Federal Funding for Syringe Exchange: The More Things Change, the More They Stay the Same

• In Event: 066 - Section on Political Sociology Roundtables (one-hour)
  In Refereed Roundtable: Table 09. The Politics of Policy

Abstract

Syringe exchange programs provide sterile syringes and injection supplies to drug users to prevent the spread of HIV, hepatitis C, and other diseases. Over the past thirty years, syringe exchange has proven to be effective and programs have spread across the country. Tragically, approximately two hundred thousand Americans with AIDS contracted through injection drug use have nevertheless died. Despite these consequences, the federal government has prohibited funding for syringe exchange almost continuously since 1988. What explains the endurance of this remarkably counterproductive policy? While previous scholars have blamed the controversy on an obdurate and highly-charged moral debate, this simplistic view does not match the historical reality. Rather, the ban has persisted because at each critical moment in its history, politicians who in fact support the existence of syringe exchange programs—including two Democratic presidents—have also supported the federal ban. At various points in time and under changing historical conditions, the ban has been seen as a progressive victory over harsher alternatives, a largely symbolic measure, and a drain on scarce political capital. In each historical period, both friends and foes of syringe exchange have helped to keep it in place. The federal funding ban demonstrates the double-edged potential of social crises, like the AIDS epidemic, to spur and shape political struggle by temporarily reordering political priorities and empowering new groups and experts.

Author

• David Showalter, University of California-Berkeley