A Legal Guide to HIV and Substance Abuse

What is the connection between substance abuse and HIV?

As of June 30, 2001, 15 % of all reported cases of HIV infection in the United States were transmitted by injectable drug use. Here in Louisiana, injectable drug use accounted for 18 % of all cases reported through June 30, 2002. There have been 1107 reported cases of injectable drug transmissions in Louisiana through the same date. In addition, a large part of the growing infection rate of HIV among women can be attributed to trading sex for drugs. Drug and alcohol intoxication contributes to the growing rate of HIV infection by clouding judgment and reducing inhibitions in the users, often leading to participation in high-risk sexual activities.

In addition, recent studies have shown that people who are HIV-positive and continue to use drugs or drink alcohol regularly may have drug interactions between their HIV meds and any illegal substances or alcohol. Drugs and/or alcohol can make HIV meds less effective, and conversely, HIV meds can increase the level of drugs or alcohol in one's blood so much that it can cause an overdose. It is important to inform a doctor of the drugs you are taking in order to reduce the risk of having drug interactions.

I know I can go to jail for using drugs, but does it matter if I have HIV, too?

La. R.S. 14:43.5 states that "no person shall intentionally expose another to any acquired immunodeficiency syndrome (AIDS) virus through sexual contact without the knowing and lawful consent of the victim." The law goes on to state that "no person shall intentionally expose another to any acquired immunodeficiency syndrome (AIDS) virus through any means or contact without the knowing and lawful consent of the victim."

For the purposes of this law (see AIDSLaw's pamphlet "HIV and Criminal Liability" for more information about this), "any means or contact" is defined as "spitting, biting, stabbing with an AIDS contaminated object, or throwing of blood or other bodily substances." Intentional exposure is a felony offense which carries a fine of up to five thousand dollars, imprisonment with or without hard labor for up to ten years, or both.

Sharing contaminated needles falls into the category of "any means or contact." If you share your needles with someone, he or she must have prior knowledge of your HIV infection and consent to share needles with you. (CITE?) The only real way to prove this would be a written affidavit from that person. Moreover, anyone whose judgment has been impaired by drugs or alcohol could be considered unable to give legal consent.

Okay, I won't share needles. But how do I get clean ones?

Louisiana classifies needles and hypodermic syringes as drug paraphernalia and makes it illegal to possess or use them unless you have a prescription for a licit, injectable drug (La. Rev. Stat. Ann. § 40:1033). On the other hand, regulations of the state pharmacy board permit pharmacists to dispense hypodermic syringes if they see a "medical need" to do so. (La. Admin. Code tit. 46, § LIII(5)). Note, however, that pharmacists have to keep a record of the buyer's name and address, and the quantity of needles purchased.

Can I get clean needles through a needle exchange program?

No. Although such programs have been started in many places around the country, needle exchanges are illegal in Louisiana and come with severe penalties (CITE). Social workers and other health care professionals can lose their licenses upon a second conviction, while a third offense is a felony, punishable by up to five years in prison and a $5000 fine.

I've never shot up, but I find a joint helps with nausea after I take my meds. Can I get in trouble for this?

Marijuana is illegal, but doctors in Louisiana can prescribe marijuana for therapeutic use for patients suffering from glaucoma and symptoms from chemotherapy cancer treatment according to the Food and Drug Administration and Drug Enforcement Agency's regulations (La. Rev. Stat. Ann. § 40:1021).

What else should I be worried about?

Louisiana has one of the nation's highest rates of incarceration and the typical Louisiana inmate is a substance abuser who has been convicted of a drug crime. There are, of course, both state and federal penalties for drug possession, use, and sales. (Uniform Controlled Dangerous Substances Law; La. R.S. 40:961 et seq.) In addition, any property, or interest or security in any property or enterprise used or intended to be used in any manner to facilitate the manufacture or sale of illegal drugs is subject to forfeiture under both federal "zero tolerance" statutes, and the Louisiana Seizure and Controlled Dangerous Substances Property Forfeiture Act of 1989 (La. R. S. 40:2604 et seq.) This can include money, cars, businesses and residences. Both the state and federal laws permit forfeiture of property if there is probable cause to believe a connection exists between the property seized and a violation of narcotics laws. Louisiana courts have allowed this probable cause to be established by circumstantial evidence or even evidence that is otherwise inadmissible in a criminal trial.

There are other consequences as well. People can lose public housing if they are caught with drugs. Recently, the Supreme Court held that an innocent tenant could be evicted if someone had drugs on the premises, even if the tenant knew nothing about the drugs. (CITE) Any claim or potential claim that an HIV-positive client has for Social Security disability benefits can be denied if drug or alcohol addiction is perceived to cause the inability to work, even if the claimant has other, more "legitimate" causes of disability.

In addition to these legal consequences, La. R. S. 14:03.1 defines second degree murder as "the killing of a human being: ... when the offender unlawfully distributes or dispenses a controlled dangerous substance listed in Schedules I or II of the Uniform Controlled Dangerous Substances Law (LA R.S. 40:961 et seq.) which is the direct cause of the death of the recipient who ingested or consumed the controlled dangerous substance." Basically, this law says that selling "bad dope" to someone can result in murder charges against the person who sold that person the drugs.

You've convinced me I need to go into treatment. Any special advice?