GOP lawmaker urges state needle-sharing program

Zaun among advocates who say it would curtail disease

Sen. Brad Zaun, R-Urbandale
Sen. Brad Zaun, R-Urbandale

DES MOINES — New laws may be helping drive down opioid-related deaths in Iowa, but a needle exchange program backed by a key Republican lawmaker is meant, he said, to head off a different public health threat — HIV.

Iowa is at risk for an HIV outbreak, according to state and federal health data indicators.

And one way to prevent it, advocates and some health care experts say, is to create a government program offering free syringes to intravenous drug users.

Such programs are often called needle-sharing, and 37 states legalize them. Iowa does not.

Brad Zaun, a Republican state senator from the Des Moines suburb of Urbandale, for the second consecutive year has introduced legislation to create a needle-sharing program in Iowa.

“We’re talking about the spread of disease,” Zaun said. “There’s certainly been other states that have done this and it has significantly decreased the spread of disease. So I’m on the policy side of this. Of course, it takes money as well.”

The state public health department recently published a report that said preliminary 2018 data indicates opioid-related deaths are falling in Iowa after more than tripling between 2005 and 2017.

The department said recently added state laws may be helping. Among other steps taken, the state has expanded the availability of naloxone, which is used to counter an opioid overdose, and required physicians and pharmacists to use a state database for opioid prescriptions to prevent individuals from collecting opioid painkillers from multiple providers.

“We’re very excited by the positive changes we’ve seen occur in the state, but (the state public health department) can’t take all of the credit. These changes would not have been possible if it were not for the dedicated providers, communities and coalitions that recognized a need and made change happen,” DeAnn Decker, the substance abuse bureau chief with the public health department, said in a statement.


But with one public health issue seemingly improving, Zaun and advocates are turning their focus to possible ways to help prevent another, which may be related.

The public health department in 2017 determined Iowa is at risk for an HIV outbreak related to injection drug use. The concern stems from a significant increase in hepatitis infections observed in individuals who use injection drugs, including opioids and methamphetamine.

After a one-year dip in 2017, hepatitis C diagnoses among Iowans under 40 increased again in 2018, continuing a long-term trend of increases.

Randy Mayer, who leads the public health department’s HIV and hepatitis bureau, said he uses the under-40 numbers because they are the most likely to be current drug users and to have been recently infected.

Needle-sharing programs are designed to help prevent the spread of HIV and hepatitis C by curtailing the spread of those diseases through the re-use of syringes.

The federal Centers for Disease Control and Prevention says needle-sharing programs are an effective component of a comprehensive approach to HIV and hepatitis C prevention among injection drug users.

Under a typical needle-sharing program, injection drug users are able to dispose of old syringes and acquire new ones without threat of being arrested. They also interact with health care staff who are able to refer an individual to substance abuse treatment, test for HIV or hepatitis C, and help individuals look for housing or employment information.

“The idea is to provide health services to people who are using drugs and work with them on getting them into treatment for their substance use disorder,” Mayer said. “In the meantime they might not be ready for treatment. But we can keep them from getting HIV and hepatitis C, and we can immunize them from hepatitis B and refer them to services. ... So you’re building a rapport with people who you are hoping are at some point are going to utilize drug treatment services.”


The public health department is not advocating in support or opposition to Zaun’s proposal, but the department in 2017 requested the federal government declare the state in need of needle-sharing programs to help prevent a potential HIV outbreak.

“We feel like the data supports the use of syringe services programs in the state,” Mayer said.

Tiffany Carter, policy and engagement coordinator for the nonprofit advocacy group Iowa Harm Reduction Coalition, said participants in needle-sharing programs are five times more likely than the average injection drug user to enter a treatment program and 3.5 times more likely to stop using drugs.

“So if the goal for folks who are concerned about whether or not it’s enabling drug use, if their goal is drug abstinence, the results are there. The evidence is there,” Carter said. A state needle-sharing program “would cause drastic reductions in our hepatitis C and HIV rates in the state. ... Providing sterile injection equipment (and) teaching folks how to prevent disease transmission by not sharing their equipment is really a great solution to that problem.”

Officials did not have an estimate on how much a state needle-sharing program would cost. Mayer said there are federal funds available that the state could dedicate to a needle-sharing program, but that the state likely would have to set aside some funding to get the program going.

Taxpayer money cannot be used to purchase syringes, however. Carter said there are nonprofit organizations like Elton John’s AIDS Foundation that offer grants to needle-sharing programs.

Concerns with needle-sharing programs largely center on the perception they are enabling drug use by giving free, clean syringes to users.

The only lobbying organization registered in opposition to Zaun’s bill is the Iowa Police Chiefs Association.


“Some people say that I’m promoting drug use and that is the last thing that I want to do,” said Zaun, chairman of the Senate Judiciary Committee. Curtailing the spread of diseases among injection drug users can save costs for hospitals and taxpayers, he said.

Zaun and Carter said they are hopeful the proposal advances through the GOP-controlled Iowa Legislature — after failing last year — and reaches Gov. Kim Reynolds’ desk.

Zaun said he considers the education aspect of needle-sharing programs similar to the early resistance to the state’s medical cannabis program.

“It’s all about education,” he said. “Certainly opinions turn. I think it’s worthy to continue the conversation.”

Give us feedback

We value your trust and work hard to provide fair, accurate coverage. If you have found an error or omission in our reporting, tell us here.

Or if you have a story idea we should look into? Tell us here.

Give us feedback

We value your trust and work hard to provide fair, accurate coverage. If you have found an error or omission in our reporting, tell us here.

Or if you have a story idea we should look into? Tell us here.