GROUP LOBBIES FOR TREATMENT OPTIONS

In an effort to curb the spread of HIV/AIDS, a local organization hosted a
forum Wednesday to discuss a relatively new philosophy that provides an
alternative to drug treatment. The Wright Focus Group wants the local
public to be informed and supportive of an intervention program to reduce
drug-related harm to drug users, their families and the community.

An increasingly popular but still controversial component of the effort,
dubbed harm reduction, is the use of syringe exchange programs, which offer
drug users access to clean needles in exchange for dirty ones. The Centers
for Disease Control and Prevention estimates there are about 1 million
intravenous (IV) drug users in the United States, and that drug users,
their sex partners and their children account for about a third to half of
the number of new AIDS cases each year. In order to minimize the risk of
HIV transmission, the CDC supports initiatives such as syringe exchange
that can help drug users protect their health.

In North Carolina and most other states it is illegal to possess a syringe
without a prescription. So, in order to establish a syringe exchange
program locally, a public health emergency would have to be declared.

The Guilford County AIDS Partnership plans to lobby local officials for
such a declaration, said Thelma Wright, president and CEO of Wright Focus
Group.

The syringe exchange programs already operating nationwide cause their
local law enforcement officers to look at IV drug users not as criminals,
but as part of a public health issue, said the forum's speaker, Imani P.
Woods, director of the African-American Community Education Project at
Progressive Solutions in Seattle.

"A public health emergency overrides general public safety laws," Woods
explained.

Although more than 160 syringe exchange programs currently operate
nationwide, the United States still lags behind other countries in the effort.

For example, Australia, with a population only a tenth of the United
States, operates more than 2,000 syringe exchange programs. As a result,
Australia's intravenous drug using population has a 3 percent rate of
infection compared to levels of more than 50 percent in other developed
countries, according to the Australian National Council on AIDS.

Woods said that most people in the United States do not want to discuss
drug use, HIV/AIDS, or the correlation between them. Further, she said that
addiction treatment has been accepted as the only available option to
combat drug use and the spread of HIV/AIDS.

"Drug addiction is the only disease that has only one respected type of
care," Woods said. "Treatment works, but most drug users continue to use
until they die."

The more than 20 local health workers in attendance at the forum agreed
that only one out of 10 people in drug treatment actually successfully
stops using.

Harm reduction does not rule out abstinence. In fact, Woods said the
approach is often the first step toward the eventual cessation of drug use.

"Harm reduction doesn't exclude hope," Woods said. "But it has different
goals: the public health and disease communications issues."

The easiest way to transmit HIV is through a contaminated needle, said
Caroline Tisdale Moseley, community health education manager for the
Guilford County Department of Public Health.

"As the department of public health, we cannot support anything that's not
legal, however, we do support it as a science-based intervention," Moseley
said. "Syringe exchange is considered the most effective way to prevent
HIV/AIDS."

Many studies show that drug addicts involved in harm reduction are more
likely to attend drug treatment centers, inject less times daily and
eventually get off drugs, Moseley said.

Other forms or harm reduction include passing out free condoms and
encouraging prostitutes to use condoms more frequently, even though they
are usually paid more for unprotected sex, Woods said.

Although the U.S. Department of Health and Human Services has determined
that syringe exchange programs do not encourage use of illegal drugs,
restrictions on federal funding for such programs have not been lifted.

The National Institutes of Health and the American Medical Association also
endorse syringe exchange programs.