JUNKIES' 'HOW-TO' HEROIN KITS LITTER ALLEY

The surprise was a note inside the bags saying that they came from a program
bankrolled by the state.

The Massachusetts Department of Public Health's needle-exchange
program, in its 10th year, was conceived as a grass-roots way to stem
the spread of AIDS and hepatitis C from sharing dirty needles.

But community leaders have balked at the program, opponents charging
that it encourages drug use. Only four cities have permitted it within
their borders.

The nearest to Lawrence is Cambridge. How these "how-to heroin kits,"
as police call them, ended up in an alley in Lawrence over the weekend
and why they included rubber armbands and "cookers" -- virtually
everything a drug user would need besides a cheap dose of heroin --
baffled Lawrence police, who called the completeness of the packages
"disturbing" and vowed to investigate who left them there. Police
Chief John J. Romero said detectives will look into whether someone
associated with the state's four pilot needle exchange programs in
Boston, Cambridge, Provincetown, or Northampton purposefully left the
kits in Lawrence, trying to increase access to clean needles among the
city's heroin users.

The four needle exchange centers are nonprofts funded by both the
state and private sources. "I understand the intention is to stem the
spread of AIDS," said Romero. "But I question how so many needles
could have found their way into an alleyway where someone -- a child
- -- could have picked them up. Somehow someone dropped the ball, and
our intention is to find out how they could have lost control of
this." Kevin Cranston, acting director of the HIV/AIDs Bureau of the
state's Department of Public Health, which allotted $900,000 of its
2004 budget to the four centers, said the note inside the bags is
"absolutely not official." "Anyone with a word processor could have
created this," he said. The blue pamphlet reads "You are now
registered in the Commonwealth of Massachusetts Needle Exchange
Program." It also has a description of the state Supreme Judicial
Court's Dec. 2002 decision making it legal for participants in the
needle-exchange program to possess needles in other communities
besides the four participating cities.

The note says needle-exchange "identification cards" can be mailed to
participants by calling the four needle-exchange centers, and all four
phone numbers are listed on the pamphlet.

And "if you have been arrested, a letter will be mailed or faxed to
you or your lawyer to have your syringe possession charge dismissed in
court," it reads.

The note is also translated into Spanish.

The investigation into the source of the paraphernalia comes amid
calls by needle-exchange program advocates to increase access to clean
needles in communities like Lawrence, where AIDS is spreading through
injection drug use. The state Legislature will hear testimony tomorrow
on a bill that would allow hypodermic needles, the possession of which
is now illegal without a prescription or registration in a
needle-exchange program, to be bought over the counter at any drug
store in the state.

Massachusetts is one of only four states where a prescription is
needed to buy a hypodermic needle -- the others are California, New
Jersey and Delaware.

Monique Tula, director of Harm Reduction Services in Cambridge, which
runs the needle exchange program there, said, "I can tell you those
baggies didn't come from the Cambridge program."

"We can't go outside Cambridge; people have to come to us," she said,
adding that they get visitors from Lawrence, Lowell, Framingham and
even New Bedford. But she added: "In terms of what was in the bags,
that sounds like traditional harm reduction materials that we
distribute to people who are actively using. "I have no idea how they
got there," she said about the stray cache. "It's a concern because
our services come with human contact.

By having someone present (when participants pick up the kits), it
increases chances of recovery." Some 11,280 people are currently
enrolled in the needle exchange program, and state oversight of the
four centers is limited to guidelines laid out in a contract between
the Department of Public Health and the exchange centers, Cranston
said.

One of those guidelines is that the centers require participants to
register and offer them access to substance abuse programs when they
visit the centers, Cranston said. "There's a very strong expectation
that every effort be made to enable access to treatment," he said.

The particular kits Lawrence police found, whatever their source, go
"too far" in supplying drug users with the necessary tools to use
heroin, Romero said, especially given the recent spike in use.

Hospitalization statewide due to opiates such as heroin, morphine and
OxyContin soared 230 percent in the 15-24 age group between 1996 and
2001, according to the Massachusetts Department of Public Health. In
Essex County, meanwhile, heroin has become cheaper than a six-pack of
beer and pure enough to be smoked or snorted.

"We're trying to clean up this area of the city, and to me, I'm taken
aback by the fact that the whole process is made available," Romero
said. "I've been in the business 35 years and I've never seen anything
like this." But program officials, while denying that they were the
source of the bags, said "cookers" and plastic armbands are also
potential disease carriers. "Hepatitis C is a hardy virus that can
survive outside the body in dried blood so if people are sharing
anything the possibility of contracting the disease is there," Tula
said.

The needle-exchange programs provide heroin users an unlimited number
of syringes, but require visitors to exchange the same number of dirty
needles in return, so it is possible one person could walk out of an
exchange with the number of needles found in the Lawrence alley.

That may seem shocking to some, but Tula said clean needles are a tool
of survival for addicts, who shoot up three times a day on average.

Needle exchange advocates say they should use a clean needle every
time.

"I don't know the answer to helping people get off dope, but while
struggling with recovery, it's important that these people have access
to the one tool that will help keep them alive as they move to
recovery," Tula said. "That one tool is clean syringes."