NEEDLE EXCHANGE PROGRAMS SPARK HEATED BATTLES

Holyoke Eyes Plan, But Deregulation Plan In Springfield Could Alter Debate

HOLYOKE - Tommy Baker, 47, shot heroin for more than half of his life. He
is one of the many people in Massachusetts living with AIDS and who got
infected by sharing needles.

He and others in Holyoke are planning a proposal for a needle exchange
program, which is expected to be met with controversy, as similar programs
in Springfield and Worcester have been.

But a bill to deregulate the sale of hypodermic needles may undercut the
bitter debates in all three communities, where AIDS rates are driven by
injection drug use.

State Representative Dennis Murphy, a Springfield Democrat, plans to
introduce a bill that would eliminate the need for a prescription when
syringes are purchased.

Murphy also hopes the bill will halt needle exchange programs which, he
contends, ''force taxpayers to be unwitting subsidizers of drug use.'' The
bill will be introduced to the Legislature early next month.

Helen R. Caulton, director of Health and Human Services for Springfield,
said that even if the bill passes, needle exchange programs will still be
needed. If drug addicts buy their needles in drug stores they won't be
offered counseling, HIV testing, and access to treatment, she said.

Currently, there are four programs in the state that hand out sterile
syringes in exchange for used ones. Located in Boston, Northampton,
Cambridge, and Provincetown, they also provide condoms, drug counseling,
HIV/hepatitis C testing, and access to drug treatment. Such programs must
be locally approved and are paid for by the state.

Worcester, New Bedford, and most recently Springfield have failed to win
local consent for needle exchange programs. Worcester is about to try
again. Earlier this month the Springfield City Council reversed a 5-4 vote,
taken in July, that had approved a needle exchange program.

The reversal came in the wake of a nonbinding referendum that rejected the
needle exchange in the Nov. 3 elections. This marks the second time in
three years that the council has flip-flopped on the issue.

Tomorrow night, the Springfield City Council will take a final vote on the
proposed needle exchange program. Although City Council President William
J. Boyle said the vote against the exchange is expected to hold, it
probably won't end the controversy over needle exchange programs in this city.

As a case manager at the River Valley AIDS Project in Holyoke, Tommy Baker
is about to face the same controversy as his counterparts in Springfield
and Worcester. His agency is trying to establish a needle exchange in that
city.

Baker stopped shooting heroin two months earlier, something he'd done for
28 years. He shared needles with his wife, who died, as did his young son,
seven years ago. Baker now has AIDS.

Baker said he entered drug treatment at least 50 or 60 times, but it wasn't
until it was his own decision to enter treatment that he was able to quit.
He suggested that opponents of needle exchange programs confuse drug
treatment with AIDS prevention.

''I live with both these diseases and I treat each differently,'' he said.
Baker wonders whether a needle exchange could have changed his life. ''I
often think back if there was a needle exchange twenty years ago, would I
have used it?''

Supporters of needle exchange programs say their fundamental goal is to
reduce the spread of HIV and hepatitis C among drug users, their sexual
partners, and children born to infected mothers. Opponents say that giving
needles to addicts erodes drug laws, promotes drug use, and sends the wrong
message.

''To us it was really saying ... `We'll help you if you decide to shoot
heroin,''' said Karen Powell of Springfield, who started the group Citizens
Against Needle Exchange, which spearheaded the drive to put the needle
exchange referendum on the ballot.

Powell, 45, a lifelong resident of the city, said a needle exchange helps
''people use drugs when what you need to do is stop the behavior.'' She
said she would rather see state money spent on education or drug treatment.

Powell also pointed to falling AIDS rates in the city as another reason why
needle exchange programs aren't needed. ''The AIDS rate dropped ... without
a needle exchange'' she said.

The AIDS rates are falling, but they aren't an indicator of whether people
are getting infected with HIV today, public health officials say.

The rates do reflect advances in medicine, which are preventing HIV cases
from developing into AIDS. HIV statistics are not yet kept by the state.
The Department of Public Health plans to start tracking them in January.

Dr. Jeffrey Scavron, medical director of Brightwood Health Center in
Springfield, said that when the HIV numbers are released they ''will be
rather shocking in Springfield. ... It is a catastrophic epidemic in
certain neighborhoods.''

Springfield's HIV cases are concentrated in the minority community. Scavron
said at his small health center 30 to 35 patients die every year from AIDS.
''That's an astronomical number,'' he said.

Worcester has the same high rates of AIDS related to drug use as
Springfield. In fact, the two cities are tied for third place on a list of
Massachusetts cities with the highest AIDS rates due to injection drug use
since the beginning of the epidemic. New Bedford is in first place,
Fitchburg, second.

Worcester is considering a needle exchange program for the third time. Joe
McKee, a member of the Harm Reduction Coalition, which has put together the
most recent proposal, said that the coalition's idea is unique, in part
because it guarantees beds for addicts seeking drug treatment. The proposal
is before Worcester's Health Committee and will be subject to public
hearings before the end of the year.

McKee will be up against one of the most active needle exchange opponents
in the state, William T. Breault, chair of the Worcester-based Main South
Alliance for Public Safety. Breault has traveled throughout Massachusetts,
Vermont, and Connecticut fighting needle exchange programs.

Just a few days after the Springfield City Council approved a needle
exchange program last summer, Breault held a press conference there,
speaking out against the vote. Karen Powell saw him on television and
sought his advice on starting a ballot initiative campaign in Springfield.

Breault not only gave advice, but also helped pay for fliers placed in the
local newspaper. He says he adamantly opposes the latest proposal in
Worcester. A needle exchange program, he contends, ''delivers the
instrument of addiction at taxpayers' expense.'' And, unlike cancer and
heart disease, Breault believes ''AIDS is avoidable.''

Baker disagreed. ''There's a lot of unwitting [AIDS] victims,'' he said.
Pointing to a framed photograph that dominates his office, Baker said,
''That's my son right there. If he had been my priority, maybe he wouldn't
have been dead."

Checked-by: Richard Lake