A PRICKLY DILEMMA

When Evelyn Taylor raises a concern about drug abuse, she deserves to be heard.

Taylor, a former resident of the now-demolished Morningside Homes,
stubbornly defied crack pushers and the crime that came with them. Even
when they slashed her tires and threatened her life, she kept fighting.

She's still fighting today, most recently against a proposed needle
exchange program in Guilford County that would provide clean syringes to
addicts in an effort to slow the spread of AIDS.

A bill in the General Assembly would allow three pilot needle exchanges to
operate throughout the state with immunity from drug paraphernalia laws.
Guilford may choose to vie for it.

The state would fund programs in three undetermined counties and monitor
their effectiveness. If such money ever materializes, Taylor says, spend it
somewhere else. "We're not helping them to get off it, we're helping them
to stay on it," Taylor said of addicts at an April 18 county health board
meeting.

Taylor's passion and conviction are admirable. Yet a mountain of research
and a who's-who of health and law-enforcement professionals say otherwise.

A 1997 National Institutes of Health study concluded that needle-exchange
programs produced a 30 percent or more reduction of HIV. Similarly, a 1996
New York City study found that drug addicts who used sterile needles were
66 percent less likely to become infected with HIV.

Among organizations that endorse such programs are the American Bar
Association, American Medical Association, National Academy of Sciences,
World Health Organization -- and, closer to home, the Triad Health Project,
whose board has voted unanimously to endorse the bill. Sheriff BJ Barnes
says he supports the concept so long as it makes clear how his officers are
to distinguish who is and is not a needle-exchange client.

If people must use drugs, needle-exchange proponents argue, at least let
them avoid the double jeopardy of drug addiction and AIDS.

They have a point. Drug users aren't the only ones at risk. So are their
loved ones, who may not even be aware that a partner or spouse uses drugs.
One speaker at the April 18 health board meeting said she traces her HIV
infection to her late husband.

Still, the moral discomfort about needle exchanges is understandable.
Needle exchanges, say critics, are a tacit endorsement of illegal behavior.

"It's a reasonable question," says Dr. John Campbell of the Infectious
Disease Clinic at Moses Cone Hospital. "But there is no evidence to support
the hypothesis that syringe-exchange programs will encourage drug use."

In fact, if needle exchanges were such a threat, wouldn't High Point police
by now have arrested a man who has operated his own exchange program for
months and who has appeared on the front page of this newspaper?

Finally, needle exchanges should foster increased contact between addicts
and health professionals and create a greater likelihood for treatment. At
the very least, the pilot programs are worth trying.

"We are just being swamped by new HIV and Hepatitis C cases," says Cone's
Campbell. "Whatever the community chooses to do about (HIV), it ought to be
different from what we're doing now."

This bill acknowledges that reality.