COMMENTARY: Conservatives changed governor's mind on needle exchange

Even amid a sprawling outbreak of HIV in poor, rural Scott County that was fueled by intravenous drug use, Pence tried to shut down a needle exchange proposal by declaring his “long-standing” opposition to programs that provide clean needles to drug users. 

Back then Pence insisted that a needle exchange aimed at curbing the spread of disease was a lousy drug policy.

By late Wednesday, when he pledged to sign the new bill, he’d reframed it as a wise health policy.

It took a chorus of voices, growing ever louder, to change his mind.

Back in early March, as HIV numbers spiked in Scott County, Pence stopped state health officials from distributing “harm reduction” kits stocked with needle-cleaning supplies such as bleach, cotton and alcohol wipes.

By the end of the month, conservative Republicans from communities near the HIV epicenter had convinced him that the situation was dire enough to set aside ideology.

They pushed him to take a first step — declaring a 30-day emergency that cleared the way for a limited exchange in Scott County, wherein health officials could get clean needles into the hands of HIV-infected drug users.

House Public Health Committee Chairman Ed Clere, R-New Albany, wanted more. He filed a measure to let local health officials expand needle exchanges to other communities where IV drug use is fueling a fast rise in Hepatitis C – a blood-borne disease that often accompanies HIV.

Key lawmakers joined him, including Senate Public Health Chairwoman Patricia Miller, R-Indianapolis, a staunch conservative trained as a nurse, and House Ways and Means Chairman Tim Brown (R-Crawfordsville), the Legislature’s only physician.

Still, there was resistance. Senate President David Long (R-Fort Wayne) said Pence worried that if Indiana started giving out needles, it would be on a slippery slope to becoming like Denmark. That’s where the government allows local officials to open so-called consumption rooms where addicts can bring illegal drugs but use them, legally, under the watchful eye of a nurse.

Public health officials told the governor it didn’t have to be that way. They pointed to needle exchanges in the United States, endorsed by the Centers for Disease Control and Prevention, that successfully curbed the spread of HIV.

To counter Pence’s argument that needle exchanges enable drug users – an argument echoed by prosecutors — Republican Attorney General Greg Zoeller went public with his support.

“I’m not going to have anybody put to death with HIV just because they’ve broken the law,” said Zoeller. By the time he made that statement, he had been lobbying both lawmakers and the governor’s staff to support Clere’s needle exchange bill.

When the final vote came, supporters had assuaged many of their colleagues’ aversion to a policy that puts needles in the hands – and arms – of illegal drug users. The House voted 80-19 for it. The Senate approved it on a 38-11 vote.

Clere says the negotiated version of the bill isn’t perfect: It makes local health departments convince their elected leaders to seek permission from the state public health commissioner to launch a needle exchange. He worries some of those officials may be as hard to convince as Pence was.

Still, Clere sees it as a major move forward in recognizing the perilous public health issues that the state faces.

Last week, more than 140 confirmed cases of HIV were tied to the Scott County outbreak. Without widespread HIV testing, health officials acknowledged they didn’t really know how far the epidemic has spread.

“I hate that it took a crisis to force this discussion,” Clere said. “But I’m glad we were finally able to have it.”