislation. Earlier this morning I pointed out that the Committee on
Rules had caved in to orders from the leadership to bypass the
committee of jurisdiction, the Committee on Commerce. The only reason
this bill is on the floor today without any committee deliberation
whatsoever is because the Republican leadership wanted to avoid any
critical scrutiny of the bill. They wanted to turn this public health
issue into a political football.
There have been some pretty ludicrous claims made about needle
exchange programs. One would think that we were about to install them
in vending machines next to Coke machines around the country.
Here is another reality check. Needle exchange programs not only save
lives by stopping the spread of AIDS but they can reduce drug use and
bring IV drug users into the health care system. People who normally
shun contact with the public and authorities get referrals to health
care, drug rehabilitation and treatment. In fact, the NIH found that IV
drug users in needle exchange programs are more likely to get drug
treatment because they are already in the program.
Needle exchange programs send a simple message. If you use IV drugs,
you can get AIDS and you can spread it. If you need treatment, there is
a place where you can get it.
Mr. Speaker, I include the following material for the Record:

[From the Washington Post, April 23, 1998]

Clean Needles, No Money

President Clinton's latest policy response to a national
epidemic--the spread of AIDS among intravenous drug users--is
little more than a political fix. In one breath, the
administration is declaring that needle-exchange programs do
help curb the spread of AIDS--but that no federal funds
should be spent on this approach. This half-and-half
solution, intended to resolve internal policy disagreements
among the president's advisers, puts politics ahead of public
health.
The administration says the announcement does send out an
important message: that even without federal subsidies, the
decision that needle exchanges have scientific merit should
assist state and local programs in securing financial
backing. Secretary of Health and Human Services Donna E.
Shalala reportedly would have preferred to begin allowing
certain programs to qualify for federal aid--a reasonable
introduction. But those in the administration who argued that
lifting the ban on federal funding would send a bad message
found reinforcements among congressional leaders who said the
votes to uphold needle-exchange funding weren't there--that
pressing a fight could result in legislation taking other
federal money away from groups or governments that provide
free needles.
Secretary Shalala has argued since the announcement that
the administration's endorsement of the approach will include
educational efforts to underscore the findings of all major
leading research groups, public as well as private, that
needle exchanges are scientifically sound. The federal
government should have a clear and important role in this
attack on AIDS. Needle exchanges are but part of a broader
effort, including improved drug-abuse prevention and
treatment. But study after study shows that the exchanges do
not promote greater use of illegal drugs. In any event, drug
addicts who are not under treatment don't stop their drug use
just because clean needles are unavailable. They will go to
infected needles. The National institutes of Health reports
that needle exchange has brought about an estimated 30
percent or greater reduction of HIV in injection users of
illegal drugs. In terms of money, these programs are a
fraction of the lifetime cost of treating a person with HIV/
AIDS. Full support, not White House lip service, should be a
priority.
____

[From the Los Angeles Times, Apr. 22, 1998]

Cop-Out on Needle Exchanges

Clinton administration officials would have us believe they
took a sensible middle road on Monday, producing
incontrovertible evidence that needle exchange programs save
lives but not going so far as to lift a prohibition on the
use of federal funds for the controversial programs. Health
and Human Services Secretary Donna Shalala, administration
officials argued, would never have been able to gain approval
for needle exchange programs from a skeptical Congress.
In fact, what the Clinton administration presented as
moderation was really evasion, for Shalala's department has
not needed congressional approval since 1990, when Congress
granted it authority to lift a ban on needle funding provided
it could demonstrate just what Shalala announced Monday: that
needle exchange programs lower the spread of HIV and do not
increase substance abuse.
The administration's decision to maintain the funding ban
will surely cost lives, for injection drug users compose the
group in which AIDS is spreading most rampantly. According to
Surgeon General David Satcher, tainted needles account for
75% of all new AIDS infections among women and children and
for 40% of all new AIDS infections overall.
Generous funding for needle exchange programs already
exists. About $630 million is doled out yearly by the Centers
for Disease Control for regional AIDS programs, and civic
groups like the U.S. Conference of Mayors have asked Shalala
to let them spend some of that money on needle exchange
programs.
Some legislators understandably object to the notion of the
federal government handing out needles to substance abusers.
The programs, however, don't stop at handing out needles;
their primary aim is attracting and then treating the sort of
substance abusers whom public health officials would
otherwise have difficulty finding, and an abuser untreated is
a threat to others.
Ideally, substance abusers would flock to treatment without
any incentives. But this is the real world: Thirty-three
Americans are infected each day with AIDS because of
injection drug use. Needle exchange programs could change
those sad numbers.
____

[From the New York Times, Apr. 9, 1998]

The Politics of Needles and AIDS

(By Julie Bruneau and Martin T. Schechter)

[[Page H2467]]

But clean needles are only part of the solution. A
comprehensive approach that includes needle exchange, health
care, treatment, social support and counseling is also
needed. In Canada, local governments acted on our research by
expanding needle exchanges and adding related services. We
hope the Clinton Administration and Congress will provide the
same kind of leadership in the United States.
____

[From the New York Times, Feb. 22, 1997]

Federal Funds for Clean Needles

Health and Human Services Secretary Donna Shalala says in a
new report to the Senate that needle-exchange programs are an
effective way to combat the spread of H.I.V., the virus that
causes AIDS. But the Secretary does not go far enough. It is
time the Clinton Administration lifted the ban on Federal
funding for needle-exchange programs.
Such programs now exist in more than 50 American cities,
including New York. They provide intravenous-drug users with
sterile needles, thus reducing the likelihood that addicts
will share needles contaminated with H.I.V. The programs
typically have very small budgets, often are run by
volunteers and are plagued with unstable funding from year to
year. Yet even these modest programs have been effective.
Secretary Shalala's report reviews the research on the
issue. Earlier studies done by the National Academy of
Sciences, the General Accounting Office, the Centers for
Disease Control and the University of California at Berkeley
found that providing addicts with sterile needles could help
slow the spread of the virus. Equally important, those
studies found no evidence that needle-exchange programs
increase the amount of drug use by addicts or attracted new
users.
More recent studies done for the Massachusetts Department
of Public Health and in Baltimore by the Johns Hopkins School
of Public Health confirmed those observations. Federally
funded studies conducted by the National Institute on Drug
Abuse also report no increase in the frequency of drug
injection associated with needle-exchange programs. A
conference of scientists convened by the National Institutes
of Health on AIDS prevention stated unequivocally last week
that there is no doubt that needle-exchange programs work.
The consistency of these findings justifies Federal support
to help pay for needle-exchange programs in communities that
need and want them. Unfortunately, the debate continues to
focus on politics and morality rather than public health
needs. Opponents argue that providing addicts with needles
implies approval of drug abuse. They forget that addicts can
infect their spouses and offspring who do not abuse drugs and
yet must live with the consequences of dirty needles.
Congress imposed the ban on Federal funding for needle
exchanges in 1992. But the Administration can lift the ban if
the Surgeon General declares that the programs can reduce
H.I.V. spread and do not increase drug use. Secretary
Shalala's report offers ample evidence that both requirements
have been met. The Administration no doubt wants to avoid
giving its opponents any reason to bash President Clinton for
being soft on drugs. But lives can be saved with needle-
exchange programs. The President should show some courage on
this issue.
____

[From the Wall Street Journal, July 10, 1996]

Needle-Swap Programs Spark Life-and-Death Debates

(By Amanda Bennett)

Optimism about life-prolonging drug therapy for AIDS
patients is running high at the International Conference on
AIDS in Vancouver. But two researchers, yesterday delivered a
sobering message: If needle-exchange programs aren't widely
adopted and publicly funded, they said, more than 11,000 new
HIV infections that could be prevented will occur before the
end of the decade.
``People's lives are at stake,'' says one of the
researchers, Peter Lurie of the Center for AIDS Prevention
Studies at the University of California at San Francisco.
Needle-exchange programs allow drug addicts to swap used
needles for clean ones. But needle distribution without
prescription is illegal in at least nine states, and nearly
all the states have laws prohibiting carrying drug
paraphernalia. What's more, under an amendment sponsored in
1988 by North Carolina's Republican Sen. Jesse Helms, such
programs are barred from federal funding.
Against that backdrop, Dr. Lurie and his colleague, Ernest
Drucker of Albert Einstein College of Medicine in New York,
estimate that as many as 10,000 infections could have been
prevented between 1987 and 1995 had programs that supply
clean needles to addicts been generally available. The
researchers reached their conclusion by mathematically
combining the results of previous studies of the
effectiveness of needle-exchange programs and of the numbers
of people expected to use them if they were available.
While other researchers have estimated the impact of
needle-exchange programs in individual locations, this is the
first attempt to calculate the national effect. ``It's
unique,'' says David Purchase, director of the North American
Syringe Exchange Network in Tacoma, Wash., a service
organization for syringe-exchange programs. Other researchers
applauded the effort, even while noting that they believed
the figures Drs. Lurie and Drucker obtained--reductions of
infections of between 15% and 33%--were low.
``It's a very good start, but I think it seriously
underestimates the potential effectiveness of syringe
exchanges,'' says Don Des Jarlais, director of research of
the Chemical Dependency Institute of Beth Israel Medical
Center in New York.
Dr. Des Jarlais himself is presenting a paper at the
conference that he says shows syringe exchanges in New York
(where they are legal) are ``working much better than anyone
expected.'' Since 1992, the doctor says, the programs he
studied showed a decrease in HIV infections of more than 50%.
The analysis underscores the battle that continues to rage
between politics and science, more than 15 years into the
epidemic. This past Monday, President Clinton's own Advisory
Council on HIV/AIDS criticized him for failing to support
needle-exchange programs. In a report, the panel said that
absence of support is ``not consistent with current knowledge
regarding the impact of such programs on HIV infection.''
(The Clinton administration has the power to lift the ban on
federal funding of needle-exchange programs if scientific
evidence shows that is warranted.)
Some who oppose needle-exchange programs believe that they
tacitly encourage the use of illegal drugs. Others, such as
Democratic Rep. Charles Rangel of New York, who represents a
largely minority community in New York City, support needle-
exchange programs only if they don't divert resources from
drug treatment.
The conflicting nature of the various arguments is evident
in the experience of Herbert J. Kleber, a Columbia University
professor who was a member of a National Research Council
panel that found needle-exchange programs effective in
reducing HIV transmission. Dr. Kleber said several months ago
that he nonetheless had doubts about the programs, noting
that participants in one of them, in Montreal, actually had a
higher rate of HIV and of new HIV infections. (An analysis of
the Montreal program is also being presented at Vancouver;
one of the investigators called the findings ``worrisome''
and ``paradoxical,'' and said that additional studies were
being planned.)
The competing political forces create other complications.
In California, Attorney General Dan Lundgren has been
aggressively fighting needle-exchange programs, but local
officials, like San Francisco Mayor Willie Brown, support
them. In Oakland, three exchange sites give out about 50,000
clean needles a month; one part of the program, which offers
drug counseling and outreach, is funded by federal and state
money, says spokeswoman Camille Anacabe, but the syringe-
exchange part of the program is funded by a private
foundation.
Nationwide, the number of needle-exchange programs
continues to grow, some operating either illegally or on the
edge of the law. Dr. Lurie of the Center for AIDS Prevention
Studies estimates that there are 88 in operation today,
compared with 68 in 1994 and 37 in 1993.
Still, Dr. Des Jarlais says his study demonstrates that the
reach of such programs can be greatly extended following
legalization. He says after the programs he studied were
legalized in 1992, the number of needles distributed
increased 25-fold.
The study by Drs. Lurie and Drucker assumes that needle-
exchange programs could have grown from zero in 1987 until
they served 50% of all needle users in 1994--the percentage
served in Australia, which implemented such programs early in
the epidemic. The study further assumes that preventing
infections in drug users also prevents other infections.
About 12% of the infections they estimate to have been
preventable are among drug users' sex partners and newly born
children. However, the study's authors also figure that some
infections that appear to be due to intravenous drug use are
actually due to sexual transmission and so wouldn't be
affected by exchange programs.
Drs. Lurie and Drucker figure that the U.S. could have
avoided up to $538 million in treatment costs by preventing
new infections through needle exchanges. Dr. Des Jarlais
notes, however, that the study doesn't take into account
potential infections averted by legalizing pharmacy sales of
syringes to drug users, which is another method favored by
the prevention community.
Jon Stuen-Parker, an ex-addict and a longtime AIDS
activist, doesn't deal in abstracts: He spends much of his
time giving out clean hypodermic needles to injection drug
users. ``Nothing is more urgent than stemming the spread of
the virus'' among addicts, he says. Last month, Mr. Stuen-
Parker was given an 18-month suspended jail sentence in New
Hampshire, where it is illegal to possess a syringe without a
prescription.
____

American Public

Health Association,

Washington, DC, April 28, 1998.
Dear Member of Congress,
The American Public Health Association (APHA), consisting
of more than 50,000 public health professionals dedicated to
advancing the nation's health, strongly urges you to vote
against HR 3717 when it comes before the full House tomorrow
for consideration. HR 3717 would prohibit the use of Federal
funds for the distribution of needles or syringes for the
hypodermic injection of illegal drugs. APHA opposes this bill
and any legislation that would enact a permanent federal ban
on the use of federal funds for needle exchange programs.
Since 1994, APHA specifically has advocated the
development, implementation,

[[Page H2468]]

evaluation, and funding of needle exchange programs to help
prevent HIV infection. All APHA public policy is passed by
the Association Governing Council and is required to meet
strict scientific criteria. APHA policy on needle exchange is
no different--an enormous body of published research,
including more than seven federally sponsored reports,
demonstrates that needle exchange programs reduce the spread
of HIV while not increasing drug use by program participants
or others in the community where the program is conducted.
Secretary of Health and Human Services Donna Shalala recently
has confirmed these findings in a statement issued on Monday,
April 20, 1998.
The current epidemiology of HIV/AIDS is clear--women and
children are affected disproportionately by heterosexual HIV
infection associated either directly or indirectly with
transmission from injectable drug users. These new cases of
HIV/AIDS that are linked to injectable drug use largely can
be prevented through the provision of sterile needles to drug
users coupled with other public health tools including health
education and condom distribution.
Needle exchange programs increase the contact that health
professionals have with injectable drug users, thereby
increasing opportunities to conduct health education and
disease prevention activities, including drug treatment and
counseling. Federal funding for needle exchange programs is
essential to protecting the public's health. The efficacy of
these programs is proven and the Federal government has a
responsibility to provide the leadership and the funding to
allow these programs to be developed in those communities
that determine they need this important public health
intervention. Public health and saving lives must take
precedence over politics and rhetoric.
Congress should be taking action now to release Federal
funding for needle exchange programs rather than enacting a
ban on such support. Your opposition to HR 3717 is critical
to protecting public health.
Thank you for your consideration of our views and your
attention to this critical public health matter.
Sincerely,
Mohammad N. Akhter, MD, MPH,
Executive Director.
____

American Bar Association,

Governmental Affairs Office,

Washington, DC, April 28, 1998.
Hon. Thomas J. Bliley, Jr.,
Chairman, Committee on Commerce, House of Representatives,
Washington, D.C.
Dear Mr. Chairman: We understand that H.R. 3717,
legislation to permanently ban federal funding for needle
exchange programs for drug addicts, is scheduled to be marked
up by your committee this week. We are writing to urge you to
oppose H.R. 3717 because it is unnecessary and
counterproductive, and removes a critical medical and public
health decision from the province of public health officials.
Last year, the American Bar Association adopted the
following policy on the subject of needle exchange programs:
Resolved. That in order to further scientifically based
public health objectives to reduce HIV infection and other
blood-borne diseases, and in support of our long-standing
opposition to substance abuse, the American Bar Association
supports the removal of legal barriers to the establishment
and operation of approved needle exchange programs that
include a component of drug counseling and drug treatment
referrals.
This legislation was introduced on Monday, April 27, and is
moving on an exceptionally fast track, even though the
Administration has announced that it is not going to lift the
restriction on federal funding despite the fact that HHS
Secretary Donna E. Shalala has now determined that the
criteria for federal funding mandated by Congress in 1989
have been met, i.e., such programs are effective in
preventing the spread of HIV and do not promote drug use.
Rather than authorizing federal funding, the Administration
is encouraging communities to continue to use their own funds
to develop or enhance needle exchange programs and to share
their experiences so that other communities can construct the
most successful programs.
Permanently prohibiting federal funding of needle exchange
programs will not advance this nation's efforts to combat
drug abuse. It may in fact inhibit current efforts since
needle exchange programs have been shown to increase the
opportunity for counseling drug addicts and encouraging their
participation in appropriate drug treatment programs.
Secretary Shalala said that a meticulous scientific review
has now proven that needle exchange programs can reduce the
transmission of HIV and save lives without losing ground in
the battle against illegal drugs, and that, in fact
successful needle exchange programs refer participants to
drug counseling and treatment as well as necessary medical
services.
Likewise, enacting a permanent ban on federal funding of
needle exchange programs will prevent public health officials
from using a proven tool to reduce the transmission rate of
HIV among a high risk population that is contracting HIV at
alarming rates. Surgeon General David Satcher has stated that
40% of new AIDS infections in the United States are either
directly or indirectly attributed to infection with
contaminated needles; among women and children, the figure is
75%.
Since there is no cure for HIV and no vaccine to protect
against HIV, it is essential that public health officials
have the ability to use all reasonable methods to protect the
uninfected public and to counsel and provide treatment to
infected intravenous drug users. This proposed legislation
would remove the decision to use a potentially powerful
method of reducing HIV transmission and intravenous drug
abuse from the province of public health officials.
For all the above reasons, the American Bar Association
urges you not to support H.R. 3717.
Sincerely,
Robert D. Evans
____

Council of State and

Territorial Epidemiologists,

Albany, NY, April 28, 1998.
Dear Member of Congress: The Council of State and
Territorial Epidemiologists (CSTE), an association of 450
state and local public health epidemiologists, urges you to
vote against H.R. 3717, which is expected to be considered by
the full House tomorrow, April 29th. H.R. 3717 would place a
permanent ban on use of federal funds for needle exchange
programs designed to prevent the spread of AIDS.
Injection drug use continues to be a major source of HIV
transmission in the United States. It is imperative that
public health officials develop effective prevention
strategies aimed at reducing the risk of transmission among
drug users. Currently available data strongly suggest that
improving access to sterile syringes and needles may be an
important strategy in curtailing the spread of the HIV
epidemic.
These facts led CSTE to adopt, at our 1997 annual meeting,
a position statement supporting increased access to sterile
syringes and needles among injecting drug users. A number of
states already support syringe exchange programs with their
own funds. CSTE strongly supports state-based efforts to
reduce barriers involving access to sterile syringes and
needles and believes that these activities are likely to have
important implications for the long term prevention of death
and disability caused by HIV in this country. States should
have the flexibility to administer federal funds according to
local need. CSTE also believes that if Members of Congress
were provided a full opportunity to evaluate the evidence of
the effectiveness of needle exchange programs in reducing HIV
infection rates without incurring additional illegal drug
use, they would not support a permanent ban on use of federal
funds for needle exchange programs.
Sincerely,
Guthrie S. Birkhead, MD, MPH,
President.
____

April 28, 1998.

County and City Health Officials Oppose Permanent Ban on Federal
Funding for Needle Exchange Programs to Prevent HIV

The National Association of County and City Health
Officials (NACCHO) urges the House of Representatives not to
pass HR 3717, a measure that would prohibit permanently the
use of any federal funds to assist localities in making
available sterile needles through needle exchange programs.
Local needle exchange programs have been shown convincingly
to reduce the transmission of HIV and other blood-borne
pathogens through the use of unsterile injection drug
equipment, and there is no evidence whatever that such
programs encourage greater use of illegal drugs. The research
supporting these conclusions has withstood the scrutiny of
repeated reviews, including those commissioned by the Centers
for Disease Control and Prevention, the General Accounting
Office, and a rigorous analysis by the National Academy of
Science.
HIV infection rates continue unabated and the rates of
infection from injection drug use have been increasing.
Needle exchange programs are public health interventions that
have been demonstrated to be effective in reducing HIV
transmission. They also can work in concert with drug abuse
prevention programs to help identify and refer drug abusers
to treatment. We can ill afford to handicap localities that
choose to implement effective prevention strategies in their
own communities by restricting the uses of federal funds that
are important resources in battling the AIDS epidemic. The
persons who ultimately suffer are not only HIV-infected drug
abusers, but also their spouses, sexual partners, and babies
who become infected during pregnancy.
NACCHO understands that the Administration currently
prohibits such funding, while encouraging localities that
choose to use needle exchange programs as part of a
comprehensive prevention strategy to do so using non-federal
sources of funding. However, the twin public health threats
of HIV and abuse of illegal drugs present great challenges to
local public health officials, and NACCHO continues to urge
that local communities be given maximum flexibility to
address them according to local needs and conditions. H.R.
3717 would permanently thwart local efforts to expand the use
of a proven public health intervention.
NACCHO is the national organization representing the nearly
3,000 local public health departments in the United States.
Local health departments work daily on the front lines in
protecting the health of their communities
____

Human Rights Campaign,
Washington, DC, April 28, 1998.
Dear Member of Congress: On behalf of the Human Rights
Campaign, I am writing

[[Page H2469]]

to ask you to oppose H.R. 3717, a bill which would
permanently ban the use of any federal funds for needle
exchange programs. The bill is scheduled to be considered by
the House on Wednesday. As you know, on Monday, April 20,
Secretary Shalala announced that there is unequivocal support
from the scientific literature that needle exchange programs
reduce HIV infection and do not contribute to illegal drug
use. Nevertheless, the Administration clearly stated its
commitment to maintain the current prohibition on federal
funding for needle exchange programs. H.R. 3717 is redundant
and unnecessary, given the Administration's clear position.
As the attached article reports, AIDS deaths have declined
significantly in the last two years primarily due to the
success of new drug treatments which help keep people with
HIV disease alive and healthy for longer periods of time. New
HIV infections, however, continue to occur at an unacceptable
rate. The article highlights that injection drug use is
increasingly fueling this epidemic. In fact, over 50% of new
HIV infections can be attributed to injection drug use and
recent data indicate that 74% of all AIDS cases among women
and over 50% of all AIDS cases among children are connected
directly or indirectly to injection drug use. In the African
American community, 48% of AIDS cases are related to
injection drug use.
As the HIV epidemic continues to grow, it is vital that
public health considerations drive the debate on funding and
policy decisions. Instead of legislating a ban on federal
funding for needle exchange programs, Congress should be
taking affirmative and bold actions to reduce the numbers of
new infections by increasing HIV prevention funding and
expanding the operations communities have to address their
growing infection rates. Legislation banning federal funding
for needle exchange programs would only serve to further
politicize an issue that should appropriately be addressed by
scientists and state and local public health officials.
Please do not politicize HIV prevention and take public
health determinations out of the hands of scientists and
public health experts. Amending the Public Health Service Act
is a serious matter and should not be done hastily on the
House floor without careful consideration from the Committee
with jurisdiction. Please vote no on the rule and return this
issue to Committee for the appropriate attention it deserves
and vote no on H.R. 3717. Thank you for you attention to this
urgent matter.
Sincerely,
Winnie Stachelberg,
Poitical Director.
____

[From the Washington Post, April 28, 1998]

HIV's Spread Is Unchecked

(By Rick Weiss)

Although the number of new AIDS cases in the United States
has declined substantially in recent years, HIV continues to
spread through the population essentially unabated, according
to data released yesterday by the Centers for Disease Control
and Prevention.
The first direct assessment of HIV infection trends shows
that the recent decline in U.S. AIDS cases is not due to a
notable drop in new infections. Rather, improved medical
treatments are allowing infected people to stay healthy
longer before coming down with AIDS, overshadowing the
reality of an increasingly infected populace.
``The findings of this report give us a very strong
message, that mortality may be going down--therapy is
working--but HIV continues its relentless march into and
through our population,'' said Thomas C. Quinn, an AIDS
specialist at the National Institute of Allergy and
Infectious Diseases. ``These data tell us we have a lot of
work to do.''
The findings also confirm previously identified trends
showing that women and minorities are increasingly at risk.
Especially worrisome, officials said, is that the annual
number of new infections in young men and women 13 to 24
years old--a group that has been heavily targeted for
prevention efforts--is virtually unchanged in recent years.
``It certainly documents that we have ongoing new
infections in young people,'' said Patricia L. Fleming, chief
of HIV/AIDS reporting and analysis at the CDC in Atlanta.
The report also shows continuing high numbers of new
infections among intravenous drug users, a population that
has recently been the focus of a political debate over the
value of needle exchange programs that offer drug users clean
syringes to prevent the spread of HIV, the virus that causes
AIDS. [International financier George Soros yesterday offered
$1 million in matching funds to support needle exchange
programs around the country, the Associated Press reported.]
CDC officials would not comment directly on President
Clinton's decision this week to extend a ban on federal
funding of needle exchanges. But both Fleming and Quinn said
that AIDS prevention programs in this population need to be
improved.
``It's clear that something stronger is needed to slow this
epidemic,'' Quinn said.
The new figures, in today's issue of the CDC's Morbidity
and Mortality Weekly Report, are based on HIV test results
compiled by 25 states from January 1994 to June 1997. They
indicate that the number of new infections during that period
remained ``stable,'' with just a ``slight'' decline of 2
percent from 1995 to 1996, the most recently full year
included in the new analysis. By contrast, deaths from AIDS
declined 21 percent in 1996 and dropped an additional 44
percent in the first six months of last year.
From 1995 to 1996, the number of HIV infections increased
by 3 percent among women. And it jumped 10 percent among
Hispanics, although officials said that figure was imprecise.
Infections declined by 2 percent in the white and 3 percent
in the African American populations.
All told, the study tallied 72,905 infections during the
survey period. The number nationwide is much higher, since
participating states account for only about 25 percent of
U.S. infections.
The single biggest risk category was men having sex with
other men, but heterosexual transmission continued its steady
increase. Most of those cases involved women contracting the
virus through sex with male drug users, Fleming said.
The survey is the first to track infection trends by
looking directly at HIV test results in people coming to
clinics and other health outlets. That's a major change from
the previous system, in which officials simply estimated the
number of new infections by counting the number of people
newly diagnosed with AIDS.
The old ``back calculation'' method worked fine during the
first 15 years of the epidemic, when HIV infection progress
predictably to disease over a period that averaged about 10
years. With drug therapies now slowing disease progression,
however, the number of new AIDS cases no longer reflects the
number of new infections, and public health officials were
becoming uncertain about how they were doing in prevention
efforts.
The new reporting system, now spreading to other states has
helped officials regain those bearings, Fleming said. And
although everyone wishes the numbers were more encouraging,
she said, at least officials now have a clearer picture of
the task at hand.
____

National Alliance of State and

Territorial AIDS Directors

Washington, DC, April 29, 1998.
Dear Member of Congress: The National Alliance of State and
Territorial AIDS Directors, an alliance of the nation's state
and territorial health department HIV/AIDS program managers,
strongly urges a no vote on H.R. 3717, legislation which
would strike a devastating blow to our nation's efforts to
reduce the spread of HIV in vulnerable, underserved
communities across the country.
Injection drug use continues to be a major source of new
HIV infections in the United States. To address this serious
public health problem, it is critical that public health
officials and communities have the most effective prevention
strategies and interventions possible for addressing the
alarming spread of HIV, particularly in African-American and
Latino communities. Needle exchange programs have proven time
and time again to be effective intervention--one that many
state and local jurisdictions have chosen to include in their
comprehensive programs to address HIV prevention among
injection drug users.
By placing a permanent ban on the use of federal funds for
needle exchange programs, H.R. 3717 poses a serious threat to
our nation's ability to end the HIV epidemic.
NASTAD strongly urges the Congress to follow the science
and advice of the nation's leading public health experts.
Vote no on H.R. 3717. The lives of thousands of Americans are
at stake.
Sincerely,
Julie M. Scofield,
Executive Director.
____

The United States

Conference of Mayors,

Washington, DC, April 28, 1998.
We have just been informed that House Rules Committee
Chairman Gerald Solomon (NY) will bring to the House floor
tomorrow, April 29, a bill designed to permanently prohibit
the use of any funds made available under any Federal law to
be, ``expended, directly or indirectly, to carry out any
programs of distributing sterile needles or syringes for the
hypodermic injection of any illegal drug.''
As you know, the Administration recently decided that it
would not provide funding for ``needle exchanges,'' but
acknowledged the value of such programs. The Solomon bill,
which is going to be brought directly to the House floor--
bypassing committee--would permanently impose this ban.
In addition, we have been informed that the Solomon
language--which again has not been debated in standard
committee action--could possibly be interpreted at a later
date to limit the use of state or local funds for needle
exchange programs.
The U.S. Conference of Mayors has adopted policy which
supports the lifting of the prohibition against federal
funding of needle exchange programs. The Solomon bill goes
directly against that policy, and could have even broader
consequences.
I have attached a copy of the bill, a copy of our policy
adopted in June of 1997, and a letter from Detroit Mayor
Dennis Archer on the issue of federal funding for needle
exchanges.
J. Thomas Cochran,
Research Director.

Mr. WICKER. Mr. Speaker, I yield 3 minutes to the distinguished
gentleman from Florida (Mr. Shaw).
Mr. SHAW. I thank the gentleman for yielding me this time.
Mr. Speaker, this debate is not about AIDS. This debate is about drug
abuse. Let us not lose sight of that fact. We

[[Page H2470]]

have heard an awful lot coming from the White House. We know that this
debate is going on at the White House and did go on at the White House.
Much to the President's credit, he came down on the right side and
yesterday announced that he would not use existing funding to hand out
needles. But that debate is still raging. General McCaffrey came out
with a very strong condemnation of using the needle exchange program,
and the President in the final analysis agreed with him.
But I would disagree with the last speaker when he just said that
there is no funding for needle exchange. There is funding out there
that can be used for needle exchange. This debate that is going on
within the administration has sent out mixed signals, and it is up to
the Congress now to set the record straight. The record simply says
that there will be no Federal funds used for a needle exchange program
that is designed for the injection of illegal drugs.
We have heard a lot about Joe Camel. We have heard a lot about
cigarette advertising and the effect that that has on our kids. The
government has not condoned smoking. But what kind of signals are we
going to be sending out if your Federal Government, the government we
all love and pledge allegiance to every day in this Chamber, what kind
of message are we going to send out if we say, ``You're not supposed to
use illegal drugs, but if you do, we'll give you the needles''? That is
crazy. That makes absolutely no sense.
Tomorrow at 2 o'clock, there is going to be a rally on the steps of
this Capitol. There is a bipartisan invitation that has gone out to
invite the Members to get together and sign a pledge of not only to
continuing the war on drugs but to win the war on drugs. We cannot win
the war on drugs by sending out mixed signals. There is one signal that
should come out of this House, there is one signal that should come out
of this Congress, there is one signal that should come out from our
government, and that is illegal drugs kill, they destroy your future,
they destroy your neighborhoods, they corrupt this population.
Let us get together, let us come out with a single message, and let
us not get that message garbled. This vote is about drug abuse. Vote
yes on this most important resolution to condemn and to prevent by law
the expenditure of Federal funds on a needle exchange program.
Ms. PELOSI. Mr. Speaker, I yield 1\1/2\ minutes to the gentleman from
California (Mr. Becerra), the chair of the Hispanic Caucus.
Mr. BECERRA. I thank the gentlewoman for yielding me this time.
Mr. Speaker, today something tragic is about to happen. Again. Like
so many debates before this House, we are about to allow the politics
of fear to trump policies of reason. Logic tells us that if you have a
problem and you can identify a sensible solution, your problem is on
the way to being resolved. Here is the problem. Injection drug use is
responsible for nearly 50 percent of all the new cases of HIV, the
virus that causes AIDS. It is responsible for 44 percent of all the
cases reported for African-Americans, 44 percent of all the cases
reported for Latinos, and 61 percent of all the cases reported for
women. A sensible approach to a devastating problem as AIDS/HIV is, is
needle exchange programs. It is one of the weapons we can use in an
arsenal. HIV transmission is reduced when injection drug users are
furnished with clean needles in exchange for dirty, potentially
infected used ones.
This is where the politics of fear comes into play. Those on the
other side of this debate will tell you that needle exchange programs
encourage illegal drug use and our streets will be overrun with drug
addicts, and that is because we are offering them free needles. First
of all, as we have already heard, the science does not bear that out.
As we have been told, the General Accounting Office, the University of
California, the National Institutes of Health have all conducted
studies which show the efficacy of needle exchange programs. Second,
more is involved in a person's decision to use illegal drugs than the
provision of a free needle. To suggest that Americans are so weak-
willed and feeble-minded that they would begin using illegal drugs
solely because of the provision of clean needles is insulting.
Mr. Speaker, I implore my colleagues in this House to allow reason to
trump fear. Needle exchange programs work. Let us defeat this bill and
let us save lives.

{time} 1345

Mr. WICKER. Mr. Speaker, I yield myself 30 seconds.
We have heard some strong verbiage today from our friends on the
other side of this issue. We have heard just now ``the politics of
fear.'' We heard earlier discussion about ``narrow-mindedness.''
I would remind my colleagues that when they use terminology such as
that they are speaking about people like General Barry McCaffrey, the
administration's own drug czar, the man tasked with fighting drugs in
this Nation. He has looked at the science, do not think he has not, but
he has also looked at the big picture, and he has said needle exchange
programs are wrong.
Mr. Speaker, I yield 1 minute to the gentleman from Ohio (Mr.
Portman) a very distinguished leader in some programs to fight drug
abuse that are actually working.
Mr. PORTMAN. Mr. Speaker, I thank the gentleman for yielding this
time to me, and I was just down here actually on something else and
started listening to this debate, and I want to make two quick
statements.
One is the science is not conclusive. Whether we listen to Dr. James
Curtis of Columbia University and Harlem Hospital or whether we look at
the Vancouver study or the Montreal study, one cannot say the science
in this is conclusive.
I will tell my colleagues one thing we know which is conclusive which
is that the message counts. If we learned anything in the last 30 years
in this country, it is that the message does matter. We reduced drug
substance abuse in this country from 1979 to 1991 by over 70 percent by
sending a clear and consistent message that drug use is wrong and that
it is dangerous.
This sends the wrong message. That is why this legislation is
necessary.
I think General McCaffrey got it right. I think if we are really
serious about reducing drug abuse in this country, and remember teenage
drug abuse has doubled in the last 5 years, it has doubled and
continues to go up, it has got to be our top public health priority, it
has got to be our top crime reduction priority, it has got to be our
top education priority if we are going to turn the corner, if we are
going to make a difference in this, and unfortunately needle exchange
does not fit in that.
Ms. PELOSI. Mr. Speaker, I yield 1 minute to the gentlewoman from the
District of Columbia (Ms. Eleanor Holmes Norton) who has fought in the
trenches against substance abuse in the District and is a leader on
this issue.
Ms. NORTON. Mr. Speaker, I thank the gentlewoman for yielding this
time to me.
We failed for decades to control addiction. At least it was contained
with addicts. Now, with AIDS, needles have taken a deadly disease into
the community itself. Now it is not addicts and not even those who
addicts, when they become criminals, prey upon. It is women. It is
children. Two-thirds of AIDS in women comes for needles. Fifty percent
of AIDS in children comes from needles.
The Congress asked the scientists for the answer. Because the
scientists gave them back an answer they did not want to hear, they
want to ignore the science, and it is unmixed.
Race looms larger and larger in this issue. We are stabilizing AIDS
among white homosexuals. It is spreading like an epidemic among blacks
and hispanics, and the reason is unsafe needles. One-third of AIDS
deaths today come from needles.
Mr. Speaker, when my colleagues cast their vote they should remember
who they are voting for life, and who they are voting for death.
Ms. PELOSI. Mr. Speaker, I yield 1 minute to the gentlewoman from the
Virgin Islands (Ms. Christian-Green) who is a health professional as
well as being a Member of Congress.
(Ms. Christian-Green asked and was given permission to revise and
extend her remarks.)
Ms. CHRISTIAN-GREEN. Mr. Speaker, I come here today as a member of

[[Page H2471]]

the Congressional Black Caucus committed to ridding the country of this
scourge of drugs and as a physician who counts among my patients many
wonderful men and women with AIDS. Almost all of them contracted this
disease because of IV drug use. They are now leading clean and
productive lives with their children and other family members but are
condemned to death because of AIDS.
Mr. Speaker, apparently it is correct what the NIH panel said, that
the greatest threat to public health are legislative bodies. This bill,
unfortunately, supports that opinion. Because we know that needle
exchange programs do not cause increased drug use, they decrease drug
use. They make it more likely that addicts will enter treatment. We
know that it saves lives.
Mr. Speaker, I urge my colleagues to vote no on H.R. 1317. Let us
choose life, my colleagues. Vote no on this bill.
Ms. PELOSI. Mr. Speaker, I yield 1\1/2\ minutes to the gentleman from
Georgia (Mr. Lewis) one of the deputy whips of the House and a great
leader in this Congress.
Mr. LEWIS of Georgia. Mr. Speaker, the scientific evidence is clear.
Needle transfer programs can reduce HIV infection and save lives.
Needle exchange programs do not increase drug use.
Last week, the Secretary of HHS announced that Federal funds would
not, I repeat, would not fund needle exchange programs. Local
governments can decide whether or not they want to fund these programs.
AIDS is a devastating disease. It is a devastating sickness. It is
heartbreaking to know someone who is suffering with AIDS. Half of the
new AIDS infections come from injection of drugs. We must do everything
in our power, must use every resource at our command to reduce the
spread of AIDS. We must fund research, we must provide health care, and
we must let local governments make their own decisions.
If local governments choose to fund needle exchange programs,
programs that reduce the spread of AIDS, we should not stand in their
way. Leave it up to the City of Atlanta, to the City of New York, to
the City of Birmingham to decide. Leave it to the doctors and the
scientists. Leave it to the women and men of medicine. This is a matter
of public health.
I, for one, will not stand in the way of local governments who want
to save lives and reduce the spread of AIDS. Stop playing politics with
the lives of our people who are living and suffering with HIV and AIDS.
I urge my colleagues vote no on this bill.
Ms. PELOSI. Mr. Speaker, I yield 1 minute to the gentlewoman from
Oregon (Ms. Furse) who knows firsthand of what she speaks on this
subject.
Ms. FURSE. Mr. Speaker, as cochair and cofounder of the Diabetes
Caucus, I rise today to oppose H.R. 3717. I believe this bill has
absolutely nothing to do with public health but everything to do with
election year politics.
Now if we want to reduce drug use, let us get drug addicts into drug
treatment programs. And in Tacoma, Washington, 43 percent of the new
recruits into a methadone treatment program were referred from a needle
exchange program.
If we are in a drug war, let us not get rid of one of the weapons in
that war. The State of Oregon uses needle exchange programs as just one
part of the State's drug prevention program.
We have heard a lot about AIDS. Well, let me tell my colleagues that,
while needle exchange programs may seem unpleasant to some Members in
this House, the fact remains that it is one of the most effective
strategies to reduce the rate of HIV infection amongst a population
that is high in risk.
Let us do what is right for the people, not what is right for our
elections. Let us vote against H.R. 3717.
Ms. PELOSI. Mr. Speaker, I yield 1 minute to the gentleman from
Florida (Mr. Wexler).
Mr. WEXLER. Mr. Speaker, if I thought for one minute that a drug
exchange, needle exchange program for drug addicts would increase the
likelihood of teenagers in America using drugs, I would not support it.
But common sense dictates that there will not be a single 16-year-old
teenager in America who says, oh, now I can go get a needle exchange,
rather than going to the corner drugstore and buy one for five cents or
ten cents, and now I am going to get addicted to heroin and ha, ha, ha.
Having nothing to do with common sense, it tells us the way in which
we prevent people from getting AIDS, the way in which we prevent people
from spreading AIDS to people who are innocent is to make certain the
needles they are using are clean.
The question is not whether we are for or against drug abuse. We are
all against it. The question is simple. Should drug addicts be using
clean needles or should they be using AIDS-infected needles? And the
taxpayers of America are better off if the needles are clean rather
than AIDS infected, and all Americans who do not use drugs are better
off if we make certain that those who do are not infected with AIDS
needles.
Ms. PELOSI. Mr. Speaker, I yield 1 minute to the gentleman from New
York (Mr. Engel) who has been a leader in this House and also in the
assembly before he came to the State legislature as the chairman of the
Committee on Alcohol and Drug Abuse.
Mr. ENGEL. Mr. Speaker, I rise in strong opposition to this
legislation.
Before I came to Congress 10 years ago, I was chairman of the New
York State Assembly Committee on Alcoholism and Drug Abuse, and I can
tell my colleagues that needle exchange programs work, they save lives.
I am as opposed to drugs as the next person, but I also live in the
real world. I represent an area of New York City, the Bronx, where AIDS
has just gone sky high, and we need to use every available resource
that we have to try to combat the scourge of AIDS.
As has been said by my colleagues, needle exchange programs are used
to get addicts into drug treatment programs. Why would we not want to
use every tool that we have? We do not have the luxury of being
ostriches and sticking our heads in the sand. We do not have the luxury
of feel-good legislation. We do not have the luxury of platitudes. We
live in the real world, those of us that represent inner cities, and we
want to make sure that AIDS is not spread.
This did not come before the Committee on Commerce of which I am a
member. I wish it had because we could have had some hearings and we
could have made some good points. But this legislation does not make
sense.
Please, choose life over death. Defeat this legislation.
Ms. PELOSI. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I am sorry, but if my other speaker arrives, I will
yield to the other speaker.
But one thing I am glad about, about this resolution coming to the
floor, it gives us another opportunity to say to our colleagues and to
the American people just what the science is on this subject of needle
exchange programs.
My colleagues, as a mother of five and a grandmother of two, I join
with everyone in this body, and I know I speak for every single person
here saying one of our top priorities here is to eliminate drug abuse
from our country and from this earth. Let us stipulate to that, that we
all recognize the good intentions of everyone here to do that.
Having said that, we must use new approaches to this as well, because
I do not think anyone can say that the approach that has been taken to
date has been a complete success.
When we talk about the subject of needle exchange programs, I share
the concern of some of my colleagues when I hear their remarks. They
just do not understand it. Because, clearly, they do not know what a
needle exchange program is. And for many people, when they hear about
it, at first blush they say, why would I support that? What message
does that send? How often we have heard that today.
Well, one message it sends is that we will be courageous enough to
take the steps that will save lives and will reduce substance abuse and
drug abuse in our country.
We have heard people try to blur the science on this, but the science
is, we go hand in hand with the science as we ask our colleagues to
vote down this resolution. This is a difficult decision because most of
our constituents, many of them may not be aware of the benefits of a
needle exchange program. But because it is a difficult decision does
not mean we should take the easy way out. We must demonstrate that
making difficult decisions is not above

[[Page H2472]]

the pay grade of Members of Congress and that we are willing to lead
and indeed to teach our constituents.
They do not need to learn much though. Our constituents, the American
people, say that the needle exchange program, 61 percent of the
American people favor changing federal laws to allow State and local
governments to decide for themselves whether to use their Federal funds
for needle exchange programs.
That is why I have in my motion to recommit, which will be discussed
later, the provision that needle exchange programs could not use
Federal funds unless the Governor, State health officer, local/
municipal health authority determines that the use of Federal funds for
such a program would reduce the rate of transmission of HIV and would
not encourage the use of illegal drugs and is acceptable to the
affected State, city and other units of local governments or
communities.

{time} 1400

I listened to my colleagues, and I hope to address their concerns in
this motion to recommit, and I hope that whatever position people take
on the Solomon resolution, that they will support the motion to
recommit.
My colleagues, as they make their decisions, as we are sent here to
review the facts and to vote, the facts are these: This is the poster,
by the way, that a Republican colleague did not want to have on display
in the House, and it says, April 1998, needle exchange reduces the
spread of HIV/AIDS. After reviewing all of the research, we have
unanimously agreed that there is conclusive scientific evidence that
needle exchange programs, as part of a comprehensive HIV prevention
strategy, are an effective public health intervention that reduces the
transmission of HIV and does not, and does not encourage the use of
illegal drugs.
Dr. Harold Varmus, winner of the Nobel Prize, Director of the
National Institutes of Health; Dr. Anthony Fauci, Director of the
National Institutes of Allergy and Infectious Diseases; Dr. Alan
Leshner, Director of the National Institute on Drug Abuse; and Dr.
David Satcher, Surgeon General. Please make a vote to save lives. Have
the courage to make that vote. Vote ``no'' on the Solomon resolution.
Mr. WICKER. Mr. Speaker, it is my privilege to yield the balance of
my time to the distinguished majority whip, the gentleman from Texas
(Mr. DeLay) to close the debate on this legislation today.
The SPEAKER pro tempore (Mr. Foley). The gentleman from Texas (Mr.
DeLay) is recognized for 5\1/2\ minutes.
Mr. DeLAY. Mr. Speaker, I rise in support of this legislation, and I
want to commend my colleagues, the gentleman from New York (Mr.
Solomon), chairman of the Committee on Rules; my chief deputy whip, the
gentleman from Illinois (Mr. Hastert); and most importantly, the
gentleman from Mississippi (Mr. Wicker) for showing leadership, for
showing leadership when it comes to the war on drugs.
I have the utmost respect for the gentlewoman from California (Ms.
Pelosi) and her position, and I do tend to understand her position, but
it has been said so many times here on this floor during this debate. I
just feel very strongly that the best science is on our side and
refutes the science that the gentlewoman is putting forward.
I also understand because she is a beautiful mother and a loving
mother and a grandmother, although she does not look like a
grandmother, the gentlewoman from California understands what
``enabling'' means. Enabling your children to do bad things by bailing
them out, say, if they got in trouble at school and one goes and beats
up on the principal and makes sure there are no consequences, or
enabling an alcoholic by giving them a drink does not free them from
alcoholism. Enabling a drug addict by giving them a clean needle, it
enables that drug user to continue their habit.
So I just say, if we are really, really serious about the war on
drugs, and everybody seems to be for it, then I would urge that side of
the aisle to join us tomorrow in a major show of rededicating this
Congress and this House and this government to a real war on drugs. But
I have to tell my colleagues, we understand that there is an effort
going to pull the Democrats away from this bipartisan effort to
rededicate ourselves.
The lack of leadership here is really frightening. Clearly, this
Nation needs leadership in the war on drugs. Sadly, the President has
already given up on that fight. By condoning and embracing the concept
of giving free needles to drug addicts, President Clinton has raised
the white flag of surrender. He is sending the wrong message to the
youth of this country. He is saying that we cannot end drug abuse in
this country, so we might as well mend it.
Well, Mr. Speaker, that is the wrong approach. Drug abuse continues
to be the top concern of parents across this Nation. Mothers and
fathers are rightfully worried that the ravages of drug abuse may
victimize their children. Over 20,000 young people die as a result of
illegal drug trade in this country every year, and thousands more are
victimized by drugs in countless other ways.
Illegal drug use really is not a laughing matter, and the President
and the President's press secretary can make all the jokes they want
about their own drug use, but their casual attitude encourages a new
generation of drug abusers in this country. It is no coincidence that
teenaged drug use has skyrocketed, skyrocketed during the Clinton
Presidency. The Nation expects leadership from its President when it
comes to an issue like drug abuse. Instead of leadership, we get a
dead-head President who supports a program that gives free needles to
drug addicts.
Well, Mr. Speaker, let us send a message to this President. Let us
vote for this legislation, and let the American people know that this
Congress still wants to fight the war on drugs.
Mr. LANTOS. Mr. Speaker, I first want to thank my colleague and
friend Congresswoman Nancy Pelosi for her leadership on the issue of
needle exchange.
Mr. Speaker, there is confusion and misconception coming from the
opponents of needle exchange. The Republican leadership is under the
impression that the American people do not care about ending the AIDS
epidemic that is ravaging our country. They are under the impression
that the American people will choose to believe rhetoric over
scientific statements of fact from our nation's most trusted scientific
experts. They are also under the impression that American citizens
prefer more of the politics of division and empty symbolism, rather
than sound public health practices. Mr. Speaker, the Republican
leadership is mistaken.
I rise in strong opposition to this ill-conceived and unnecessary
piece of legislation, H.R. 3717. The bill purports to ban permanently
all federal support for needle exchange programs. However, not one
single federal mandate currently requires states to administer needle
exchange programs.
The decision to fund needle exchange programs should be left to the
states. Local governments and the American people do not want to close
the door on a proven method of combating HIV transmission. Over 60
percent of Americans want their communities to make the decision on
needle exchange programs. This legislation is blatant hypocrisy. Those
in this Chamber who have been the most outspoken and vociferous in
raising the cry of ``states rights'' and urging that the Congress stop
imposing Federal mandates upon the state governments are the very same
ones who are leading the charge today to prohibit states from making
independent decisions about what is in the public health interest of
their own citizens.
Mr. Speaker, the American people don't want to play political games
with the AIDS epidemic. The proponents of this legislation are trying
to pit the AIDS epidemic against the war on drugs. This strategy will
backfire. Americans understand that needle exchange programs reduce the
transmission of HIV, and Americans understand what scientific studies
have established--needle exchange programs do not encourage the use of
illegal drugs.
The proponents of this legislation are ignoring the intelligence of
the American people. They are ignoring the conclusions of countless
scientific experts who support needle exchange programs--Dr. David
Satcher, United States Surgeon General; Dr. Harold Varmus, Director of
the National Institute of Allergy and Infectious Diseases; Dr. Anthony
Fauci, Director of the National Institute of Allergy and Infectious
Diseases; Dr. Alan Leshner, Director of the National Institute of Drug
Abuse; and Dr. Claire Broome, Acting Director of the Centers for
Disease Control. All of these leading public health experts agree that
needle exchange programs are an effective AIDS prevention method that
does not cause increased use of illegal drugs. The National Institutes
of Health, our own federally-sponsored health care research
organization which we are supporting with over $3.5 billion this year,
supports needle exchange programs.

[[Page H2473]]

Thousands of other medical experts and healthcare organizations,
including the American Medical Association and the American Academy of
Pediatrics, in the United States and around the world have stated that
needle exchange programs are necessary in the fight against AIDS. These
respected organizations tell us that needle exchange programs do not
promote the use of illegal drugs. The proponents of this legislation
are ignoring this overwhelming and unanimous evidence.
Needle exchange does not promote drug use. In fact, the opposite is
true. Needle exchange programs encourage injection drug users to seek
drug treatment. Needle exchange programs are an integral component of
drug treatment networks in terms of health care, counseling,
psychosocial services, and outreach strategy. Needle exchange programs
keep people alive, keep people safe from the HIV infection, and can
help in encouraging people to take the first critical steps to begin a
drug-free life.
Mr. Speaker, I strongly oppose illegal drug use. But we must not
confuse the fight against drug abuse with the fight against AIDS. Those
who support H.R. 3717 are arguing for legislation that would
effectively declare the life of any person who has used drugs or is
using drugs, as well as the lives of their spouses and children, to be
worth less than the ten cents it would cost to save them from AIDS. I
cannot share that position.
Mr. Speaker, injection drug users can pass on HIV infection to their
partners, to their children, and to other drug users. Over 50 percent
of all new HIV infections are due to injection drug use. I am appalled
that anyone in this Congress could have a higher priority than saving
the lives of these innocent victims. Millions of women and children's
lives can be saved indirectly through needle exchange programs. Some 74
percent of all AIDS cases among women are connected directly or
indirectly to injection drug use. The rate of infection in women is
steadily climbing. More than 50% of AIDS cases in children are also
connected to drug use. Minorities suffer disproportionately from this
disease. All these lives are worth saving, and there is a simple method
to save them--needle exchange.

Mr. Speaker, the choice to be made is between exchanging needles and
losing millions of lives to AIDS--to say nothing of the horrendous
health care costs that these AIDS cases will create. Needle exchange is
a cost-effective public health measure to combat HIV transmission and
infection. Those who support this legislation are denying our
communities the right to choose for themselves one of the best and most
effective methods of fighting new HIV infections. This legislation goes
against common sense, against science, and against our own values.
Mr. Speaker, we must not be put aside by short-sighted political
maneuvers. The American people are too smart to let anyone pull the
wool over their eyes. They are too smart to accept ignorance and
bigotry in place of scientific knowledge. The American people know
better. H.R. 3717 is a vote against the judgment of state and local
health officials, a vote against the rights of local communities to
make thoughtful decisions, a vote against scientific evidence, a vote
against the judgment of the American people, and a vote against
countless lives which could be saved by needle exchange programs.
Mr. KENNEDY of Massachusetts. Mr. Speaker, I have listened to this
debate and I have listened to the arguments made by the other side.
The supporters of this bill to ban Federal funding for needle
exchange programs say that it sends the wrong message to our kids--And
that it encourages drug use.
Let me make it clear that this debate is not about illegal drug use,
it is about saving lives.
Secretary Shalala for the first time acknowledged the enormous body
of scientific evidence proving that needle-exchange programs reduce HIV
and save lives without increasing drug use.
To not reach out to the communities that are struggling with this
epidemic is like discovering the world is round and not launching the
ships to explore it.
Clean needles are only part of the solution. A comprehensive approach
that includes needle exchange, health care, treatment, social support
and counseling is also needed.
Since the other side is worrying about sending mixed messages, how do
we explain to our kids that we know how to slow a lethal epidemic--we
know one way to help prevent the spread of HIV from drug addicts to
partner to child--But we are not going to help!
I urge my colleagues to vote against this bill.
Mr. LEVIN. Mr. Speaker, last year Congress approved a conference
report on a bi-partisan basis that prohibited the use of federal funds
for any needle exchange programs until the Secretary of Health and
Human Services determines that based on scientific evidence these
programs are effective in preventing the spread of HIV and do not
encourage the use of illegal drugs.
The Secretary has not decided to continue the ban on federal funding,
and leave it to state and local units to finance needle exchange
programs, which the scientific review requested by the Secretary found
useful in saving lives without increasing drug use if part of a
comprehensive anti-drug program.
I support the administration's decision.
As the Administration has stated regarding this matter, it ``. . .
concurs in the longstanding position of the Congress that the Secretary
of Health and Human Services should have the authority to determine the
scientific and public health merit of needle exchange programs as they
affect rates of HIV transmission and injection drug use. The
Administration believes, as Congress has to this point, that the top
public health leadership of the federal government remains the
appropriate place for this determination, and that the decision on
which HIV prevention strategies to use should rest with State and local
officials.''
The bill before us would try to make this ban permanent, regardless
of what might be scientific findings at a future date and regardless of
the experience in and results from programs now underway in a
substantial number of communities.
Ms. KILPATRICK. Mr. Speaker, I rise today in strong opposition to
H.R. 3717, legislation that would permanently ban federal funding for
needle exchange programs. Needle exchange programs reduce new human
immunodisease virus (HIV) and Hepatitis B infection among intravenous
drug users, do not lead to more drug use, are cost effective and are
supported by a wide array of scientific and medical experts and
organizations. In the light of President Clinton's opposition to the
funding of needle exchange programs, it makes absolutely no sense to
adopt this legislation.
Before I continue, let me add that I vehemently oppose the use of
illegal drugs. Democrats, Republicans and Independents need to remember
who, and what, is the real enemy here. The real enemy is our collective
inertia, inaction, and inability to practically do anything that will
reduce illegal drug use. Drug abuse is not a Democratic, Republican or
Independent problem--it is an American problem. All Americans concerned
about the deterioration of the future of our country--our children--
should unite to protect our children, break the cycle of illegal drugs
and crime, provide treatment for drug abuse, strengthen our laws on
money laundering, and reduce the supply of drugs to our cities,
suburbs, and rural areas.
According to a recent Detroit Free Press article, about 33,000 heroin
users live in the city of Detroit. I recently had the honor of meeting
Mr. Harry Simpson, Executive Director of Life Points. Life Points is a
non-profit organization dedicated to the reduction and eradication of
illegal drug use among the citizens of the City of Detroit. On December
1, 1997, the city's first licensed needle-exchange program began. Mr.
Simpson realizes that we need a two-pronged attack against the abuse of
drugs: prevention and treatment. In a recent Associated Press article,
Mr. Simpson said, ``We're not sitting on the porch handing out syringes
to everyone who passes. It isn't about distributing needles, promoting
drug use or promoting illegal behavior. I just don't think people need
to die just because they use drugs.''
I am opposed to this legislation for four reasons:
Needle exchange programs reduce the risk of HIV and Hepatitis B
infection. The National Research Council and Institute of Medicine's
report titled, ``Needle Exchange Programs Reduce HIV Transmission Among
People Who Inject Illegal Drugs,'' makes this point abundantly clear.
In this report, panel chair Lincoln E. Moses, professor of statistics
emeritus at Standford University, said, ``The activities of needle
exchange and bleach distribution programs go beyond just providing
sterile injection equipment and bottles of bleach. These programs often
result in more referrals to drug abuse treatment. Although not all
communities may choose to implement them, needle exchange and bleach
distribution programs can be important parts of comprehensive
approaches to reduce drug use and the spread of AIDS. Needle sharing is
a primary route of HIV transmission among people who inject illegal
drugs.''
Needle exchange programs do not lead to increased drug use. The
National Institutes of health, one of the preeminent health research
facilities in the nation, published the Consensus Development Statement
on Interventions to Prevent HIV Risk Behaviors. This report concluded
that needle exchange programs ``show a reduction in risk behaviors as
high as 80% in injecting drug users, with estimates of a 30% or greater
reduction of HIV.'' The report also concluded that the majority of
evidence shows either a decrease in injection drug use among
participants or no changes in their current levels of drug use.
Needle exchange programs are cost effective. According to the
National Association of Persons with AIDS, needle exchange programs
could prevent HIV infection among drug

[[Page H2474]]

users, their sexual partners, and their children at a cost of about
$9,400 per prevented infection. This pales in the cost of more than
$100,000 per lifetime of treating a person with AIDS.
Needle exchange programs are supported by many non-partisan,
respected, scientific organizations and boards of review. The
Congressional Office of Technology Assessment; the National Institutes
of Health, the U.S. General Accounting Office, and the American Medical
Association support needle exchange programs.
My vehement opposition to illegal drugs has not clouded my desire to
protect women or children. It is my desire that the wisdom of Congress
prevails in defeating this legislation, and that Congress collectively
take measures that will eliminate the use of illegal drugs in our
country.
Ms. CHRISTIAN-GREEN. Mr. Speaker, I come to the floor today as a
member of the Congressional Black Caucus which has as its highest
priority, the ridding this country of the scourge of drugs, and as a
family physician who counts among my patients, many men and women with
AIDS. Almost all of them contracted this disease because of IV drug
use, but today they are ``clean'' and leading productive lives, with
their children and other family members, but are condemned to death
because of AIDS.
Mr. Speaker, the NIH panel was apparently correct last year when it
said that the greatest threat to the public health are legislative
bodies. This misguided bill, certainly supports that opinion.
We know, because the evidence is clear, that needle exchange program
do not cause increased drug use. On the contrary, they decrease drug
use and further increase the likelihood that an addicted person will
enter drug treatment. It is incumbent upon us to provide the funding to
make those treatment programs available on demand.
We have heard much today about the Canadian studies. The researchers
whose work is being misrepresented by our Republican colleagues are on
record in saying that the data has been misinterpreted, and that their
findings indeed support the use of needle exchange programs in
conjunction with strong prevention and treatment.
We also know, without a doubt that these programs greatly reduce the
transmission of HIV, and in doing so saves the lives of countless
people--especially women and children.
Who among us could possibly be against saving lives?
I plead with you my colleagues, not to put politics before the lives
of the people we are here to serve. Do not ignore the facts which have
been placed before us by researchers and public health experts. Let us
not misinterpret and misrepresent their findings to the people who
depend on us for the truth.
Mr. Speaker, my colleagues, choose life. Vote no on H.R. 3717.
Mr. DAVIS of Illinois. Mr. Speaker, I rise today to oppose this bill
for several reasons. First, this bill contradicts all the scientific
data from experts that suggests needle exchange programs reduce HIV
infection and do not increase drug use. While AIDS deaths are down,
clearly HIV infection continues to increase especially in inner city
areas where injection drug use is prevalent.
The bill ignores the fact that needle exchange does not increase drug
use, rather it encourages a society that would have fewer individuals
infected with HIV. These programs make needles available on a
replacement basis only, and refer participants to drug counseling and
treatment. The National Institutes of Health's March 1997 study
concluded that needle exchange programs have shown a reduction in risk
behaviors as high as 80 percent in injecting drug users, with estimates
of 30 percent or greater reduction of HIV.
In addition, I oppose this bill because it is politically driven,
rather than scientifically based. This bill whips on the poorest of the
poor. This bill puts at risk millions of Americans who might be married
or committed to someone who they may not know is an intravenous drug
user. More importantly, this bill puts children at risk. The Centers
for Disease Control reported that the rate of HIV/AIDS in the African
American community is 7 times that of the general population.
Make no mistake about it this is not just a African American problem
this is a American problem. This is a public health issue and the
Surgeon General, and the Secretary of Health and Human Services both
support needle exchange programs. When we help save American lives--
America is stronger. The Federal Government must provide leadership on
this critical issue and therefore, I urge my colleagues to oppose this
bill.
Mr. DELAHUNT. Mr. Speaker, I rise in opposition to the bill.
Since coming to the Congress I have been asked to vote on legislation
on a variety of subjects which I considered ill-conceived or even
foolish. But I have never seen as silly a piece of legislation as the
bill before us today.
One might have expected opponents of needle exchange programs to
mount an effort to prohibit federal funding for such programs--if the
Administration had taken steps to authorize the release of funds.
But Secretary Shalala announced just 10 days ago that the
Administration does not intend to release the funds.
This must be one of the few occasions in Congressional history in
which members are attempting to deny the Administration the authority
to make a decision they agree with.
Personally, I do not agree with the Administration's decision, and I
therefore regard this legislation as not only unnecessary, but unwise
in the extreme.
In 1989, Congress barred the use of federal funds for needle exchange
programs unless the Secretary of Health and Human Services could
determine both that such programs are effective in preventing the
spread of HIV and that they do not encourage the use of illegal drugs.
In enacting this provision, Congress sought to ensure that the
decision as to whether such programs merit federal support would be
made by public health experts acting on the basis of sound science,
rather than by politicians re-acting on the basis of uninformed
opinion.
Pursuant to that mandate, the Secretary conducted an exhaustive
review of the scientific literature. Her investigation yielded an
impressive body of evidence that properly administered needle exchange
programs are an effective weapon in preventing HIV transmission, and
that, far from encouraging drug use, they can actually play a role in
encouraging injection drug abusers to enter treatment.
In my own state of Massachusetts, these programs are doing precisely
that.
Last week, the Secretary reached the only conclusion the data would
support, and issued the long-awaited determination that the
Congressionally-mandated criteria had been met for federal funding of
these programs.
Yet instead of announcing that federal funds would be made available,
the Secretary announced a continuation of the status quo.
It's hard to see how the status quo could have provoked this kind of
reaction. It's as though the proponents of the bill were so eagerly
anticipating a different decision that, when it didn't come, they
decided to offer their bill anyway.
It goes without saying that no hearings have taken place, and the
committee of jurisdiction took no action on the bill.
As a former prosecutor and a member of the Judiciary Committee, I
take very seriously the epidemic of drug addiction in our society. But
we cannot make responsible public policy on fear and ignorance.
Yesterday, I received a Dear Colleague letter from proponents of the
bill citing a Canadian study published in the American Journal of
Epidemiology in support of their claim that drug addicts who
participate in needle exchange programs are more likely to contract HIV
than those who do not participate.
What they failed to tell you is that the authors of the study have
stated categorically that this claim is a mischaracterization of their
research. Writing in the New York Times on April 9, Professors Julie
Bruneau and Martin Schechter said that the reason the addicts who took
part in needle exchange programs in Vancouver and Montreal had higher
HIV infection rates than those who did not is that these programs are
in inner-city neighborhoods where they serve those who are most at risk
of infection.
Having misstated the conclusions of this study, the supporters of the
bill ignore the numerous other studies conducted and compiled by such
agencies as the National Research Council, the Centers for Disease
Control and Prevention, and the National Institutes of Health.
This voluminous research has persuaded such respected organizations
as the American Medical Association, the American Public Health
Association, the Association of State and Territorial Health Officers,
the American Nurses Association, the American Academy of Pediatrics,
the U.S. Conference of Mayors, and the American Bar Association, to
give their support to needle exchange.
It is time for Congress and the Administration to follow suit.
Indeed, it is long past time. While we wait, the epidemic continues to
decimate our cities and towns. Like the mad emperor of the ancient
world, Congress fiddles while Rome burns.
Mr. TOWNS. Mr. Speaker, I rise in strong opposition to H.R. 3717,
which would implement a permanent ban on federal funding for needle
exchange programs.
According to the National Organization responding to AIDS, an
estimated 1 to 2 million Americans inject illegal drugs and the sharing
of needles among injecting drug users is a leading cause of HIV
transmission. Furthermore, since 1988, when this program ceased, an
estimated 20-25,000 people have contracted AIDS as a direct result of
contact with an intravenous drug user. Needle exchange programs would
involve the swap of dirty needles for clean needles. Since one can only
obtain a clean needle in exchange for a dirty

[[Page H2475]]

needle, there is an incentive to collect and turn in the needle.
In an age where HIV and AIDS are spreading at enormous rates, needle
exchange programs not only reduce HIV infections but also have the
potential to act as a bridge to drug treatment. AIDS is the leading
cause of death amongst African Americans that are between 25-44 years
of age. The Center For Disease Control reported that the rate of HIV/
AIDS in the African American community is 7 times that of the general
population. This means that 72 African Americans are infected every
day. By supplying clean syringes, we simply assure that death is not a
certainty.
The National Commission on AIDS, National Academy of Sciences and the
National Institutes of Health are just a few organizations that,
through extensive sound scientific research, have concluded that needle
exchange programs are effective and can significantly reduce the number
of new HIV and AIDS cases. The American Academy of Pediatrics, the
American Medical Association and the National Association of City and
County Health Officials, among many others, are leading world
organizations that have endorsed federal funding of needle exchange
programs. In fact, research has shown, there is no evidence that needle
exchange programs lead to increased drug use by exchange clients.
From a financial standpoint, needle exchange programs are
surprisingly cost effective. One model estimates that over a period of
five years, needle exchange programs could prevent HIV infections among
clients, their sexual partners and their children at a cost of
approximately $9,400 per infected person. Compare this with the
lifetime cost of treating an individual with AIDS, which exceeds
$100,000.
I urge my colleagues to vote against H.R. 3717 which bans federal
funding for needle exchange programs. Needle exchange programs have
proven to be effective in reducing the transmission of HIV and AIDS and
through this program, communities would be safer from the health
hazards associated with dirty needles littering the streets. No one
ever built a reputation on what they were going to do. We've seen what
banning federal funding for needle exchange programs can do. Let's
establish a solid reputation by funding needle exchange programs that
would reduce the transmission of HIV and other diseases and more
importantly, save lives.
Mrs. MORELLA. Mr. Speaker, I rise in opposition to H.R. 3717,
legislation to impose a permanent ban on federal funding for needle
exchange programs.
This bill is particularly unnecessary given the fact that the Clinton
Administration announced that it will not lift the ban on federal
funding, despite its conclusion that the science has demonstrated that
needle exchange programs reduce HIV transmission and do not encourage
the use of illegal drugs.
This bill would remove the authority of the Secretary of Health and
Human Services to manage public health threats--and would, in effect,
substitute political expediency for sound science and public health
policy. Since 1990, we have given the Secretary this authority in
annual appropriations bills.
The American Medical Association, the American Bar Association, the
American Public Health Association, the Association of State and
Territorial Health Officials, the National Academy of Sciences, the
American Academy of Pediatrics, the American Nurses Association, the
National Black Caucus of State Legislators, and the United States
Conference of Mayors all have expressed their support for needle
exchange, as part of a comprehensive HIV prevention program. A number
of federally funded studies have reached the same conclusion and have
found that needle exchange programs do not increase drug use--including
a consensus conference convened by the National Institutes of Health
last year. According to the NIH Consensus Statement, ``A preponderance
of evidence shows either no change or decreased drug use . . .
Individuals in areas with needle exchange programs have increased
likelihood of entering drug treatment programs.''
The American Bar Association, in a letter dated April 28, 1998,
stated: ``Permanently prohibiting federal funding of needle exchange
programs will not advance this nation's efforts to combat drug abuse.
It may in fact inhibit current efforts since needle exchange programs
have been shown to increase the opportunity for counseling drug addicts
and encouraging their participation in appropriate drug treatment
programs . . . Likewise, enacting a permanent ban on federal funding of
needle exchange programs will prevent public health officials from
using a proven tool to reduce the transmission rate of HIV among a high
risk population that is contracting HIV at alarming rates.''
In my own state of Maryland, injection drug use is the major mode of
transmission for HIV/AIDS. Baltimore City's needle exchange program has
been associated with a 40% reduction in new cases of HIV among
participants, and evaluation of the program has demonstrated that
needle exchange did not increase drug use. In fact, a bill was approved
to continue the program by an overwhelming vote in the Maryland State
Legislature last year--it passed by a vote of 113-23 in the House of
Delegates and by a vote of 30-17 in the State Senate. And, earlier this
month, the Maryland State Legislature voted to allow Prince George's
County to establish a needle exchange program.
Nationally, 66% of all AIDS cases among women and more than half of
AIDS cases in children are related to injection drug use. It is
important to note that if the Secretary had decided to lift the ban,
federal funding for needle exchange programs would not mean that local
communities would have to implement them. Only those communities that
believe such a program would be effective in their HIV prevention
strategy would do so--thereby leaving the decisionmaking to the local
communities. Community-based solutions have always been the most
effective prevention programs, and are consistent with our attempts in
this House to prevent the federal government from interfering with
local decisionmaking.
I urge my colleagues to act in the best interests of our nation's
public health. Public health decisions should be made by public health
officials . . . science should dictate such decisions, not politics.
Vote NO on H.R. 3717.
Mr. PACKARD. Mr. Speaker, I am appalled by the increase in drug-use
in this nation. Day after day, we are confronted with statistics
demonstrating that our children are at risk. We've all heard the facts:
marijuana use among 4th to 6th graders has risen 71 percent and overall
drug use has jumped to 78 percent since 1992. We can quote the numbers,
but the real issue is what are we going to do about it?
Recently, the Clinton administration aired its decision to lift a
ban that prohibits the distribution of hypodermic needles to drug
addicts at Government expense. Condoning needle-exchange programs
ultimately sends the message that it's okay for our children to use
drugs. As a parent who raised 7 children. I know the war on drugs must
be fought from our homes and communities. But as elected leader, we are
still obligated to help our neighborhoods attack this problem.
Distributing needles encourages drug use, and I will not stand for it.
Today we will vote on H.R. 3717, the Needle Ban-Plus Bill. This
legislation prohibits the Federal Government from subsidizing the
distribution of hypodermic needles or syringes for the injection of
illegal drugs. Mr. Speaker, let's demonstrate our commitment to winning
this battle. I invite my colleagues to join me in supporting H.R. 3717.
The SPEAKER pro tempore. All time has expired.
The bill is considered read for amendment.
Pursuant to House Resolution 409, the previous question is ordered.
The question is on engrossment and third reading of the bill.
The bill was ordered to be engrossed and read a third time, and was
read the third time.

Motion to Recommit Offered by Ms. Pelosi

Ms. PELOSI. Mr. Speaker, I offer a motion to recommit
The SPEAKER pro tempore. Is the gentlewoman opposed to the bill?
Ms. PELOSI. Yes, I am opposed to the bill.
The SPEAKER pro tempore. The Clerk will report the motion to
recommit.
The Clerk read as follows:
Ms. Pelosi moves to recommit the bill, H.R. 3717, to the
Committee on Commerce with instructions to report the same
back to the House with the following amendment: Page 2, line
8, insert before the period the following: ``, unless the
Governor, State health officer, or local municipal health
authority determines that the use of Federal funds for such a
program would reduce the rate of transmission of the human
immunodeficiency virus (commonly know as HIV), would not
encourage the use of illegal drugs, and is acceptable to the
affected State, city or other unit of local government, or
community''.

The SPEAKER pro tempore. The gentlewoman from California (Ms. Pelosi)
is recognized for 5 minutes.
Ms. PELOSI. Mr. Speaker, as I said earlier in my remarks, I was going
to offer this motion to recommit because I think that it sincerely
attempts to address the concerns that have been expressed in the course
of the debate on this issue. Not only that, it is consistent with the
language of the appropriations bill that brings us here today,
actually.
Frankly, I was quite disappointed in the actions taken by some of my
Republican colleagues, because I thought we had come to a deal on the
needle exchange program. When the appropriations bill was passed, it
was agreed

[[Page H2476]]

that the Secretary of Health and Human Services could not lift the ban
on the needle exchange programs until March 31, 1998, unless the
Congress acted beforehand to prevent her from lifting the ban. It
established criteria for the Secretary to lift the ban, and that
criteria was that the projects are effective in preventing the spread
of HIV and do not encourage the use of illegal drugs. I think that the
scientific information and evidence that we have presented demonstrates
conclusively that that is the case.
In addition, the Secretary was expected to make a determination based
on the review of the relevant science, and the additional science that
has come forth in the last 6 months demonstrates even more clearly the
strong scientific basis, without which we would never ask our
colleagues to make this vote. And it also provides, the legislative
language also provides the referrals for treatment of drug abuse and
other appropriate health and social services.
So with that, we went forward with the idea that if the science came
forward, as it has, that the Secretary would be able to lift the ban.
Now, the administration has not lifted the ban, but this body wants to
act forevermore, flying in the face of the science, in defiance of the
effectiveness of the needle exchange programs.
I want to call to the attention of my colleagues some of the
organizations that support the needle exchange programs. The American
Medical Association, the American Public Health Association, the
National Academy of Sciences, the American Nurses Association, the
American Academy of Pediatrics, the U.S. Conference of Mayors, the
American Bar Association. Why would the U.S. Conference of Mayors
support the needle exchange program if they thought it would increase
crime, as our colleagues have contended?
So I say to my colleagues, in addition to that, I want to call two
other endorsements to the attention of my colleagues. Some of those on
the other side of this issue have spoken on the epidemiology of
substance abuse and HIV/AIDS. That means how it is spread in our
population. The Council of State and Territorial Epidemiologists have
written to Congress to reject H.R. 3717, the bill before us, and the
county and city health officials, the National Association of County
and City Health Officials, oppose it as well.
So I say to my colleagues, listen to the motion to recommit. The
motion to recommit sends this bill to the Committee on Commerce, which
is the appropriate route for this bill to take, with the following
amendment: That unless the Governor, State health officer, or local
municipal health authority determines that the use of Federal funds for
such a program would reduce the rate of transmission of HIV and would
not discourage the use of illegal drugs, and is acceptable to the
affected State, city or other unit of local government or community. No
Federal funds unless it meets that test: Reduce the rate of
transmission of HIV, would not encourage the use of illegal drugs, and
is acceptable to the affected State, city or unit of local government
or community.
Mr. Speaker, we are having this education of our colleagues, this
transfer of information between each other, among each other today
because we have not really gone through the regular order, the hearing
process. I heard my colleague say last week, how on earth could we vote
on the IMF because we have not had hearings? Well, how on earth can we
vote on this matter of life and death bypassing the committee structure
where we could conclusively review the scientific evidence to remove
all doubt in anyone's mind what is self-evident to the National
Institutes of Health?
I say once again that if we are funding NIH to the tune of $13.6
billion for this year, and many of us are calling for the doubling of
the NIH budget over the next 5 years, why on earth would we ignore
their scientific findings? Not only NIH, the Administrator himself, but
the various institutes that work to this end.
Mr. Speaker, I really do not like saying things about Congress that
are not complimentary, but ignoring the science really is the Flat
Earth Society mentality, and if we want to put our head in the sand, we
do not get any more room to do it on a flat earth. I urge my colleagues
to think seriously about the science, vote to save lives; support the
motion to recommit.
Mr. WICKER. Mr. Speaker, tomorrow the gentleman from Georgia (Mr.
Gingrich), the Speaker of the House, will lead what I hope is a
bipartisan delegation of Members of this body to announce a renewed war
against illegal drugs in this country, and I am pleased at this point
to yield him the balance of our time in opposition to the motion to
recommit.
The SPEAKER pro tempore. Is the gentleman from Georgia in opposition
to the motion?
Mr. GINGRICH. I am, Mr. Speaker.
The SPEAKER pro tempore. The gentleman from Georgia (Mr. Gingrich) is
recognized for 5 minutes.
Mr. GINGRICH. Mr. Speaker, let me just say that I really believe this
is a very important turning point for the United States. And I believe
this motion to recommit is a perfect symbol of why, for the last 6
years, we have been losing the war on drugs, a totally unnecessary
defeat, something that had been avoidable and something which has cost
lives.
The fact is there are some 14,000 Americans a year who die directly
from drugs, and another 6,000 who die from secondary effects, including
violence. Every year. Imagine if we were losing 20,000 Americans in
Bosnia or 20,000 Americans in Iraq, or 20,000 Americans anywhere else
in the world. That is higher than the death rate of the Vietnam War,
and yet our friends seem confused about what has happened.
Under Ronald Reagan and George Bush, there was a simple, clear
policy: Drug use is bad, do not do drugs. If one is a drug addict, get
off drugs. Come in, get help, get detoxed, get rehabilitation, but do
not be confused, drug use is bad.
Many of our more liberal friends laughed when Nancy Reagan said, just
say no. But guess what? By saying just say no and meaning it, drug use
under Reagan and Bush came down by two-thirds. Thousands of young
people were saved from addiction. Thousands of young people were saved
from dying. This is a real problem.
A member of my staff had a sister who went out on a date 3 years ago,
was given a designer drug, overdosed, went into a coma. She was 19.

{time} 1415

She has celebrated her 20th and 21st birthdays in a nursing home in a
coma and she will never recover.
In Plano, Texas, we have been reading about suicides and overdoses.
This is very serious business for America.
Tomorrow, the gentleman from Illinois (Mr. Hastert) the chairman of
our task force on the drug war, will be launching what we hope will be
a truly bipartisan effort where we hope Democrats will feel comfortable
joining us in being together as Americans saying: Do not do drugs.
What is the debate about today? Giving away needles for drug addicts?
Saying to somebody who is injecting heroin into their body that we have
a public health policy, we want them to use a clean needle so they will
be a healthy heroin addict? I just want to suggest to my friends, it is
not possible to be a healthy heroin addict. The act of injecting heroin
into the veins makes a person unhealthy.
The job of the United States Government is to reach out to every
addict and say to them, ``Please come into a hospital, please get off
drugs, please let us help you rebuild your life.'' And when the
government says, ``Drop by for some free needles,'' we are clearly
saying something.
Mr. Speaker, my colleagues do not have to believe me. I realize I am
a conservative Republican and I realize some people might say that is a
partisan message. So let me cite General Barry McCaffrey, President
Clinton's choice as the drug czar. This is what General McCaffrey said:
``Supporting needle exchange programs will send the wrong message to
our children. Government provision of needles may encourage drug use.''
So I am going to rely on General McCaffrey's advice. Everyone in this
Chamber who feels comfortable overruling General McCaffrey and willing
to give away free needles to heroin addicts, come and vote ``yes.'' But
they should not kid themselves. The drug czar of President Clinton says
that

[[Page H2477]]

may well lead to increased drug use. That may well say to our children
it is okay to become a heroin addict or a cocaine addict, and pure
cocaine is now often injected.
But those Members who, like me, are frightened of drugs, believe
drugs can kill, believe addiction is terrible, those who want to send a
clear signal to the children of America, those who are prepared to say
it is time to take a stand in favor of our children, vote ``no'' on
this motion to recommit, which is frankly an ``any needle, anytime,
anywhere, for any addict'' provision.
Mr. Speaker, people who could certify getting drugs here, the
governor, State health officer or local municipal health authority, we
know what this means. This means in some of our biggest cities we are
going to finance giving away needles. Let us be honest about it. This
means the U.S. taxpayer will be giving away needles. That is what this
motion to recommit means.
Let us be clear. If we want to win the war on drugs, if we want to
save children from drugs, if we want to lower the addiction rate, join
General McCaffrey and let us have a bipartisan vote ``no'' on the
motion to recommit. Then let us vote for our children to live in a
drug-free America and an America with less violence. Let us vote
``yes'' on this bill and send the signal: No free needles. Help the
addicts get off drugs. Do not help the addicts have clean needles.
The SPEAKER pro tempore (Mr. Foley). Without objection, the previous
question is ordered on the motion to recommit.
There was no objection.
The SPEAKER pro tempore. The question is on the motion to recommit.
The question was taken; and the Speaker pro tempore announced that
the noes appeared to have it.

Recorded Vote

Ms. PELOSI. Mr. Speaker, I demand a recorded vote.
A recorded vote was ordered.
The SPEAKER pro tempore. Pursuant to the provisions of clause 5 of
rule XV, the Chair announces that he will reduce to a minimum of 5
minutes the period of time within which a vote by electronic device, if
ordered, will be taken on the question of passage.
The vote was taken by electronic device, and there were--ayes 149,
noes 277, not voting 7, as follows:

[Roll No. 113]

AYES--149

Abercrombie
Ackerman
Allen
Baldacci
Barrett (WI)
Becerra
Berman
Blagojevich
Blumenauer
Boehlert
Bonior
Borski
Boyd
Brown (CA)
Brown (FL)
Brown (OH)
Campbell
Capps
Cardin
Carson
Clay
Clayton
Clyburn
Conyers
Coyne
Cummings
Davis (IL)
DeFazio
DeGette
Delahunt
DeLauro
Deutsch
Dicks
Dingell
Doggett
Dooley
Engel
Eshoo
Evans
Farr
Fattah
Fazio
Filner
Frank (MA)
Furse
Gejdenson
Gephardt
Greenwood
Gutierrez
Harman
Hastings (FL)
Hefner
Hilliard
Hinchey
Hinojosa
Hooley
Hoyer
Jackson (IL)
Jackson-Lee (TX)
Jefferson
Johnson (CT)
Johnson, E. B.
Kanjorski
Kennedy (MA)
Kennedy (RI)
Kennelly
Kilpatrick
Klink
Kolbe
Kucinich
Lantos
Lee
Levin
Lewis (GA)
Lofgren
Lowey
Maloney (CT)
Maloney (NY)
Manton
Markey
Martinez
Matsui
McCarthy (MO)
McCarthy (NY)
McDermott
McGovern
McHale
McKinney
Meehan
Meek (FL)
Meeks (NY)
Menendez
Millender-McDonald
Miller (CA)
Mink
Moakley
Moran (VA)
Morella
Nadler
Neal
Oberstar
Obey
Olver
Owens
Pallone
Pastor
Payne
Pelosi
Pomeroy
Price (NC)
Rangel
Reyes
Rivers
Rodriguez
Rothman
Roybal-Allard
Rush
Sabo
Sanchez
Sanders
Sawyer
Schumer
Scott
Serrano
Shays
Sherman
Skaggs
Slaughter
Smith, Adam
Snyder
Stabenow
Stark
Stokes
Stupak
Thompson
Thurman
Tierney
Torres
Towns
Velazquez
Vento
Waters
Watt (NC)
Waxman
Wexler
Weygand
Woolsey
Wynn
Yates

NOES--277

Aderholt
Andrews
Archer
Armey
Bachus
Baesler
Baker
Ballenger
Barcia
Barrett (NE)
Bartlett
Barton
Bass
Bentsen
Bereuter
Berry
Bilbray
Bilirakis
Bishop
Bliley
Blunt
Boehner
Bonilla
Bono
Boswell
Boucher
Brady
Bryant
Bunning
Burr
Burton
Buyer
Callahan
Calvert
Camp
Canady
Cannon
Castle
Chabot
Chambliss
Chenoweth
Christensen
Clement
Coble
Coburn
Collins
Combest
Condit
Cooksey
Costello
Cox
Cramer
Crane
Crapo
Cubin
Cunningham
Danner
Davis (FL)
Davis (VA)
Deal
DeLay
Diaz-Balart
Dickey
Doolittle
Doyle
Dreier
Duncan
Dunn
Edwards
Ehlers
Ehrlich
Emerson
English
Ensign
Etheridge
Everett
Ewing
Fawell
Foley
Forbes
Ford
Fossella
Fowler
Fox
Franks (NJ)
Frelinghuysen
Frost
Gallegly
Ganske
Gekas
Gibbons
Gilchrest
Gillmor
Gilman
Gingrich
Goode
Goodlatte
Goodling
Gordon
Goss
Graham
Granger
Green
Gutknecht
Hall (OH)
Hall (TX)
Hamilton
Hansen
Hastert
Hastings (WA)
Hayworth
Hefley
Herger
Hill
Hilleary
Hobson
Hoekstra
Holden
Horn
Hostettler
Houghton
Hulshof
Hunter
Hutchinson
Hyde
Inglis
Istook
Jenkins
John
Johnson (WI)
Johnson, Sam
Jones
Kaptur
Kasich
Kelly
Kildee
Kim
Kind (WI)
King (NY)
Kingston
Kleczka
Klug
Knollenberg
LaFalce
LaHood
Lampson
Largent
Latham
LaTourette
Lazio
Leach
Lewis (CA)
Lewis (KY)
Linder
Lipinski
Livingston
LoBiondo
Lucas
Luther
Manzullo
Mascara
McCollum
McCrery
McDade
McHugh
McInnis
McIntosh
McIntyre
McKeon
McNulty
Metcalf
Mica
Miller (FL)
Minge
Mollohan
Moran (KS)
Murtha
Myrick
Nethercutt
Neumann
Ney
Northup
Norwood
Nussle
Ortiz
Oxley
Packard
Pappas
Parker
Pascrell
Paul
Paxon
Pease
Peterson (MN)
Peterson (PA)
Petri
Pickering
Pickett
Pitts
Pombo
Porter
Portman
Poshard
Pryce (OH)
Quinn
Radanovich
Rahall
Ramstad
Redmond
Regula
Riggs
Riley
Roemer
Rogan
Rogers
Rohrabacher
Ros-Lehtinen
Roukema
Royce
Ryun
Salmon
Sanford
Saxton
Scarborough
Schaefer, Dan
Schaffer, Bob
Sensenbrenner
Sessions
Shadegg
Shaw
Shimkus
Shuster
Sisisky
Skeen
Skelton
Smith (MI)
Smith (NJ)
Smith (TX)
Smith, Linda
Snowbarger
Solomon
Souder
Spence
Spratt
Stearns
Stenholm
Strickland
Stump
Sununu
Talent
Tanner
Tauscher
Tauzin
Taylor (MS)
Taylor (NC)
Thomas
Thornberry
Thune
Tiahrt
Traficant
Turner
Upton
Visclosky
Walsh
Wamp
Watkins
Watts (OK)
Weldon (FL)
Weldon (PA)
Weller
White
Whitfield
Wicker
Wise
Wolf
Young (AK)
Young (FL)

NOT VOTING--7

Barr
Bateman
Cook
Dixon
Gonzalez
Sandlin
Smith (OR)

{time} 1440

Messrs. ENGLISH of Pennsylvania, THOMAS, LAMPSON and MOLLOHAN changed
their vote from ``aye'' to ``no.''
Messrs. BLAGOJEVICH, PALLONE and DEUTSCH changed their vote from
``no'' to ``aye.''
So the motion to recommit was rejected.
The result of the vote was announced as above recorded.
The SPEAKER pro tempore (Mr. Combest). The question is on passage of
the bill.
The question was taken; and the Speaker pro tempore announced that
the ayes appeared to have it.

Recorded Vote

Mr. WICKER. Mr. Speaker, I demand a recorded vote.
A recorded vote was ordered.
The SPEAKER pro tempore. This will be a 5-minute vote.
The vote was taken by electronic device, and there were--ayes 287,
noes 140, not voting 6, as follows:

[Roll No. 114]

AYES--287

Aderholt
Andrews
Archer
Armey
Bachus
Baesler
Baker
Baldacci
Ballenger
Barcia
Barrett (NE)
Bartlett
Barton
Bass
Bentsen
Bereuter
Berry
Bilbray
Bilirakis
Bishop
Blagojevich
Bliley
Blunt
Boehner
Bonilla
Bono
Boswell
Boucher
Boyd
Brady
Bryant
Bunning
Burr
Burton
Buyer
Callahan
Calvert
Camp
Canady
Cannon
Castle
Chabot
Chambliss
Chenoweth
Christensen
Clement
Coble
Coburn
Collins
Combest
Condit
Cook
Costello
Cox
Cramer
Crane
Crapo
Cubin
Cunningham
Danner
Davis (FL)
Davis (VA)
Deal
DeLay
Diaz-Balart
Dickey
Doolittle
Doyle
Dreier
Duncan
Dunn
Edwards
Ehlers
Ehrlich
Emerson
English
Ensign
Etheridge

[[Page H2478]]

Everett
Ewing
Fawell
Forbes
Ford
Fossella
Fowler
Fox
Franks (NJ)
Frelinghuysen
Frost
Gallegly
Gekas
Gibbons
Gilchrest
Gillmor
Gilman
Gingrich
Goode
Goodlatte
Goodling
Gordon
Goss
Graham
Granger
Green
Gutknecht
Hall (OH)
Hall (TX)
Hamilton
Hansen
Hastert
Hastings (WA)
Hayworth
Hefley
Hefner
Herger
Hill
Hilleary
Hobson
Hoekstra
Holden
Horn
Hostettler
Houghton
Hulshof
Hunter
Hutchinson
Hyde
Inglis
Istook
Jenkins
John
Johnson (WI)
Johnson, Sam
Jones
Kaptur
Kasich
Kelly
Kildee
Kim
Kind (WI)
King (NY)
Kingston
Kleczka
Klink
Klug
Knollenberg
LaFalce
LaHood
Lampson
Largent
Latham
LaTourette
Lazio
Leach
Lewis (KY)
Linder
Lipinski
Livingston
LoBiondo
Lucas
Luther
Manzullo
Mascara
McCarthy (MO)
McCollum
McCrery
McDade
McHugh
McInnis
McIntosh
McIntyre
McKeon
McNulty
Metcalf
Mica
Miller (FL)
Minge
Mollohan
Moran (KS)
Murtha
Myrick
Nethercutt
Neumann
Ney
Northup
Norwood
Nussle
Ortiz
Oxley
Packard
Pallone
Pappas
Parker
Pascrell
Paul
Paxon
Pease
Peterson (MN)
Peterson (PA)
Petri
Pickering
Pickett
Pitts
Pombo
Pomeroy
Porter
Portman
Poshard
Price (NC)
Pryce (OH)
Quinn
Radanovich
Rahall
Ramstad
Redmond
Regula
Reyes
Riggs
Riley
Rodriguez
Roemer
Rogan
Rogers
Rohrabacher
Ros-Lehtinen
Roukema
Royce
Ryun
Salmon
Sanchez
Sanford
Saxton
Scarborough
Schaefer, Dan
Schaffer, Bob
Sensenbrenner
Sessions
Shadegg
Shaw
Shimkus
Shuster
Sisisky
Skeen
Skelton
Smith (MI)
Smith (NJ)
Smith (TX)
Smith, Linda
Snowbarger
Solomon
Souder
Spence
Spratt
Stearns
Stenholm
Strickland
Stump
Stupak
Sununu
Talent
Tanner
Tauscher
Tauzin
Taylor (MS)
Taylor (NC)
Thomas
Thornberry
Thune
Tiahrt
Traficant
Turner
Upton
Visclosky
Walsh
Wamp
Watkins
Watts (OK)
Weldon (FL)
Weldon (PA)
Weller
White
Whitfield
Wicker
Wise
Wolf
Young (AK)
Young (FL)

NOES--140

Abercrombie
Ackerman
Allen
Barrett (WI)
Becerra
Berman
Blumenauer
Boehlert
Bonior
Borski
Brown (CA)
Brown (FL)
Brown (OH)
Campbell
Capps
Cardin
Carson
Clay
Clayton
Clyburn
Conyers
Cooksey
Coyne
Cummings
Davis (IL)
DeFazio
DeGette
Delahunt
DeLauro
Deutsch
Dicks
Dingell
Doggett
Dooley
Engel
Eshoo
Evans
Farr
Fattah
Fazio
Filner
Foley
Frank (MA)
Furse
Ganske
Gejdenson
Gephardt
Greenwood
Gutierrez
Harman
Hastings (FL)
Hilliard
Hinchey
Hinojosa
Hooley
Hoyer
Jackson (IL)
Jackson-Lee (TX)
Jefferson
Johnson (CT)
Johnson, E. B.
Kanjorski
Kennedy (MA)
Kennedy (RI)
Kennelly
Kilpatrick
Kolbe
Kucinich
Lantos
Lee
Levin
Lewis (CA)
Lewis (GA)
Lofgren
Lowey
Maloney (CT)
Maloney (NY)
Manton
Markey
Martinez
Matsui
McCarthy (NY)
McDermott
McGovern
McHale
McKinney
Meehan
Meek (FL)
Meeks (NY)
Menendez
Millender-McDonald
Miller (CA)
Mink
Moakley
Moran (VA)
Morella
Nadler
Neal
Oberstar
Obey
Olver
Owens
Pastor
Payne
Pelosi
Rangel
Rivers
Rothman
Roybal-Allard
Rush
Sabo
Sanders
Sawyer
Schumer
Scott
Serrano
Shays
Sherman
Skaggs
Slaughter
Smith, Adam
Snyder
Stabenow
Stark
Stokes
Thompson
Thurman
Tierney
Torres
Towns
Velazquez
Vento
Waters
Watt (NC)
Waxman
Wexler
Weygand
Woolsey
Wynn
Yates

NOT VOTING--6

Barr
Bateman
Dixon
Gonzalez
Sandlin
Smith (OR)

{time} 1450

Mr. BERRY changed his vote from ``no'' to ``aye.''
So the bill was passed.
The result of the vote was announced as above recorded.
A motion to reconsider was laid on the table.

____________________