MAKE HARM REDUCTION THE GOAL

Though appreciative of the June 28 Mountain Xpress commentary, "Consider
This: Low-cost Solutions to the AIDS Crisis" by Brian Elderbroom of the
Common Sense Foundation, complete credit [should not] be given to the
efforts of the Needle Exchange Program of Asheville for lower HIV-infection
rates or case numbers in Western North Carolina.

As coordinator of NEPA since its 1994 inception, I know that we have
reached only a small [portion] of the actual number of [intravenous]
drug users in the region. We exchange several hundred needles per
month on average [through] our continual but illegal operation -
illegal due to the inability of the North Carolina General Assembly to
enact any of the bills introduced over the years that would have made
needle exchange legal.

Brian is correct that "North Carolina law prohibits needle exchange
programs, despite the overwhelming research demonstrating their
effectiveness." The most current legislative effort, HB 411,
stipulates four criteria to be met before any North Carolina county
may operate a needle exchange program. Even before the bill has
passed, Buncombe County demonstrated that it could meet three of them,
and Guilford County demonstrated that it could meet all four. Still,
our General Assembly men and women are not swayed to vote in favor of
this scientifically proven HIV/hepatitis-prevention education strategy.

We [could] amend our paraphernalia laws in reference to injection
equipment, potentially saving millions of health-care dollars [for]
treatment and care of newly infected people each year. The savings in
paying for prevention efforts up front far exceed the cost of care as
a result of new infections (estimated by the N.C. Department of Health
to be $300,000-plus per HIV infection). Moreover, NEPA has never
advocated for state funding. Private funding sources exist; North
Carolina just has to make the operation of needle-exchange programs
legal.

So, I am grateful to Brian for his piece in this paper, but I am also
grateful to the many local businesses that provide distribution access
to free condoms and other accoutrements of HIV/STD/hepatitis
prevention and education.

Finally, though a bit ironic, gratitude must be given to the
ever-present and overly employed crack pipes in Asheville. You see, as
crack [became] the more accessible drug-of-choice in WNC, fewer people
have been injecting drugs. Crack use may lead to behaviors (including
unprotected sex) that pose risks for HIV/STD/hepatitis, but crack
moves us away from needle use.

I am still in favor of providing clean needles to folks who cannot
access them. I will always be that advocate. [But] there are other
HIV/STD/hepatitis-prevention efforts and variables helping to keep our
numbers low.

Think of harm reduction as the goal. Accept people where they are on
that spectrum. Support healthy interventions like comprehensive
needle-exchange programs, and let's continue to move forward with
other important issues facing our communities.

Michael Harney

NEPA Coordinator

Asheville