NY Medicaid Officials Consider Needle Exchange

New York state officials are searching for ways to save money in the Medicaid program, and a controversial suggestion to fund syringe exchange programs has provoked debate among lawmakers. A team appointed by Gov. Andrew Cuomo claims that the addition of more preventative services for drug users will save money, along with restructuring how services are billed; however, the practice of needle exchanges is illegal in the US, and has been long a subject of controversy (despite having proven effective in reducing rates of disease in places like British Columbia). “It’s almost like a subset, it’s part of the prevention process,” says Peter Constantakes, a spokesman for the New York Department of Health. “It’s cheaper to prevent illnesses (among the groups affected by health disparities). If we can help prevent disease that comes from use of the same needle, it definitely would promote better health, and could save costs in the long run.” Despite the fact that many agencies—including the World Health Organization and the Center for Disease Control and Prevention—back needle exchanges as an effective health measure, many lawmakers remain opposed. “The answer is not to coddle drug addicts,” says assemblyman-elect and conservative talk show host Bill Nojay. “It’s something that must be done through law enforcement. We need severe consequences to show that society does not tolerate this kind of behavior.” Nojay argues that Medicaid should offer fewer services, instead of adding more.

However, even if officials were able to gather enough support for a needle exchange, Medicaid would be banned from financing the program under current federal law. Barack Obama lifted the federal ban on these types of programs in 2009, only to have Congress reinstate it soon after; however, many advocates are hopeful that the law could soon be repealed. Sean Barry, spokesman for the AIDS advocacy group Voices of Community Activists and Leaders New York, says that disease by needle injection is a growing issue in the US. The rise of prescription drug abuse has led to an increase in use of injectable drugs—since opiate addicts often begin injecting heroin if they can't access prescription drugs. “The abstinence approach does not work for many individuals,” says Steven Price, senior director of community health initiatives with AIDS Care Rochester. “So the next best step is to empower individuals to reduce the harm associated with their substance use and keep them engaged in care, which has long been the position of AIDS Care.”