Subject: Cities Grapple With Question of Giving Clean Needles to Addicts to Fight AIDS Date: Published: 8/9/91 (131 lines) Source: Wall Street Journal. Copyright Dow Jones & Co. Inc. Cities Grapple With Question of Giving Clean Needles to Addicts to Fight AIDS ---- By Michael J. Ybarra Staff Reporter of The Wall Street Journal BALTIMORE -- On a scorching day, three children blast each other with cool arcs of water shot from used syringes found in the street. Don Scordo grabs the needles, scratches out their points on the sidewalk and gives the youths a quick lecture on AIDS. "That's a deadly weapon," says Mr. Scordo, a volunteer at the Street Voice drug outreach program, as he stoops to break the tip on another hypodermic. In East Baltimore, where needles litter some trash-choked alleyways the way leaves collect in the better parts of town, the discarded syringes are a reminder of the city's 30,000 to 50,000 IV drug users -- and a symbol of a stalemated public-policy debate over the propriety of giving out clean needles to stem the spread of the HIV virus. Many public health experts say such programs are one of the few promising options in the bleak battle against AIDS. The past few years have seen several tolerated, but not officially sanctioned, needle-exchange programs spring up around the nation; a few communities have set up formal programs. A study released last week by researchers at Yale University estimates that the eight-month-old needle-exchange program in New Haven, Conn., has reduced new HIV infections 33%. But for most of the large cities bedeviled by heavy IV drug use and surging AIDS infections, needle exchanges remain a controversial issue. Many localities have laws making it a criminal offense to distribute drug paraphernalia. Moreover, the Bush administration has been loudly opposed to needle-exchange programs, arguing that distributing free needles would be like throwing gasoline onto the fire of the drug epidemic. Such programs are "morally scandalous" and "a recipe for public policy disaster," former federal drug czar William Bennett argued. His successor, former Florida Gov. Bob Martinez, also views decriminalization of needle laws as an unproven and dangerous approach. Still, the National Conference of Mayors in June unanimously endorsed legalization of needle-exchange programs. And this week the National Commission on AIDS slammed government policies for failing to address the link between drugs and HIV and calling for the repeal of needle laws. Don C. Des Jarlais, a member of the 15-member panel created by the White House and Congress, called the laws "obsolete and dangerous to the public health." IV-drug users, their sex partners and children account for almost a third of reported AIDS cases in the country, and are the fastest growing category. Federal health officials say close to 40,000 people nationwide have contracted the virus through shared needles. Citing the "insidious and indisputable link between substance use and HIV infection," the commission's report charged the Office of National Drug Control Policy with neglecting "the real public health and treatment measures which could and must be taken to halt the spread." Mr. Martinez, in turn, said that the commission's report and other recent studies on the issue "fail to provide clear scientific evidence that such programs reduce risk-taking behavior." Ben Banta, a spokesman for Mr. Martinez's office, added that the commission was out of step with public opinion. "It's hard enough to convince the tax-paying public to fund the war on drugs," he said. "It's probably going to be even harder to convince the taxpayers to pay for a safer environment in which to abuse drugs." One thing everyone agrees on, though, is the daunting nature of the problem. An addict who needs a fix badly enough will scrounge around for anything sharp enough to spear a vein in one of the dark, boarded-up row houses here where people climb in back windows and fight the miasma of urine and feces to shoot heroin. People in these "shooting galleries" can dull, bend or clog the standard diabetic U 100 syringe in anywhere from a day to a week. Thus a constant supply of hypos is needed; a 10-pack costs about $3 at a pharmacy but will fetch $45 or more on the street. AIDS activists have started a national civil disobedience campaign to flout the laws against passing out syringes. They've won several victories, most recently in June when a judge in New York City ruled that the greater good of preventing AIDS justified breaking the law. But activists in many communities who have been seeking to create high-profile test cases have been thwarted when local police refuse to arrest them. That's what happened here in Baltimore. More than a year ago, Mayor Kurt Schmoke, backed by his public health commissioner, suggested that the city consider exchanging used needles for clean ones. But the city had no money to even pay for a study. The result is that the idea remains stalled amid public controversy. "The people of Baltimore are not ready for needle exchange," says John Lewis, an assistant health commissioner. "Rather then continue to batter our heads against the wall, we've tried to improve other {drug} services." Among other things, the city sends out a van to provide health services and drug information to addicts and prostitutes in the streets. So far, the largest needle-exchange effort in the country is thought to be San Francisco's Prevention Point program, which has been in operation for three years and now distributes more than 8,000 syringes a week. "For 10 cents a day you can save someone's life," says Joey Tranchina, who clandestinely passed out clean needles for two years in Bay Area suburbs. In April, a Redwood City jury deadlocked 11-1 for acquittal in a syringe-distribution case involving Mr. Tranchina. Surprisingly, it has mostly been cities with much smaller AIDS populations that have taken the lead in battling the IV spread of the deadly disease. Tacoma, Wash., launched the first officially approved program about the three years ago and has been followed by a handful of other cities, the biggest being Seattle. John Daniels, the mayor of New Haven, said at a recent news conference that he is under no illusion that needle-exchange programs are a cure-all for the problem. "This program is not a solution to AIDS or to drug addiction; it is one more Band-Aid," he said. "But it is a Band-Aid we cannot afford to do without." [This article is made available here by Dow Jones Co. for the personal and non-commercial use of callers to this bbs, in the hope that it will be of some help to those who are suffering from the disease and others who are seeking to help them.]