NEEDLE EXCHANGE GIVES ADDICTS TIME TO CHANGE

The RV arrived at a corner near Washington's Marvin Gaye Park, known
locally as "Needle Park."

A steady procession of addicts came to the door, mounted a few steps
and sat down.

One by one, they dropped used needles into a container and received
new needles in return, along with alcohol wipes and the small, bottle
cap-like "cookers" in which heroin is heated.

Reggie Jackson, Teefari Mallory and Hazel Smith -- staff members at
PreventionWorks!, Washington's largest needle exchange program -- are
at the park twice a week, offering clean needles to prevent disease
transmission, condoms, drug treatment referrals, AIDS testing and a
few kind words: "You still play the guitar?" "Love you baby."

It is the eyes and arms of addicts that draw your attention.

Eyes that are glassy, unnaturally bright or tired beyond exhaustion.

Arms that are ulcerated sticks or purple parchment; with repeated
use, needles become blunt and tear the skin.

Some addicts adopt a defensive politeness -- "yes, sir" -- and
quickly leave. Others want to talk -- "I love plants and I love kids"
- -- trying to provide hints of their humanity. They are America's least wanted.

They are also at the centre of a controversy.

Needle exchange programs have always been controversial, with
opponents arguing they send a mixed moral message about drug use.

The U.S. House of Representatives recently passed an amendment
banning exchanges in the District of Columbia within 300 metres of
sites where children gather -- which, if approved by the Senate,
would effectively put programs like Prevention-Works! out of
business: Staffers joke they could only work in graveyards or the
middle of the Potomac.

This might make sense if needle exchange programs increased the
number of addicts.

But they don't.

Dr. Anthony Fauci, the director of the National Institute of Allergy
and Infectious Diseases at the National Institutes of Health, has
reviewed the studies on needle exchange.

"It does not," he says, "result in an increase in drug abuse, and it
does decrease the incidence of HIV . . . The idea kids are going to
walk out of school and start using drugs because clean needles are
available is ridiculous."

My experience in Washington was consistent with Fauci's view. Addicts
who came for needles were generally older. Clean needles no more
caused their addiction than the provision of clean shot glasses would
cause alcoholism.

The main purpose of needle exchange, according to Reggie, the
supervisor of the mobile unit, is to keep people alive until they can
get clean, something that can take years.

Needle-sharing is the third-leading cause of HIV infection in
Washington. It is also a major contributor to the spread of hepatitis
C, the main cause of liver transplants in the U.S.

Reggie is well acquainted with these facts because, while an addict,
he contracted both diseases.

"If they had a truck like this in the '60s, '70s and '80s," he told
me, "maybe I wouldn't have gotten infected."

The staff of PreventionWorks! builds long-term relationships with
people no one else knows by name. Because of this, they have a good
feel for when addicts are ready for treatment.

While I was in the RV, Reggie signed up two addicts for detox.
Teefari used her own car to drive one addict, with whom she had been
working for eight years, to treatment. "He's ready, ready to go," she
said, fighting tears.

Critics say needle programs create a moral hazard by legitimizing drug abuse.

But it does not legitimate drug abuse to help addicts avoid deadly
diseases until they are ready for help.

Instead, sacrificing their lives to send an "unmixed" moral message
sends a troubling moral message: The unwanted have no worth.

Street addicts are connected to the rest of us by only a few
invisible strands -- people such as Hazel, Reggie and Teefari.

Those strands should not be severed.

Michael Gerson is a research fellow at the Institute for Global
Engagement and columnist for the Washington Post. He is a former
speechwriter and advisor to U.S. President George W. Bush.