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 (/yr/mo/day/early/04229822curt.html)). 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

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 edication.
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