STUDY EXAMINES LAWS ON DRUG NEEDLES

Prescriptions For Addicts Supported By Doctors

PROVIDENCE, R.I. - Doctors in 48 states can legally prescribe sterile
syringes to drug addicts to prevent transmission of HIV and other
infections, according to a study co-written by a Brown University
researcher and published last week in the Annals of Internal Medicine.

In Rhode Island, a group of Brown doctors has prescribed more than 30,000
syringes to about 250 injection-drug users in a little-known program that
started in spring last year. Far from encouraging drug use, the clinic
opened a doorway to addiction treatment for some participants, study
co-author Dr. Josiah D. Rich, of Brown and Miriam Hospital, said.

The Annals study, described as the first thorough analysis of the legality
of prescribing and dispensing syringes, points to a new avenue for getting
sterile syringes to people who cannot or will not stop injecting drugs.

Although there are many needle-exchange programs around the country, they
reach a tiny minority of drug users, and only six states - including Rhode
Island, effective Sept. 1 - have passed laws legalizing syringe purchases
at drugstores.

Prescribing needles to injection-drug users "should be mainstream
medicine," said Dr. Peter Lurie, of the Public Citizen Health Research
Group and one of the study's authors.

"We think physicians are ethically obligated, in areas where it's legal, to
prescribe syringes to those patients who are using injected drugs," Lurie
said, noting that the American Medical Association supports the practice.

Lurie said that many studies have shown that providing needles to addicts
does not increase drug use, but does lower the rate of HIV infection.

Half of all new HIV infections are occurring among drug users, who transmit
the deadly virus to each other by sharing needles, the researchers said.

The study's authors, a team of legal and medical experts, examined laws and
regulations in 50 states, the District of Columbia and Puerto Rico, in a
project financed by the Substance Abuse Policy Research Program of the
Robert Wood Johnson Foundation.

State laws allow physicians to prescribe and pharmacists to sell devices
for legitimate medical purposes, such as preventing the transmission of
disease, said Scott Burris, of Temple University's Beasley School of Law,
the lead author of the study. But other laws - the drug paraphernalia or
"head shop" laws - prohibit the sale of

devices intended for administration of illegal drugs. Some of those
statutes specifically outlaw syringes.

Delaware and Kansas are the only two states where it is "clearly illegal"
for physicians to prescribe sterile needles to drug addicts.

In Ohio and Oklahoma, physicians have a "reasonable claim to legality" for
prescribing needles, meaning that some lawyers would say it was legal, but
some might disagree.

For pharmacists, in 25 states and Puerto Rico, it is clearly legal to fill
prescriptions for syringes, and in 21 states and Washington, D.C., there is
a reasonable claim to legality. In Delaware, Kansas, Hawaii and Georgia, it
is clearly illegal for pharmacists to sell prescribed syringes.

Doctors and pharmacists unsure of how to act could seek the advice of their
regulatory boards and local law enforcement officials, Burris said.

In most states, they could also go to court to seek a declaratory judgment
giving them the right to prescribe and dispense syringes, he said.