TO END ABUSE, CLEAN NEEDLES ARE A FIRST STEP

To the Editor:

Dr. James L. Curtis misses the point in "Clean but Not Safe" (Op-Ed, April
22). While needle-exchange programs are not a cure-all, they allow addicts
to lower their risk of H.I.V. infection. As a study published last year in
The Lancet found, H.I.V. infection dropped by an average of 5.8 percent a
year among drug users in 29 cities with needle-exchange programs but rose
by 5.9 percent a year in 51 cities without programs.

Exchange programs give addicts in poor and minority communities direct
access to the public-health community. This is crucial for directing the
neediest addicts toward the drug-treatment programs Dr. Curtis advocates.

MIREILLE JACOBSON Cambridge, Mass., April 22, 1998

Giving In to Addiction

To the Editor:

Bravo to Dr. James L. Curtis for condemning needle exchanges for drug
addicts (Op-Ed, April 22). Not only do these programs not work, but they
ignore the innate dignity each addict possesses as a human being. In
effect, they say: "You can shoot up and be as high as you like. We really
don't care as long as you don't get or spread AIDS."

The same can be said for free-condom programs and so-called safe-sex
education in our schools. These say to teen-agers: "Have sex with whomever
you wish, whenever you wish. We don't care as long as you don't catch AIDS
or burden us with your babies."

BRIAN SCULLY , M.D. New York, April 23, 1998 The writer is an associate
professor of clinical medicine at Columbia University.

They'll Get a Fix

To the Editor:

In "Clean but Not Safe" (Op-Ed, April 22), James L. Curtis writes that
"needle exchanges merely help addicts continue to use drugs." It seems
fairly obvious that hard-core drug addicts who use needles are suffering
from an insidious and overwhelming disease and are going to get their fix
with or without these programs.

The value in needle exchanges is that they give addicts a safer, cleaner
way of using drugs until they come to their senses and seek treatment.

MARC D'ANDRE Los Angeles, April 22, 1998

Communities at Risk

To the Editor:

As a nurse-practitioner who has worked with H.I.V.-infected patients since
1983, I disagree with Dr. James L. Curtis's characterization of
needle-exchange programs as "reckless experiments" and "not unlike giving
an alcoholic a clean Scotch tumbler to prevent meningitis"(Op-Ed, April 22).

Advocates of needle exchanges do not generally deny the importance of
"comprehensive treatment," drug rehabilitation or antiretroviral medication.

Dr. Curtis identifies himself as a black psychiatrist; all the more reason
he should be an advocate of needle exchanges, given that poor black
communities are much more adversely affected by a significant increase in
H.I.V. infection than the alleged adverse effects of the exchanges.

STEPHEN L. RODGERS New York, April 23, 1998