NEEDLE BILL MISSES POINT

Even for advocates of making needle exchange programs legal, a new bill
working its way through the Legislature has a huge flaw that needs rethinking.

Exchange programs provide addicts with sterile needles. They have been used
in some places since the beginning of the AIDS epidemic to reduce the
spread of such communicable diseases as AIDS and hepatitis among
intravenous drug abusers and their partners who share infected needles.
From those people, the diseases are spread to non-drug users through
sexual contact.

A few needle exchange pilot programs are allowed in California. Where they
aren't, some programs are operated anyway by private groups, but with the
tacit approval of local authorities. The idea has always had strong support
from AIDS activists and increasingly among mainstream medical and public
health experts.

SB 1785 by Sen. John Vasconcellos, D-Santa Clara, would go part of the way
toward making the programs legal. It is the missing part that is the problem.

As needle exchange programs are usually operated, addicts can exchange
used, infected syringes for sterile ones on a one-for-one basis. In
addition, they are given counseling in sterilization procedures and
safe-sex practices or abstinence.

Vasconcellos' bill would allow people to buy syringes at pharmacies without
a prescription. The need for a prescription is the reason intravenous drug
abusers share needles -- a major cause of the spread of AIDS and hepatitis.

Tainted needles are the cause of 19 percent of HIV infection among gay men
in places like San Francisco -- the second leading cause after unsafe
sex.The incidence is even worse among women -- 37 percent. They are doubly
at risk: sharing infected needles and having sex with infected men.

So Vasconcellos' bill would have the virtue of removing the leading barrier
to drug addicts' ability to use clean needles. But it does nothing to take
the infected needles off the street because it does not mandate an exchange.

The question that has to be answered -- and it has not been in legislative
analysis of the bill -- is whether this halfway approach compounds the
problem rather than reduces it. The idea seems to create a medical version
of the economic trickle-down theory.

Aware drug addicts who have money will use clean syringes. But without the
mandate for disposal of used and infected ones, they may well pass the used
and infected ones on to less fortunate fellow users.

As a matter of political reality, needle exchange programs should be a
local option -- but only with a true exchange and disposal requirement.