PUBLIC HEALTH OVERRIDING ISSUE FOR NEEDLE SALE SUPPORTERS

Hoping to slow the spread of HIV and Hepatitis C, state legislators
have approved legislation that would legalize the over-the-counter
purchase of hypodermic needles and syringes.

In November the House voted 115-37 in favor of the measure. Last
Thursday, the Senate voted 26-9 in favor of the measure, filed by
Sen. Robert O'Leary, D-Barnstable. The bill was sent to Gov. Romney,
who is expected to veto it. But it is anticipated the veto will be
overridden. Forty-seven other states have decriminalized the
non-prescription sale and possession of hypodermic needles and syringes.

The purpose of the bill is to counteract the spread of Hepatitis C
and AIDS through the sharing of contaminated needles.

"It's an enormous public health issue," O'Leary said. "Almost 40
percent of all AIDS infections in Massachusetts are the result of
dirty needles. I think two-thirds of all Hepatitis C infections,
which can be fatal, are the result of dirty needles."

Rep. Jeffrey Perry, R-Sandwich, was the only Cape legislator to
oppose the bill. Perry said that it would inhibit the state's ability
to get drug users into treatment programs.

"As a former police officer, I know that sometimes police come upon
people using drugs and the only things left is the hypo needle.
Currently the person can be arrested and charged with said
possession. The upside to the arrest is that this is the usual way IV
drug users get into some type of court-ordered treatment. If we take
the ability of police officers to arrest people who are in possession
of hypos [because they have already used the drugs], less people will
get into the system and be 'forced' into the help they need." Perry said.

Perry also argued that to say it is OK to purchase and possess
something that is used for illegal drug use sends the wrong message
to young people.

Should the bill become law, it would mean that clean needles, which
currently are available only to drug users at four needle exchange
programs in Massachusetts (with Provincetown being the only Cape
location), would be obtainable at any pharmacy in the Commonwealth.

Not A Needle Exchange Program

O'Leary made it a point to differentiate between the
decriminalization of the sale and possession of hypodermic needles
and syringes, and needle exchange programs, which require town approval.

"Frankly [needle exchange programs] don't work. They require a
community to step up and agree to exchange needles. That means that
everybody in the region who is using needles illegally drives to that
community and exchanges. Understandably communities have complained
about that," O'Leary said.

In March a West Yarmouth man arrested for drug possession was
discovered to have in his possession 900 new hypodermic needles and
600 used hypodermic needles. He reportedly had obtained 1,300 needles
from the Provincetown needle exchange program. The incident raised
questions about the control of hypodermic needles and the ability of
such a limited program to prevent the spread of infectious diseases.

O'Leary's views on the needle exchange program are not shared by
Deborah H. Fournier, associate director of public policy for the AIDS
Action Committee. She said that the two programs serve different populations.

"I think they're complementary approaches, but I don't think they're
substitutes for one another."

While needle exchange programs have helped slow the spread of
disease, the ability of intravenous drug users to purchase needles
and syringes at local pharmacies without prescriptions would greatly
expand the availability of clean needles. What it wouldn't do that
needle exchange programs do is provide a means for getting used
needles out of circulation. The Massachusetts Pharmacists
Association, which came out in favor of pharmacists dispensing
hypodermic needles without a prescription, is opposed to pharmacies
being mandated to accept used needles.

The bill requires that the state Department of Public Health to
explore various needle disposal and report their finding to the state
Legislature within a year. Barnstable County already has such a plan
in place, with disposal locations across the Cape. "[Needle disposal]
is a problem whether you have a needle program or not, because the
vast number of needles that are used are used by diabetics," O'Leary
pointed out.

O'Leary said that the availability of needles for IV drug users will
not increase the amount of used needles that are improperly disposed
of. He said that based on the experience in other states, "If you
decriminalize needles, people will use clean needles and dispose of
the ones that are dirty. And you will not spread nearly as much disease."

Fournier said that by decriminalizing the possession of needles the
likelihood of their being disposed of improperly or of someone being
accidentally stuck with one is decreased.

"One of the reasons that people dispose improperly is because they're
trying to get rid of something that would incriminate them," Fournier
said. "They no longer have to do that. When they get patted down by a
police officer they can say 'before you pat me down, let me take this
out of my pocket.'"

Arguments that the legalization of needle sales and possession would
increase drug use are dismissed by Fournier and O'Leary.

O'Leary said that legislators who raised that argument when opposing
the bill were unable to provide any studies to back up their statements.

"We kept asking them over and over again to show us the statistics,
show us the study that shows there's a correlation, and there was a
deafening silence."

Fournier said that where needles have been available over-the-counter
there has been no evidence to suggest that drug use had increased.

"Addiction is more complicated than that," Fournier said. "Whether or
not someone chooses to use drugs is not triggered by whether or not
needles are available."