NEEDLE-EXCHANGE PLAN HITS WALL IN SAN DIEGO

Conservatives Fight Programs They Say Perpetuate Crime

San Diego -- To the things that set this region apart from most urban
areas, add this: San Diego County has no official needle-exchange program
for drug addicts.

The American Medical Association, the National Institutes of Health and the
Centers for Disease Control and Prevention say such efforts can reduce the
spread of disease without increasing drug usage, but San Diego's
conservative political leadership has been steadfast in its opposition.

A bill signed by Gov. Gray Davis in 1999 authorizes such programs, provided
there is governmental oversight and they are part of a drug treatment effort.

Despite a dramatic rise in hepatitis C and fears among health professionals
that the disease -- commonly passed along by dirty needles -- could spread
beyond drug users, the needle-exchange issue is no longer under discussion
at the all-Republican county Board of Supervisors, which sets county health
policy.

The San Diego City Council in October took a tentative step toward
authorizing a needle-exchange program. Council members, who set health
policy in California's second-largest city, voted 5 to 2 to proclaim a
state of health emergency because of the rising rate of hepatitis C and HIV
infection.

But the first action taken last month by newly elected Mayor Dick Murphy
and four new council members was to rescind that declaration, which under
state law can be a precursor to a needle-exchange program.

"I'm not going to aid and abet criminal activities," Councilman Jim
Madaffer, elected in November, said earlier this month. "I'm not going to
give a gun to everybody so they can put in the bullets and kill people."

The feeling among many San Diego politicians is that much of the nation --
including Los Angeles, San Francisco and a long list of cities from New
York to Honolulu -- is following a dangerously misguided notion about drug use.

Needle-exchange programs "are simply wrong because they send a mixed
message to our youth about the dangers of drugs," said Board of Supervisors
Chairman Bill Horn. "Neither the county nor I will ever aid and abet drug
usage in this or any other way."

Activists at the San Diego-based Alliance Healthcare Foundation, a
nonprofit group involved in numerous public health issues, find the
opposition of Horn and others dismaying. The group has been pressing for a
needle-exchange program since 1993.

"We reside in a politically conservative community which does not view
science as a way to make decisions to guide public health or safety
decisions, " said Ruth Lyn Riedel, the foundation's chief executive
director and a former public health faculty member at the University of
Washington. "They are more concerned about what they see as moral and
ethical concerns."

Riedel's group has offered to pay for the program so that public money need
not be spent.

Dr. Robert Ross, until recently the director of the county's Department of
Health and Human Services, told reporters near the end of his tenure that
needle exchange was the most controversial issue he faced with the supervisors.

When he worked for the public health department in Philadelphia, he
supported programs providing clean needles and syringes for addicts.

When he worked in San Diego, he did not.

Despite the 4-to-4 vote last month by the council, the issue of
needle-exchange programs in the city is not dead. The council established a
task force whose members plan to visit needle-exchange programs in Los
Angeles and Baltimore.

And, at the risk of arrest, health activists not linked to the Alliance
Healthcare Foundation have run a clandestine needle-exchange program for
several years. But without public support, the effort is limited.