PROVIDING NEEDLES

Law Helps Addicts, But Many Don't Know About It

As the morning sun burns over the corner of 122nd Street and
Park Avenue, Angel Tompkins and her team unload their van and set up
shop for the day. Pamphlets on a card table offer information on
assorted topics: how to handle a heroin overdose, the hazards of
shooting up veins in your neck.

A lanky man carrying a rumpled, brown paper bag full of blood-spotted
syringes comes up to the van and hands over the bag with his needle
exchange card.

"Hey, baby," says Tompkins, a social worker for the group known as
From Our Streets With Dignity, or FROST'D. "How you feeling today?"

"All right," the man answers softly. He asks for two 10-packs of clean
needles and walks off.

For years, needle exchanges such as the one FROST'D runs in Harlem
have been the only place where drug addicts in the city could trade
dirty needles for clean ones, free of charge. In Queens, Staten Island
and Long Island, which have no needle-exchange sites, users either
trekked to other boroughs, cleaned their needles or resorted to
sharing dirty ones.

But a new state law allows drugstores to sell up to 10 needles at a
time without a prescription. The controversial health measure, known
as the Expanded Syringe Access Demonstration Program, or ESAP, was
enacted to prevent the spread of bloodborne diseases such as HIV/AIDS,
and Hepatitis B and C. According to the city department of health,
almost half of all AIDS cases in New York were transmitted by
intravenous drug use.

Since the law took effect in January, some 2,200 pharmacies and health
centers across the state have registered with the Health Department to
sell needles over the counter. In New York City, about 700 drugstores
such as CVS, Duane Reade and Rite-Aid have signed up as providers. The
average cost for a 10-pack of needles ranges from $1.60 to $4,
depending on the type of needle.

Yet, while advocates praised the law in concept, they have discovered
it has flaws. Inquiries made by needle exchange advocates at a handful
of participating drugstores found that some pharmacists were clueless
about the law. And many addicts remain unaware that they can purchase
the needles, because the law prohibits drugstores from
advertising.

In addition, although pharmacies situated in the city's 11 public
hospitals might seem an ideal place to obtain clean needles, the New
York City Health and Hospitals Corp. decided not to participate in the
program.

Dr. Van Dunn, senior vice president of medical and professional
affairs for HHC, said drug users who inquire about clean needles at
city hospital pharmacies are provided with a list of nearby drugstores
that sell them. The city's 11 public hospitals do accept dirty
syringes for safe disposal.

"We did not feel that giving out needles was part of our mission,
given that there are so many providers in the program," Dunn said.

"This does not mean we are shirking from our responsibilities," he
said. "But, rather than just providing syringes, we emphasize
providing education and comprehensive medical services."

Dennis DeLeon, executive director of the Latino Commission on AIDS
expressed anger with the HHC decision. He said it was consistent with
Mayor Rudolph Giuliani's opposition to city funding for clean needles.

"I know the mayor has a stance which has not been friendly to needle
exchange. That's putting politics before health," said DeLeon. "For
the mayor and HHC not to participate in this program is really
disappointing."

After three years, the law will be evaluated by a subcommittee of the
state AIDS Advisory Council, said Christine Smith, spokeswoman for the
state Health Department. The committee will examine patterns in needle
and syringe sharing, disease transmission, substance abuse and
criminal activity.

At that time, HHC will reassess its position on providing syringes,
Dunn said.

Aside from drugstores, the AIDS Center of Queens County, in
cooperation with the New York Hospital Medical Center of Queens, is
developing a related program that will supply clean needles and
syringes, free of charge, at their offices in Rego Park, Jamaica and
Far Rockaway.

Philip Glotzer, executive director of the AIDS Center of Queens
County, said more than half of the agency's 2,000 clients in the
borough were infected through drug use.

"This law is a wonderful new tool to prevent the transmission of AIDS,
and that's our mission," Glotzer said.

Cookie Ramos, a peer educator at the AIDS Center of Queens County,
spent 15 years shooting heroin and sharing needles until she became
infected with HIV and got off drugs.

"Maybe by having these people coming for needles, we can start telling
them about our services, so they know where to go when they want to
stop," she said. "If I had that, maybe things would be different for
me today."

Because HHC and smaller neighborhood pharmacies are reluctant to
promote the law, social workers are trying to educate local
pharmacies. Tompkins, of the FROST'D needle exchange program, visited
drugstores in Harlem and Coney Island and distributed fliers
explaining the law. Drugstores will not accept dirty needles, so
Tompkins and several other needle-exchange programs have told
pharmacists to send people with dirty needles to their sites.

"I found after we educated them, the pharmacists were really
receptive," Tompkins said. "But they need to get the word out. They
need to understand that every time they sell a clean needle, that's a
life they're saving."

Because of the outreach, said Drew Kramer, executive director of the
Lower East Side Needle Exchange in Manhattan, the law has had an
unanticipated result - creation of informal partnerships between
needle exchange programs and neighborhood drugstores.

The question remains: Will addicts take advantage of their new
privilege? Kramer believes drug users will, eventually.

"Most of those drugstores are open 24 hours a day, seven days a week,"
he said, while needle-exchange programs are "only open a few hours.
This gives addicts more opportunity to protect themselves."

Lucille, a former heroin addict who now works for FROST'D and asked
that her last name not be published, doubted that many addicts would
start buying needles at drugstores.

"I would never go. That's just too open for me," she
said.

A Harlem drug user who dropped by the needle-exchange van on his
bicycle said he would not use drugstores because he prefers the
support offered at the city's 11 needle exchange programs.

Aside from clean syringes, most needle-exchange sites offer
information on detoxification, health care and free meals. At the
corner on 122nd Street where FROST'D stops every Tuesday, many clients
even receive a hug from Angel Tompkins before they leave.

"No, thank you," said the man on the bicycle. "I'll keep coming right
here. What do I need to go to a drugstore for when I have my people
right here?"