Helms Amendment (1989)

In the early 1980s, doctors discovered that a previously unknown virus—subsequently named the human immunodeficiency virus (HIV)—that was responsible for a lethal illness was spreading through the San Francisco gay community. The illness, now known around the world as acquired immunodeficiency syndrome (AIDS), resulted in the deterioration of the human immune system to such an extent that those afflicted with it faced a high risk of dying from pneumonia, an illness that is normally overcome by the human body’s natural immune system. Medical authorities soon discovered that HIV was a communicable disease that was spread through the commingling of certain body fluids, and that it was increasingly being discovered among individuals of different sexual orientations who lived outside the San Francisco area. This knowledge convinced many health professionals that public health programs designed to control the spread of HIV should be quickly enacted.

Since HIV is transmitted through body fluids, it became obvious that the sharing of unhygienic needles among intravenous drug users was a high-risk activity. Indeed, a 1995 study reported by the National Academy of Sciences states that ‘‘[t]he epidemiologic data indicate that the HIV epidemic in this country is now clearly driven by infections occurring in the population of injection drug users, their sexual partners, and their offspring.’’ By the end of the 1980s, it had become apparent to many in the field of public health that one of the most effective ways to reduce the spread of the HIV virus would be to provide intravenous drug users with free needles. The merits of this idea were strongly reinforced by a 2004 World Health Organization study which explains that ‘‘[p]roviding access to and encouraging utilization of sterile needles and syringes for [intravenous drug users] is now generally considered to be a fundamental component of any comprehensive and effective HIV-prevention programme.’’

Yet in a contrary move spearheaded by Senator Jesse Helms (R-NC), the U.S. Congress enacted an amendment in 1989 that prohibited federal funds from being used to support free needle programs for illicit drug users. This controversial policy, which has remained in effect since that time, was supported by lawmakers who thought that free needle programs would promote the intravenous use of illegal drugs in several important ways. First, if the government provides free needles, then one of the costs normally associated with intravenous drug use would have been eliminated. Second, the threat of acquiring the HIV virus by sharing needles acts as a strong deterrent to intravenous drug use. Finally, free needle programs might convey a message—especially to young people who are not yet intravenous drug users—that the government condones the intravenous use of illegal drugs. These arguments, though, have been strongly challenged by critics of the policy.


References and Further Reading

  • Normand, Jacques, David Vlahov, and Lincoln E. Moses, eds. Preventing HIV Transmission: The Role of Sterile Needles and Bleach. Washington, DC: National Academy Press, 1995.
  • Szalavitz, Maia. ‘‘Death Penalty for I.V. Drug Users.’’ Salon.com, 2005. http://www.salon.com/news/feature/ 2005/03/24/needle_exchange/.
  • Verghese, Abraham. My Own Country: A Doctor’s Story. New York: Vintage Press, 1995.
  • World Health Organization. ‘‘Effectiveness of Sterile Needle and Syringe Programming in Reducing HIV/AIDS among Injecting Drug Users.’’ 2004. http://www.who. int/hiv/pub/prev_care/en/effectivenesssterileneedle.pdf.


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