DISEASE CONTROL

Recent doubts have emerged about the utility and efficacy of
Pittsburgh's privately funded needle exchange program, Prevention
Point Pittsburgh ("Pointed Debate," April 3).

The program provides injection drug users with sterile injection
equipment, along with referrals to drug treatment programs, access to
health care and other social services, on-site counseling and testing
for HIV and hepatitis C in an effort to markedly reduce the spread of
the two diseases.

Syringe exchange programs are better understood as public health
policy. It is simply old-fashioned infectious disease control; to
assume that there is not enough evidence to support the benefits of
these programs is flatly wrong. Scientific, medical and legal bodies
studying the issue have concluded that improved access to sterile
syringes can be a practical and effective method to reduce the spread
of HIV and hepatitis C. Overwhelming evidence and support from the
scientific community have shown that needle exchange programs do not
promote substance use. In fact, programs when linked to other
services, as is the case with Prevention Point Pittsburgh, can even
assist patients in breaking the cycle of substance use and save lives.

I would be deeply troubled and worried about my patients if the
Allegheny County Health Department would take away the major
treatment resource and hope for recovery that is the Prevention Point
Pittsburgh program. Losing that service would no doubt lead to more
human suffering resulting from increased HIV and hepatitis C
infections, the related health-care costs and deaths.

ANTOINE DOUAIHY, M.D.

Medical Director, Addiction Medicine Services

Western Psychiatric Institute and Clinic

Oakland