TO STOP AIDS 'BREEDING GROUND' NEEDLE EXCHANGE A MUST, MANY SAY

While Politicians Bicker, More Intravenous Drug-Related Infections Occur

Empty bags of heroin, orange syringe caps, needle plungers, spent
lighters, stainless steel cooking spoons, bloody clothes and used
condoms -- all surround a tattered bed in an abandoned Wilmington row house.

The second-floor bedroom, stinking of urine and feces, has long been
a hideaway for drug addicts and prostitutes. Earlier that day, a
worker clearing out the property had thrown out more than a
half-dozen dirty hypodermic needles. In a nearby alley, a rusting
needle lay in the wet dirt.

Basha Closic, a drug prevention specialist, winced as she tiptoed
through the house in the city's Hilltop neighborhood, calling the
mess a biological hazard and "breeding ground" for HIV/AIDS,
hepatitis C and other infectious diseases.

"There's a bed for sex, needle sharing going on, and probably
contaminated fluid all over the place," said Closic, program director
at Brandywine Counseling in Wilmington.

To Closic, the decadence at the West Fourth Street "shooting gallery"
is a textbook illustration of why Delaware needs a needle-exchange
program for intravenous drug users.

Delaware remains one of only two states that does not have a program
that allows drug users to swap used needles for sterile ones or to
buy syringes in pharmacies without a prescription. The other is New
Jersey, where Gov. Jon Corzine is trying to start a program.

HIV/AIDS infections from dirty needles is a major problem in
Delaware. Through 2004, 48 percent of the state's AIDS patients were
intravenous drug users or people who had sex with them -- fourth
highest in the nation -- according to the Kaiser Family Foundation,
which studies U.S. health issues. The national average is 31 percent.

In 2004, Delaware had the nation's sixth-highest AIDS infection rate
from all causes, the foundation reported.

Closic and other advocates of needle exchange argue that if more
addicts had access to clean needles, fewer people would contract HIV,
the virus that causes AIDS. They also point to studies showing that
infection rates drop and injection rates do not rise when addicts
have ready access to clean needles.

Said Closic: "A stack of sound scientific data proves this works."

Police chief criticized

For nearly a decade, proponents of such a program in Delaware, led by
state Sen. Margaret Rose Henry, have pleaded with lawmakers to
approve one. Last May, Henry achieved a victory of sorts when her
bill to start a pilot program in Wilmington, where heroin and cocaine
are sold openly in some areas, passed the Senate 16-4. The bill is
supported by Gov. Ruth Ann Minner, the state Division of Public
Health and Wilmington Mayor James M. Baker.

But in the year since Senate passage, the bill has languished in the
state House of Representatives, prevented from a hearing before the
entire body by powerful foes such as Majority Leader Wayne A. Smith,
R-Clair Manor.

Smith said needle exchange would condone and possibly increase
intravenous drug use. "It totally defeats the message we have in
trying to get young people not to use drugs anytime, anyhow,
anywhere," he said.

But Smith may be losing his grip on the bill. On Friday, Speaker of
the House Terry Spence, R-Stratford, guaranteed the bill will be
debated on the House floor later this month.

Even though the program could reduce the spread of AIDS, which costs
as much as $190,000 to treat one patient, Smith said he could not
"excuse some behavior that is illegal under our code because there
might be a health benefit."

Smith points to opposition by Wilmington police Chief Michael J.
Szczerba as a key reason for his objection. Szczerba's position,
however, differs from Baker and City Council, which passed a
resolution supporting Henry's bill.

"He's in the dark ages about it," Henry said of Szczerba.

Szczerba, who said he is simply trying to save lives and stem the use
of needles, bristled at the senator's characterization.

"If that puts me in the dark ages, I'll stay in the dark ages. This
proposal would condone or facilitate illegal and dangerous activity
but now you can add deadly to that," said the chief of Delaware's largest city.

Szczerba was referring to recent batches of heroin laced with the
powerful sedative fentanyl, which is suspected in at least seven
Delaware deaths.

Closic countered that the fentanyl cases demonstrate that users are
going to inject heroin, methamphetamine and cocaine -- no matter the
consequences -- and only strengthened the argument to provide clean needles.

"They are not stopping," Closic said. "They are addicts, and they are
going to shoot up and we need to offer them a safe way."

'A ridiculous argument'

Aaron DeMaris, a recovering heroin addict who has used dirty syringes
and is now in a methadone treatment program in Wilmington, agreed
with Closic and many experts about the merits of needle exchange. A
few years ago, DeMaris was in such a program in Rochester, N.Y.

Officials there gave users 12 clean needles, DeMaris said. "For each
one you turn in you get two back," he said. "If you don't return them
you don't get more needles. They are not laying on the streets for
kids to find. It reduces the transfer of the disease."

DeMaris, 33, was astounded by the suggestion that needle exchange
could lead more people to inject drugs.

"Nobody is going to say, 'Just because I can get a syringe, I'm going
to start shooting dope,' " DeMaris said. "It's asinine, just a
ridiculous argument."

Jon Willis, 56, a heroin addict who has used dirty needles, said he
has seen friends die from AIDS after contracting the disease from shooting up.

"It's very important to be able to trade in needles, especially with
the AIDS going around," he said. "Most people just throw them on the ground."

One addict and former prostitute, who spoke on the condition that she
be identified only as Sally, said she has used old needles "but by
the grace of God" has not contracted HIV.

"If you buy needles [on the black market], you don't know for sure
that they are clean," she said. An exchange program would assure
users "they won't get HIV or spread it around."

The three-year pilot program, which would be overseen by the Division
of Public Health, also would offer counseling and treatment programs.
"It can be a gateway to other services," said Paul Silverman, deputy
public health director.

Baker understands Szczerba's concerns, but added, "Every effort we
can make to save lives we should take."

Minner, in a written statement, also touted economic benefits of the
program, which would cost $315,000 the first year for a specially
equipped van, supplies and salaries for social workers and counselors.

"Drug users who contract HIV/AIDS ultimately end up needing expensive
medical care at taxpayer expense," the governor said. "It is
important that Delaware implement this program for the safety and
benefit of our residents."

'Got to do something'

President Bush, whose administration will not fund such programs, has
said they "signal nothing but abdication."

But advocates such as Bill Piper, director of national affairs for
the nonprofit Drug Policy Alliance, said numerous studies have shown
such programs are proven winners, noting that the American Medical
Association and federal Centers for Disease Control and Prevention
support improved access to clean syringes.

One report, by the National Institutes of Health Consensus Panel on
HIV Prevention, said "an impressive body of evidence suggests
powerful effects" from exchange programs. Those benefits include a
reduction in risky behavior as high as 80 percent, and estimates of
at least 30 percent reduction in HIV cases in intravenous drug users,
the report said.

Those who think otherwise are misinformed, Piper said. "They are like
people who think the Earth is flat despite all the science," Piper
said. "A lot of things in drug policy are debatable, but needle
exchange is not one of them. It reduces the spread of AIDS without
increasing drug use."

A May report by the alliance said 185 programs are operating in 36
states as well as Washington, D.C., Puerto Rico and American Indian lands.

Henry, who represents some of Wilmington's hardest-hit areas, said
the program would be a savior for the city, especially the black community.

In Delaware, where 19 percent of residents are black, 66 percent of
AIDS patients through 2004 were black, sixth highest in America.
Nationwide, blacks comprise 12 percent of the population but 40
percent of AIDS patients. The AIDS figures are from the Kaiser Family
Foundation.

"I am desperate for this to pass the House," said Henry, D-Wilmington
East. "People are going to use dirty needles. And so much of the AIDS
women have is from sexual relations [with needle users]. It will save
unborn babies from getting AIDS. And it's not just an issue in
Wilmington, but in Greenville and everywhere. AIDS doesn't discriminate."

Needle exchange has won the support of traditional legislative
hardliners like Sen. Robert Venables, D-Laurel, and Rep. Dennis
Williams, D-Wilmington North, a former city police detective.

"If it's going to reduce the spread of AIDS, we've got to do
something," Williams said. "I'm sure guys are lying and saying they
are not having sex with anybody else. I have no recourse but to support it."

Venables, who called Smith "hardheaded," said common sense told him
to vote for needle exchange. "I don't know what else you can do,"
Venables said. "It's certainly not working the way we're doing it."