'HARM REDUCTION' URGED IN DRUG TREATMENT

SEATTLE - When Edith Springer was trying to kick her drug habit decades ago
on Manhattan's lower East Side, she says she had to "fake being crazy" to
get into a psychiatric treatment program she hoped would help her get
clean. Springer achieved her goal by replacing heroin with methadone, a
legal, orally administered substitute for the drug. Until then, she felt
she had been treated like a criminal and an outcast. "I needed a hug," she
says.

The experience inspired Springer to become an advocate of "harm reduction"
strategies for fighting addiction, such as drug substitution,
needle-exchange programs that seek to stop the spread of diseases like
Hepatitis C and AIDS, and compassionate counseling for addicts.

That approach is the focus of a four-day conference here that has drawn
more than 1,000 clinicians, public health workers and researchers.

During Monday's session of the Fourth National Harm Reduction Conference,
Springer and other panelists slammed the abstinence-only rhetoric used in
most drug treatment programs.

"Drug prohibition is what causes the greatest harm, not drugs," said Patt
Denning, director of clinical services and research with the San
Francisco-based Harm Reduction Therapy Center, which helped organize the
conference. Denning believes that regarding drug users and nonusers as two
separate social groups creates an insurmountable divide that makes
effective treatment impossible.

The conference includes speakers and workshops on harm reduction in prisons
and legal barriers to syringe disposal. Speakers also provide step-by-step
instructions on how to use harm reduction techniques.

During one panel discussion, Denning dismissed the suggestion that users
must "hit rock-bottom" before they can be helped, and slammed current
methods of drug therapy that use punishment to get addicts to kick their
habits.

"There is no place for punishment in treatment," she said.

The harm reduction approach is not without its critics, including some who
say proponents of the idea have a different ultimate goal - the
legalization of outlawed drugs.

Still, the keynote speaker at the conference, director Alonzo Plough of the
Seattle-King County Department of Public Health, said local politicians and
law enforcement officials have "come a long way" in their acceptance of
harm reduction techniques.

Plough said more resources need to be poured into harm reduction programs.

In King County alone, where 15,000 to 20,000 people inject drugs an average
of three times a day, there are more than 20 million injections each year,
Plough said. The five needle-exchange locations in Seattle, where 2 million
syringes are exchanged annually, are not equipped to handle that type of
volume, he said.

Plough suggested making syringes available for sale at pharmacies and
expanding syringe disposal locations.

He also called Seattle's current methadone program "woefully underfunded."
Despite an additional $300,000 allocated in last year's budget to improve
the program, the waiting list remains "unacceptably long," he said.

Brad Lindgren, a 49-year-old former heroin user, said he came to the
conference from Austin, Texas, to learn about the latest harm reduction
techniques and raise money for a needle-exchange program he launched two
years ago.

Lindgren spent eight years as an addict, during which he contracted
Hepatitis C. Had harm reduction services been available back then, Lindgren
said he wouldn't have been a slave to the drug for so long.

Eighteen years later, he walks the streets of Austin nightly with a
backpack filled with clean syringes, trying to spare addicts the pain he
has suffered as a result of his addiction.

"I had three friends that didn't want to see me die," Lindgren said of the
moment he decided to kick his habit. "They locked me in a room and I went
through 90 hours of detox. It was a roller coaster. But I've never looked back."