NEEDLE PLAN STUCK

When life gets too hard, Susette Carroll has to clutch her side to
keep the pain at bay.

Carroll is one of thousands of San Joaquin County residents suffering
from Hepatitis C, a debilitating disease that attacks the liver. The
47-year-old Stockton resident is addicted to heroin and alcohol and
has been living with the infection for nearly seven years.

"I'm so sick all the time. I hurt so bad," she said, tears coming
with every word. "I don't want to die."

Where there's Hepatitis C, there's generally a dirty needle, said Ron
Stockmann, HIV/Hepatitis C coordinator for the San Joaquin County
Office of Substance Abuse. Over the past two years, California has
enacted laws making it legal for cities and counties to create
needle-exchange programs and enabling pharmacies to sell needles
without a prescription. Last week, the Sacramento City Council
approved the formation of an exchange program.

In San Joaquin County, however, no action has been taken. For IV drug
users such as Carroll, that means they get sick and stay sick, their
numbers growing, while agencies work out the details of a program
that may or may not be approved by the Board of Supervisors.

In 2005, the year of the most-recent county data available, 965
people contracted Hepatitis C, while an additional 52 became infected
with HIV. Up to 85 percent of the former were infected through dirty
needles, Stockmann estimated, while as many as 50 percent of the
latter were transmitted that way.

County health officials said they have been preparing for more than a
year to present the state laws to supervisors while working to build
a consensus among community leaders and law enforcement.

"We haven't taken it to the board yet, because we're trying to do our
homework first," San Joaquin County Public Health director Bill
Mitchell said. "There are some concerns by law enforcement folks."

San Joaquin County undersheriff John Drummond said he supports needle
exchange but acknowledges its polarizing effect on law enforcement.

"The way law enforcement sees it, they either hate it (and) oppose it
vehemently or they support it," he said. "People think automatically
if we provide needles it's going to increase illicit IV drug use."

Drummond, who has served on a committee with Mitchell to discuss the
state legislation, said he wonders how well health officials'
presentation will be received by the Board of Supervisors.

Chairman Victor Mow said the board likely will require a discussion
of the moral and ethical implications of legalizing drug users'
access to needles.

"Does this promote or condone the use of drugs or is it something
that's happening and is a concern of public health?" Mow said. "These
things need to be answered before a decision is made."

Needle exchanges are part of a larger effort to reduce health issues
among drug users. Advocates for such programs run up against the
conventional notion that providing clean sharps condones drug use,
said Hilary McQuie, director of the Harm Reduction Coalition's West
Coast office in Oakland.

"It takes care of people who are on drugs," she said of the program.
"It reduces needle-stick injuries and keeps syringes off the streets.
It's a place where people can come and not feel judged for who they
are and get the help they need."

Carroll said that practically every drug user she knows has Hepatitis
C. Treatment for the bloodborne virus can take from six months to a
year, and most county physicians require a patient to be completely
substance free.

No drugs, alcohol or even cigarettes is a tall order for addicts such
as Carroll. So she exists in a downward spiral, drinking to wrestle a
moment of relief from the pain, doing damage to a liver thats already
has been racked by Hepatitis A, B and C.

"I see a lot of people using each other's needles," Carroll said.
"How come we don't have a needle exchange here?"

[Sidebar]

About The Bills

SB-1159 (2003-04 Assembly): Approved by Gov. Schwarzenegger in
January 2005, this bill allows California pharmacists to sell up to
10 syringes to adults without a prescription. Designed to prevent the
spread of HIV and Hepatitis C, this bill lets county and city
governments vote on whether they will allow local pharmacies to participate.

AB-547 (2005-06 Assembly): Approved by the governor in October 2005,
this bill lets cities and counties establish needle-exchange programs
without having to declare a health emergency every two weeks. Prior
law required continued declarations as a justification for the programs.

To find more detailed information on the bills, visit
www.leginfo.ca.gov/bilinfo.html. Type the year of the bill and
keyword "syringe."