EXCHANGING NEEDLES: BEYOND THE SPREAD OF AIDS

In his April 3 front-page article, "A Helpful, or Harmful, Hand? Pr.
George's Debates Exchange of Needles," Paul Schwartzman reports that
"proponents [of syringe exchange] rest their case solely on public health
concerns: Distributing clean syringes . . . is a proven way to curtail the
spread of AIDS."

Many proponents of syringe exchange actually make the case that while
syringe exchanges have been proven to prevent the spread of AIDS, they have
also been shown to do more.

In New Haven, we found that the exchange, which served 250 clients a month,
was a conduit for enrolling people in substance-abuse programs. At the
height of its effectiveness, the program was referring almost 30 people a
month and successfully entering more than half in treatment programs. Most
of the requests for treatment came from people who did not otherwise come
to the exchange.

In Baltimore, as well, slightly more than half of those referred to a drug
treatment program by their syringe exchange entered treatment.

What the syringe exchange programs in New Haven and Baltimore had in common
at the time the data were collected was adequate funding to commit
resources to making referrals and assisting entry. Those in Prince George's
County should be sure that their proposed syringe exchange program includes
funds that focus on assisting drug users in getting into effective
substance abuse treatment. Then the program will do more than curtail the
spread of AIDS; it will reduce drug use.

Robert Heimer, New Haven, Conn.