MENINO URGES SALE OF NEEDLES TO ADDICTS

Anti-HIV plan is common elsewhere

Mayor Thomas M. Menino is championing a campaign on Beacon Hill to permit
over-the-counter sales of syringes, a measure other states have adopted in
the hope that drug addicts will stop using dirty needles, a leading cause of
HIV infection.

More than one-fifth of HIV infections in the state in recent years have been
linked directly to injected drugs, the second-most common source of the
virus. Boston is one of just four cities and towns in the Commonwealth --
the others are Cambridge, Northampton, and Provincetown -- that run
needle-exchange programs so that junkies can turn in their tainted syringes
for clean ones.

The initiative Menino is leading represents a twist on the needle-exchange
strategy, by allowing any adult to walk into a pharmacy and buy up to 10
syringes, which currently require a doctor's prescription. Backers hope the
proposal might prove more politically palatable because it would involve
spending few, if any, government dollars.

"It's not a political issue. It's a health issue, trying to prevent the
spread of HIV and hepatitis," Menino said in an interview Friday. "We're in
the business of making this a better place to live, and one of the things we
have to do is reduce diseases."

While initiatives to get clean needles into the hands of drug users have won
the support of the American Medical Association and other health care
organizations, needle-exchanges have also encountered considerable
resistance in the past, from both local activists and national groups such
as the Christian Coalition. Detractors have argued that the programs
encourage drug abuse by enabling users to continue shooting up.

Those arguments have derailed plans for needle-exchange programs in
Worcester, Springfield, and other communities where drug use accounts for an
especially high share of HIV infections.

"People have concerns that it's going to increase drug use. People have
concerns that it's going to send the wrong message, that we're condoning
drug use," said Dr. Erik Garcia, medical director of the Homeless Outreach
and Advocacy Project in Worcester and a veteran advocate of a
needle-exchange program in that city. "What's funny is that none of the
people who are actually taking care of substance abusers have that feeling."

For Menino, who is expected to endorse the proposal during World AIDS Day
ceremonies today, the syringe sale proposal represents his latest foray into
making statewide health policy. The mayor strongly backed a bar and
restaurant smoking ban in Boston, a law that set the stage for the statewide
prohibition approved this fall by the Legislature.

The proposed legislation -- filed by Representative Martin J. Walsh,
Democrat of Boston, and Senator Robert O'Leary, Democrat of Barnstable --
would repeal a law that requires a doctor's prescription to buy hypodermic
needles and instead would permit their sale by licensed pharmacists.
Previous efforts to permit over-the-counter syringe sales in Massachusetts
stalled.

Only three other states -- California, Delaware, and New Jersey -- continue
to require prescriptions for hypodermics.

"In pretty much the rest of the country, if you're 18 years old, you can
walk into a pharmacy and buy syringes," said Magnolia Contreras, director of
policy and community relations for AIDS Action Committee of Massachusetts.
"For HIV and AIDS, we know it's one of the ways we can reduce transmission
in people who are struggling with addiction."

Nationally, one-third of all AIDS cases have been associated with the use of
tainted needles since the epidemic began in the early 1980s.

From 2000 through 2002, 21.4 percent of reported cases of HIV infection in
Massachusetts were blamed on injected drugs.

But in Boston, needle-related HIV cases were only 14.6 percent of the total,
according to figures from the state Department of Public Health, perhaps
reflecting the success of the decade-old needle-exchange. Under the program,
trucks that resemble laundry or food-delivery vans roll into neighborhoods
on a regular schedule, allowing drug users to swap their used needles for
new ones.

Along with their syringes, addicts can get medical assistance -- and help
kicking their habit. The Boston Public Health Commission reports that, of
the 2,000 clients who visit the needle van each year, 20 percent wind up in
substance-abuse programs.

"We say, `We're not going to lecture you, but the ideal thing would be for
you to get into treatment. We're here to help you do that if you want it,' "
said John Auerbach, executive director of the Boston Public Health
Commission. "If they accept the offer of help, we don't just hand them a
card. We find them a bed in a program, and sometimes give them a cab voucher
to get over there."