MANY TOOLS NEEDED TO REDUCE DRUG ABUSE

I have nothing good to say about methamphetamines. Working in drug
abuse treatment from 1984 to 2002, I met hundreds of individuals and
families that had been nearly destroyed by the drug. Speed, crank,
crystal, meth -- no matter what you call it, it is a deadly toxin,
harmful to minds and bodies, to families and communities.

Right now, meth is drawing public attention to the problems caused by
drugs. This attention is valuable and it serves to underscore the
ongoing problems caused by alcohol, tobacco, marijuana, heroin, and
prescription drugs.

Drug abuse has been cited as an example of the economic model of
supply equals demand. Law enforcement works to curtail the supply of
drugs and treatment works to lower the demand. Prevention strategies
are equally valuable, lowering the demand for drugs. And harm
reduction strategies decrease the damage caused by drug use.

A carpenter needs more than one tool in his tool box. A surgeon
requires more than one instrument in her operating room. Our
community needs more than one approach to reduce substance abuse.

Everyone knows "An ounce of prevention equals a pound of cure," but
the benefits of prevention are often long-term and not immediate.

The Department of Health and Human Services has school-based programs
like Project Alert and Project Success. Staff in these programs
target junior high and high school age students, augmenting efforts
that are already going on in our local schools. Prevention activities
are evaluated to be as effective and age-appropriate as possible.

Abstinence-based treatment programs are an essential piece of
addressing our community drug problem. But many addicts are either
unwilling or unable to participate in treatment programs. Even
addicts in recovery may relapse due to the chronic nature of the
disease of addiction.

Law enforcement plays a vital role in holding addicts accountable for
the consequences of their behavior. Law enforcement serves to protect
society and create a deterrent to drug use. But there are not enough
police or jails to arrest, convict and incarcerate every addict.

Studies by the World Health Organization and the Centers for Disease
Control found strong evidence that outreach programs and syringe
exchange programs lower the transmission of HIV/AIDS. These programs
reach the drug users who are most at risk to contract and spread
diseases. They are also the users who are least likely to access more
traditional ways of receiving information and health care.

A health care worker described a client who tentatively came to a
local clinic seeking to exchange used needles. After a few meetings,
the client sought wound care for abscesses. Following that, the
client sought medication and support services for detoxification.
This is a client that had previously avoided medical care and
addiction treatment.

Harm reduction programs are growing in acceptance. Forty-eight states
allow sterile syringe exchange and 46 states allow pharmacy sale of syringes.

Harm reduction is exerting a positive influence here in our
community. In Humboldt County there is a steady decline in the
numbers of persons diagnosed with AIDS, HIV disease and hepatitis B
and C each year since 2000, although the sample size is thankfully
too small to determine statistically valid trends.

For example, Humboldt County's rate of hepatitis B has declined from
32.2 (per 100,000 population) cases in 2001 to 5.3 in 2006. Hepatitis
B can cause persistent infection, death and an on-going risk of
spreading the infection to non-using sexual partners and to unborn
babies. Hepatitis C has declined from eight cases in 2001 to one case
in 2006. HIV has dropped from 52 in 2003 to four in 2006.

While needle exchange is not a service the county provides, DHHS
supports these harm reduction options and is encouraged by the drop
in communicable diseases.

DHHS operates street outreach services to provide medical testing for
HIV/AIDS and hepatitis C. These programs also provide information on
medical care and drug treatment resources.

These programs do not make it any easier to get drugs but they do
make it easier to avoid sharing contaminated needles. Needle exchange
programs do not recruit new drug users. Nor do these programs promote
increased drug use as many participants actually decrease the number
of times they inject per day.

At the County Alcohol and Drug Advisory Board meeting of Jan. 17,
County Coroner Frank Jaeger observed that harm reduction strategies
have contributed to a decline in the number of heroin overdose
deaths. He attributed the recent increase in methamphetamine
overdoses to smoking methamphetamine, not injecting.

Needle exchange programs decrease human suffering and decrease the
spread of diseases. Yet some people remain steadfastly opposed to
these harm reduction approaches. The financial bottom line may be
compelling. Every infection averted saves California taxpayers $13,000.

I know there is still work to be done addressing the public health
problem of drug abuse and addiction. It does take mobilizing all of
our resources and utilizing a variety of approaches.