NEEDLE EXCHANGE PROPOSAL TO SURFACE AGAIN

RIVERSIDE -- Because of a rapidly rising number of cases of communicable
diseases in the region, the county health director will again ask the Board
of Supervisors to approve a controversial proposal that would allow
intravenous drug users to exchange dirty needles for clean ones.

On Tuesday, Director of Public Health Gary M. Feldman will ask the
supervisors to declare a local health emergency in the 7,200-square-mile
county that would clear the way for a needle-exchange program. After his
last plea to the supervisors in July, he was told to come back to the board
with more information.

A 1999 state law requires the board to make the declaration before a pilot
program allowing addicts to exchange dirty syringes for clean ones could
begin in the unincorporated areas of the county. Los Angeles, Santa Barbara
and Ventura counties have similar programs in place, as does the city of San
Diego.

"Dirty needles are the prime mechanism in transmitting hepatitis C and
contribute to the spread of AIDS and hepatitis B," Feldman said Friday. "We
have a genuine epidemic of hepatitis C in this county."

AIDS is a disease that attacks the body's immune system, and hepatitis C is
a virus that attacks the liver to the point where it cannot perform its
normal functions. Both diseases can be transmitted through needles, and both
can be fatal, although there have been no reported deaths directly related
to hepatitis C in the county since it began tracking reports of the virus in
1998.

Feldman said the idea is to exchange dirty needles for clean needles in
hopes of limiting the spread of hepatitis C and AIDS to other users by
sharing the contaminated needles. Regional health statistics indicate there
are an estimated 12,000 intravenous drug users in the county.

"We have lives being lost and people being put in jeopardy every day,"
Feldman said.

The county first started recording data on hepatitis C in 1999, when 1,635
cases were reported. According to regional health statistics, that number
has since jumped to 1,808 in 2000, and 2,092 in 2001, an increase of about
28 percent since 1999.

An estimated 1,250 cases of hepatitis C that were reported last year stemmed
from needle use, health officials said. More than 4,000 cases of AIDS were
reported in the county between 1990 and 2001 with nearly 2,100 people dying
from the virus between 1983 and 1999, health officials said.

Proponents of needle exchange programs say they have been successful in
controlling the spread of disease without increasing drug use, but critics,
including many law enforcement officials, object to such programs largely on
ideological grounds.

When the needle exchange program was last proposed to the board in July,
several supervisors were cool to the idea. Some felt that the program would
send the wrong message about drugs to youths -- that the board condones drug
use.

Third District Supervisor Jim Venable said he is adamantly opposed to the
needle exchange program because using drugs is illegal, and the county would
be, in effect, promoting illegal activity.

"Needles are illegal, to me the whole (program) is illegal," Venable said.
He added that law enforcement has programs to deal with drug use. "I'm not
voting for it, period."

Sheriff-elect Bob Doyle and District Attorney Grover Trask have been opposed
to the needle-exchange program because they say such programs condone
illegal behavior and undermine anti-drug efforts in the community.

"If you can't beat the system, that doesn't mean you join the system,"
Venable said. "I don't believe that. You keep plugging away until you fix
the system."

But Feldman said there is no evidence that the needle-exchange programs
promote drug use, and he points to the fact that 60 percent of new hepatitis
C infections and 33 percent of new AIDS infections stem from injection drug
use.

Feldman said AIDS and hepatitis B rates are also experiencing increases, and
said rates of all three diseases will continue to rise unchecked in the
intravenous drug using community if nothing is done. As a result, he said,
more people will die.

The exchange program would be administered by the Inland AIDS Project, a
privately funded nonprofit group that provides services for people who have
communicable diseases such as AIDS and hepatitis C.

The program is expected to cost more than $100,000 annually, all of which
would come from private sources because state and federal dollars cannot be
used to operate such a program, officials said. Each needle costs about 5
cents.

If approved, the program would take about four to six months to be
implemented, Feldman said. The Inland AIDS Project would dispatch a mobile
van, two days a week, four hours each day, to an area of the county where
intravenous drug use is prevalent.

The initial target area is expected to focus along a strip of unincorporated
land between Lake Elsinore and Perris, where intravenous drug use is
considered to be more prevalent than other sections in the county, officials
said.

Substance abuse counselors would also be available along with a variety of
information on treatment programs and other preventative measures.