Wrong kind of drug czar

Boston Globe, December 13, 2008

REPRESENTATIVE Jim Ramstad, a Republican from Minnesota, is said to be a candidate for drug czar in the Obama administration. This would take bipartisanship one step too far, at the expense of public health.

Ramstad, who is retiring after 18 years in office, gets high marks for working with a Democratic colleague, Patrick Kennedy of Rhode Island, to require insurers to cover mental health and addiction treatment (the two men are alcohol recovery partners). But Ramstad has also voted repeatedly against federal funding for needle exchange programs for drug users to fight the spread of HIV/AIDS. Washington’s paralysis on this issue goes back to when President Clinton let his drug czar, Barry McCaffrey, sabotage funding efforts by Donna Shalala, then secretary of Health and Human Services. McCaffrey hyperbolically called clean-needle programs “magnets for all social ills.” In 2002, Clinton admitted that “I was wrong” not to lift the funding ban.

A study this fall in The Lancet found that only 1.5 percent of injecting drug users in Australia have HIV, compared with 16 percent in the United States. “That’s largely because we acted very quickly in the 1980s to implement methadone programs and needle exchange programs when other countries like the US were dragging their heels,” study author Bradley Mathers of Australia’s National Drug and Alcohol Research Center told the Associated Press. Anthony Fauci, director for infectious disease at the National Institutes of Health, flatly says, “needle exchange programs work. There’s no doubt about that.”

The Centers for Disease Control says the national HIV infection rate is now 40 percent higher than previously thought. Injection drug use causes 12 percent of new infections. Obama, a supporter of needle exchange, has no time to thread the needle with his drug czar.