Nationally noted: Governor’s syringe exchange legislation foolhardy

A few weeks ago some Hoosiers were worried about the image of our state because of the ill-advised, ineptly named Religious Freedom Restoration Act. Gov. Mike Pence was so worried he decided to spend $750,000 with some opportunistic, out-of-state firm for Righteous Image Restoration Advertising.

It did not seem to me that our image would be seriously compromised by the act’s passage or the virtually meaningless “fix” applied after a massive public outcry. Our reputation was already well-established as being backward looking and ignorant. The law only confirmed what most Americans who thought of Indiana already believed.

Little noticed at the time was the Pence turnabout when the largest-ever outbreak of HIV hit the state. Long an ideological opponent of needle and syringe exchange programs, the governor authorized such an effort for Scott County alone. The rest of the state would remain in the dark ages.

Most Hoosiers did not notice this because HIV and Scott County are not on their radar screens. HIV no longer has a prominent place in the popular imagination. Scott County, with fewer than 24,000 people (and declining), is virtually unknown in the state. Only if you drive frequently on I-65 between Columbus and Louisville, or have relatives there, would you be aware of Scott County.

The governor’s action, however, was noticed nationally in the highly prestigious and widely read Journal of the American Medical Association. Two medical doctors from Brown University in Providence, Rhode Island, published an article recently titled “Ideological Anachronism Involving Needle and Syringe Exchange Programs: Lessons from the Indiana HIV Outbreak.”

The doctors trace opposition to such programs back to 1988 and Jesse Helms, a U.S. senator from North Carolina. Opponents such as Mike Pence believe these programs “condone and encourage drug use, dissuade injection drug users from seeking help, signal governmental acceptance of illegal behavior,” among other sins.

Supporters of exchange programs contend that research demonstrates “the safety and efficacy of (exchange programs),” and “do not result in increased drug use.”

In Indiana, which ranks 47th among the states in funding for health programs, the insistence on banning needle and syringe exchanges means continuation of an intentional policy that kills Hoosiers.

Drug use can be curbed by needle and syringe exchanges. Such programs, properly funded, also offer much-needed “counseling, testing and treatment for HIV as well as for hepatitis, tuberculosis and sexually transmitted diseases.” Addicted persons “have a chronic relapsing disease that is amenable to intervention were they not stigmatized, incarcerated, deprived of employment or kept at arm’s length from medical care,” according to the article.

Instead of recognizing a successful way of advancing public health, the Pence administration signals to the medical world, and to the health-related business firms we are trying to attract, that Indiana ignores the evidence of science and sits firmly upon a shaky, outdated moralizing platform.

Morton Marcus is an economist, formerly with the Indiana University Kelley School of Business. Send comments to