TOUGH CALL ON NEEDLE PROGRAM

A recent Board of Supervisors debate concluded with county Health Director
Gary Feldman declaring a local health emergency for AIDS and Hepatitis C, a
necessary step toward establishing a needle exchange program for drug users.

There are strong arguments for and against needle exchange programs. Many
studies touting their successes are based on analysis of returned needles
and mathematical models, not on hard data. Other studies of actual drug
users showed the programs to be failures. But there were problems with these
studies also.

Not surprisingly, studies involving intravenous drug users are hard to keep
within parameters. Study participants are volunteers who must be examined at
regular intervals. This poses serious challenges when the subjects are heavy
drug users, who tend to be unreliable. Much of the information gathered for
the research was based on self-reporting, leaving the conclusions of the
studies dependent on the validity of reported information.

The majority of studies, including those by the National Academy of
Sciences, the Centers for Disease Control and Prevention, and the American
Medical Association, conclude that needle-exchange programs do not result in
an increase in intravenous drug use.

What most of the studies do show is that supplying clean needles helps slow
the incidence of new HIV and hepatitis infections.

If exchange programs help protect the community from health issues and costs
associated with the use of dirty needles, why would anyone be against them?

First, giving clean needles to an intravenous drug user is like giving
matches to a pyromaniac.

Second, no one wants to witness drug users in their neighborhood lining up
to exchange needles, shooting up drugs near their property and discarding
the dirty needles haphazardly.

Third, who is going to pay for this?

To answer the first argument, yes it is morally wrong to give needles to
drug users. But how many others can be spared by keeping infection rates
down? Also I don't know of any old drug addicts. Either they die before
their time or go straight. A person who is using drugs now still holds
potential for the future.

I really can't counter the second argument. The Inland AIDS Project
reportedly has plans to set up a mobile exchange program. Making use of a
van staffed with substance abuse counselors, they will drive to areas where
drug use is most prevalent, initially unincorporated areas of Perris and
Lake Elsinore.

Mobile or not, I don't want drug users in my neighborhood lining up at a
clinic, and I wouldn't wish it on any neighborhood. If the plan ever makes
it past the Board of Supervisors, it will hit a wall of community
resistance. And it is a very small comfort to think that residents won't
have to worry about dirty needles lying about, as users will probably
scavenge dirty needles for exchange.

Government money cannot be used to operate exchange programs, so it would be
supported with private funding, which would make it less of an issue.

Reported AIDS deaths in Riverside County between 1990 and 1999 totaled
4,813. Deaths from heart disease totaled 36,586. It can be argued that both
illnesses are caused by lifestyle choices, but AIDS and hepatitis are
communicable, so others can be affected.

Although I have strong reservations, I know I can't judge, preach or wish
the problem away. A needle-exchange program in Riverside County is a viable
option for helping to keep our community safe from disease.