“This country is experiencing an unprecedented opioid epidemic, and facilitating addictions, especially those of our veterans seeking help from the VA, will only exacerbate the problem.”
WASHINGTON — Today, U.S. Senator Tommy Tuberville (R-AL) sent a letter to the U.S. Secretary of Veterans Affairs (VA) Denis McDonough expressing concern about the VA administering a needle exchange program at their medical facilities for veterans experiencing substance use disorders.
In the letter, Senator Tuberville responds to a memo issued on May 24, 2021 by Assistant Under Secretary for Clinical Services Dr. Kameron Matthews, which recommends that all Veterans Health Administration (VHA) Medical Centers develop Syringe Support Programs (SSPs) or “ensure veterans enrolled in VHA care have access to SSPs where such programs are not prohibited under state, county, or local law.”
SSPs, or needle exchange programs, purport to reduce the spread of infectious diseases, such as HIV and Hepatitis, among people who inject drugs. However, whether needle exchange programs effectively reduce drug use overall has been a point of debate for decades. These programs drive continued drug use instead of encouraging individuals to seek treatment to overcome addictions.
For over a decade, Congress has banned the Department of Health and Human Services from using taxpayer funds to purchase needles and syringes. However, in 2021, on a party-line vote, Democrats authorized funding for needle exchange programs.
Needle exchange programs are illegal in Alabama. Even the possession of hypodermic syringes and needles with the intent to use an illegal drug is a criminal offense.
In his letter to Secretary McDonough, Senator Tuberville writes, “I find VA’s continued superseding of state laws in order to drive a progressive agenda troubling, and I worry for the future of veteran health care because of it.”
In the letter, Senator Tuberville asks the VA Secretary, “Under what federal law and regulation does the VA derive authority to administer a taxpayer-funded needle exchange program?… What data does the VA have that shows, explicitly and conclusively, that SSPs are the reason for a veteran’s recovery from SUD?”
Read the full text of the letter here and below.
July 27,2023
The Honorable Denis R. McDonough Secretary
Department of Veterans Affairs
801 Vermont Avenue, NW Washington, D.C. 20402
Secretary McDonough,
As I raised in questions to Department of Veterans Affairs (VA) witnesses at the Senate Veterans Affairs Committee hearing held on June 14, 2023, I remain deeply concerned about the VA administering a needle exchange program at their medical facilities for veterans experiencing substance use disorders (SUD). These programs, known as Syringe Support Programs (SSPs), are intended to reduce the spread of infectious diseases among people who inject drugs; however, the evidence behind whether SSPs contribute to drug user reduction is questionable. In a memo dated May 24, 2021, the Assistant Under Secretary for Clinical Services recommended that all Veterans Health Administration (VHA) Medical Centers develop SSPs or “ensure veterans enrolled in H A care have access to SSPs where such programs are not prohibited under state, county, or local law.” I find VA’s continued superseding of state laws in order to drive a progressive agenda troubling, and I worry for the future of veteran health care because of it.
Currently, SSPs are not permitted in six states, including Alabama.? In fact, not only does Alabama not allow SSPs, but also possession of hypodermic syringes and needles with intent to use a controlled substance in violation of state law is a criminal offense3 While it is true that the prohibition on use of federal funds to purchase syringes directly limits the Department of Health and Human Services and not the VA.4 it seems contradictory to the will of the states that the VA should offer SSPs to veterans at their medical centers in states where it is unlawful and whose practice could expose veterans to criminal liability. Further, given the federal ban and certain state bans, it is extremely concerning that the VA holds up as the basis of its authority to provide SSPs an internal memorandum issued more than two years ago from an Assistant Under Secretary providing interim guidance. In our representative democracy, such a controversial use of authority should require an open and transparent rulemaking process that would allow the public to comment and question the provision of these programs, not only at the VA, but also in states that prohibit them.
This country is experiencing an unprecedented opioid epidemic, and facilitating addictions, especially those of our veterans seeking help from the VA, will only exacerbate the problem. To better understand the data and trends the V A used to conclude that SSPs are in the best interest of veterans experiencing SUD, please provide answers to the following questions by September 30, 2023.
- Under what federal law and regulation does the VA derive authority to administer a taxpayer-funded needle exchange program?
- How many VHA-enrolled veterans have been given access to clean needles or syringes since this VHA memo was issued?
- Of that number of veterans, how many have entered in-patient rehabilitation care at the VA?
- How many have entered in-patient rehabilitation in the community?
- Under what conditions does a veteran gain access to needles or syringes through the VA?
- Can a VHA-enrolled veteran receive clean needles or syringes without speaking to a clinician or provider?
- Can a veteran who is not enrolled in VHA gain access to clean needles or syringes through the VA?
- Do VA providers create comprehensive care plans for every veteran who is given access to VA-provided clean syringes or needles?
- What data does the VA have that shows, explicitly and conclusively, that SSPs are the reason for a veteran’s recovery from SUD?
BACKGROUND
As the son of a highly-decorated WWII veteran and Purple Heart recipient, Senator Tuberville is passionate about improving the way our nation treats its veterans and military families. He is proud to sit on the Senate Veterans’ Affairs Committee, where he advocates for the 400,000 veterans in Alabama and millions more across the country.
Getting Results
Senator Tuberville consistently works to identify targeted changes that will improve how the U.S. Department of Veterans Affairs (VA) delivers care and benefits to veterans and service members.
During his first two years in office, Senator Tuberville successfully championed two standalone bills focused on making life easier for veterans and military families. Both bills passed with bipartisan support and were signed by President Joe Biden, a rare achievement for a freshman senator in the minority party.
- Senator Tuberville introduced legislation to correct an error on VA and Department of Defense forms to make it easier for dependents to receive Post-9/11 GI Bill benefits.
- Senator Tuberville’s Supporting Families of the Fallen Act provided the first increase of maximum coverage amounts under the VA Servicemembers’ Group Life Insurance (SGLI) and Veterans’ Group Life Insurance (VGLI) since 2005 — dramatically increasing the amount from $400,000 to $500,000.
- Earlier this year, Senator Tuberville and U.S. Senator Marsha Blackburn (R-TN) reintroduced the Veterans Health Care Freedom Act to give veterans more flexibility when making medical decisions and greater access to the free-market health care system.
- The bill would expand treatment options for veterans by taking the VA out of the community care referral process and creating a three-year pilot program that allows veterans to schedule necessary appointments at medical facilities in the VA’s network.
- Senator Tuberville advocated for veterans’ access to primary, specialty, and mental health care outside of their respective Veteran Integrated Service Networks (VSIN) and non-VA facilities to cut wait times for those who have served.
- Senator Tuberville introduced several other pieces of targeted, commonsense legislation that will make the VA work better for our veterans and their families, including:
- A bill to provide veterans suffering from Traumatic Brain Injury or PTSD access to Hyperbaric Oxygen Therapy.
- Bipartisan legislation to ensure the VA reissues benefits to defrauded veterans.
- For two years, to recognize veterans suffering from service-related trauma, Senator Tuberville has been an original cosponsor of a resolution to officially designate National Post-Traumatic Stress Awareness Month.
Modernizing the VA
While Congress has passed wide-sweeping comprehensive legislation in the VA health care space in recent years veterans on the margins — such as rural, overseas or community care veterans — still face challenges in accessing care.
To fix this problem, Senator Tuberville joined his colleagues in introducing the Guaranteeing Healthcare Access to all Personnel who Served (GHAPS) Act to identify persistent gaps and craft innovative solutions to meet the unique needs of every veteran and to make certain all veterans receive quality and timely care.
The GHAPS Act would:
- Codify access standards for the Veterans Community Care Program.
- Create access standards for community care delivery to ensure veterans receive timely care in their own community.
- Direct the VA to create a strategic plan to ensure the Department is addressing continuity of care issues for veterans.
- Direct the VA to create a tele-health strategic plan to ensure the Department is deploying virtual care effectively, especially for rural veterans.
- Ensure all veterans with treatment-resistant depression have access to the necessary evidence-based care to put them on the path to recovery.
- Cut red tape for VA research so that veterans benefit from more timely research-informed care.
Protecting Veterans from Predatory Lawyers
Senator Tuberville has cosponsored legislation to cap fees that trial lawyers can charge in cases representing Marines and other individuals impacted by water contamination at Marine Corps Base Camp Lejeune in North Carolina.
Senator Tuberville joined this effort after receiving reports of attorney fees up to 60 percent, leaving little compensation for victims.
Senator Tommy Tuberville represents Alabama in the United States Senate and is a member of the Senate Armed Services, Agriculture, Veterans’ Affairs, and HELP Committees.
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