The AIDS Pandemic: Complacency, Injustice, and Unfulfilled Expectations

By Lawrence O. Gostin | Go to book overview

This nation is fighting two deadly epidemics—AIDS and drug abuse. They are robbing us of
far too many of our citizens and weakening our future. A meticulous scientific review has
now proven that needle exchange programs can reduce the transmission of HIV and save
lives without losing ground in the battle against illegal drugs. It offers communities that de-
cide to pursue needle exchange programs yet another weapon in their fight against AIDS.
Donna E. Shalala, secretary of health and human services in the Clinton administration
(1998)

Junk is a cellular equation that teaches the user facts of general validity. I have learned a
great deal from using junk: I have seen life measured out in eyedroppers of morphine solu-
tion. I experienced the agonizing deprivation of junk sickness, and the pleasure relief when
junk thirsty cells drank from the needle. Perhaps all pleasure is relief. I have learned the cel-
lular stoicism that junk teaches the user. I have seen a cell full of sick junkies silent and im-
mobile in separate misery. They knew the pointlessness of complaining or moving. They
knew that basically no one can help anyone else. There is no key, no secret someone else
has that he can give you. I have learned the junk equation. Junk is not, like alcohol or weed,
a means to increased enjoyment of life. Junk is not a kick. It is a way of life.
—William S. Burroughs, Junky (1977)


Chapter 14
The Interconnected Epidemics of
AIDS and Drug Dependency

If junk is a way of life, as William S. Burroughs vividly conveys, then the critical inquiry for law and policy is whether to punish or rehabilitate the junky. In the United States, criminal justice authorities cast drug dependency as an evil or a moral wrong to be penalized. Public health professionals regard drug dependency as a medical condition to be prevented, treated, and, if possible, cured. These competing approaches have long spawned conflict between the criminal justice and public health systems, but never have the differences been more divisive than in the debate over syringe availability;1 that is, the prescription, sale, distribution, and exchange of drug-injection equipment.

A syringe is a powerful symbol—as an essential tool of the medical profession and as an emblem in the bitter controversy surrounding drug policy in the United States.2 Criminal justice and public health ideologies profoundly differ

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