. . . Offering Clean Needles

ONE TERRIBLE side effect of drug abuse is the spread of AIDS among
intravenous drug users. Those who share contaminated needles and other drug
paraphernalia endanger not only their own lives but also those of their
sexual partners and their children. What is less known and more difficult for
some people to accept is the mounting evidence that needleexchange programs
do save lives, markedly lowering rates of HIV infection, but do not increase
drug use. This is why state and local officials and most recently, the
U.S. Conference of Mayors are urging Secretary of Health and Human
Services Donna Shalala to eliminate the ban on the use of federal funds for
needleexchange programs.

The federal government has a clear and important role in the attack on AIDS
and drug abuse. Needle exchange is but a part of a broader effort, but it
deserves federal support. It must be accompanied by improved drugabuse
prevention and treatment programs. This is the chief concern of those who
resist the cleanneedle approach: They fear that by distributing the tools of
drug use, governments are surrendering to drug abuse and even abetting it.

Yet study after study shows that the exchanges do not promote greater use of
illegal drugs. The best programs do refer not order their participants
to treatment centers, although facilities are few. It is established that
drug users who are not under treatment will not or cannot stop their drug use
just because clean needles aren't available. They will go to infected needles
for that fix.

If administration officials need an example of a program that offers clean
needles and also instruction and equipment for cleansing syringes and other
paraphernalia, they may look in their own backyard. The D.C. Needle Exchange,
run by the WhitmanWalker Clinic with limited city funds, refers users to
treatment programs, offers free HIV tests and has become a useful
communications link to more than 1,600 addicts. Staffers make no great claims
of reducing addiction; they note that treatment services are critical and
in this city, seriously limited.

The National Institutes of Health reports that needle exchange has brought
about an estimated 30 percent or greater reduction of HIV in injection users
of illegal drugs. In terms of expense, a sterile needle costs about a dime,
while officials of AIDS organizations estimate the average lifetime cost of
treating an individual with HIV/AIDS is at least $119,000. Needle exchange
programs alone certainly will not stop substance abuse, but they are helping
to stop HIV and that needs to be a priority of the federal government.

© Copyright 1997 The Washington Post Company