NEEDLES OFFER HEALTH, HOPE

The May 21 letter "Needle exchange sends wrong message," castigating syringe
exchange programs on moral grounds, was wrongheaded on two counts.

First, on the simplest of Judeo-Christian grounds, we are admonished, "Thou
shalt not kill." Denying clean needles and condoms to prevent the fatal
diseases of AIDS and hepatitis to people with the disease of addiction is
offering death over life. But in a more symbolic way, the letter writer is
also wrong about the messages sent by needle exchange programs. They are
messages of hope to those who need them. Jeff Gerritt's May 19 editorial
page column, "Needles and Lives," demonstrated this.

Such programs are also positive messages to the larger community. A survey
of inner-city teenagers in Baltimore found that teenagers were no more
likely to inject drugs because of the presence of a syringe exchange program
than because they saw anti-drug messages on television or learned about the
danger of drug abuse in school. Furthermore, the teenagers in neighborhoods
with syringe exchange programs were even less likely than those in
neighborhoods without programs to report a link between the presence of an
exchange and the chance they would inject drugs.

For many older members of the community, the exchange is a point of contact
with the health care system, which often neglects them. Many programs offer
health education about issues beyond HIV prevention. A properly funded
exchange can, and does, offer vaccinations; provide blood pressure, diabetes
and pregnancy screening; perform minor medical procedures; and test for HIV,
hepatitis, TB and other infectious diseases.

The exchanges need more support, not less. The lesson of syringe exchange is
that public health is the higher morality.

Robert Heimer, Department of Epidemiology and Public Health

Yale School of Medicine

New Haven, Conn.