NO SINGLE SOLUTION

A recent survey in Worcester suggests there is widespread support for
a needle exchange for intravenous drug users. Of the 300 residents
polled, 61 percent expressed conditional support.

The survey, funded with a $10,000 state grant, was commissioned by the
Henry Lee Willis Center, which advocates needle exchange as a strategy
for preventing the spread of hepatitis C and HIV/AIDS.

How accurately the poll results reflect general attitudes about
distributing needles to addicts is unclear, but they certainly are at
odds with political reality in Worcester at this time.

For years, the needle exchange concept has met strong resistance in
parts of the city most affected by IV drug abuse. Neighborhood groups
generally oppose distribution of needles to addicts. So do many
political leaders, including Mayor-elect Timothy P. Murray and two the
three city councilors he appointed to the Health Committee, Juan A.
Gomez and newcomer Barbara G. Haller.

Needle exchange may slow or prevent the spread of blood-borne disease,
at least among some addicts. But passing out needles, which can be
contaminated the first time they are used, is a chancy solution at
best.

The crucial issue that needs to be addressed is the underlying problem
of drug addiction itself, an epidemic that takes thousands of lives
every year through overdoses, crime and disease.

The problem cannot be addressed effectively by needle exchange alone.
What is needed is aggressive outreach to illicit drug users backed up
by ready access to treatment.

That is why we have long supported the "harm and risk reduction"
approach developed by Worcester AIDS activists several years ago. The
risk-reduction approach emphasizes treatment and counseling in a
clinical setting -- although it may include a clean-needle component,
in part to induce addicts to enter and continue treatment.

To be sure, even a comprehensive anti-addiction treatment and
education program is apt to encounter some public resistance. However,
there is a far better chance of winning political and neighborhood
acceptance for a clinical model than for strategies that put the main
emphasis on needles.