Pubdate: Thu, 28 Feb 2002
Source: Reuters (Wire)
Copyright: 2002 Reuters Limited
Author: Alan Elsner, National Correspondent
Bookmark: (Needle Exchange)
Bookmark: (Harm Reduction)


EL CAJON. Calif - Brent Whittaker spends his days breaking the law, trying 
to slow the spread of AIDS.

Whittaker, who runs a covert illegal syringe exchange program for heroin 
addicts in San Diego County, gives out up to 7,000 needles a week and 
collects thousands of used ones for disposal through a local clinic.

He drives his pickup truck, loaded with thousands of needles, to meet his 
750 regular clients in shabby mobile home parks and upscale apartments, in 
blue collar communities like El Cajon east of the city and in ritzy beach 
communities, in parking lots and on street corners where boxes of needles 
and other medical equipment quietly change hands.

"I'll take 50," said Lee, a first-time client who met Brent in his second 
floor apartment. Lee, a member of a heavy metal rock band with a new 
recording just out on compact disc, said he was injecting heroin to deal 
with the pain he suffered from Crohn's disease.

"I need it to get out of bed in the morning and function. I'm not one of 
those hood rats taking the stuff to get high and I don't want my 7-year-old 
son knowing," he said. But his wife sometimes joined him "joyriding," he added.

Needle exchange programs have been spreading in the United States and by 
the end of 1998 were operating in at least 81 cities in 31 states, 
according to a review last March by the Centers for Disease Control and 

But the decision on whether to begin such a program lies in the hands of 
local authorities, giving rise to a patchwork of official and underground 
exchanges across the nation.

The city of San Diego is about to begin an officially sanctioned pilot 
program, but in far-flung San Diego County just getting caught in 
possession of a syringe without a doctor's prescription is illegal and the 
political leadership and police remain adamantly opposed to legal needle 

Whittaker was arrested once in the city in 1994. But the authorities 
decided not to press charges and since then his privately funded San Diego 
Harm Reduction Program has operated under a kind of unspoken agreement with 
law enforcement.

"We don't flaunt it, don't shove it in their faces and they don't hassle us 
or arrest us," Whittaker said. However no such amnesty applies to the drug 
users he serves. If caught, they are prosecuted with the full severity of 
the law.

Studies Show Programs Help

Numerous scientific studies suggest that needle exchange programs can help 
arrest the spread of AIDS and hepatitis C, two deadly diseases spreading 
rapidly among injecting drug users sharing dirty needles. But many 
conservatives dispute the science and object to the morality of such programs.

The issue is political dynamite in this traditionally conservative part of 
southern California, where an estimated 23,000 people are addicted to 
heroin and where cases of hepatitis C rose by 50 percent to around 4,500 
between 1998 and 1999 alone.

After a battle that went on for several years, the San Diego City Council 
last November approved a one-year pilot program by a vote of 5-4 over the 
strong opposition of Mayor Dick Murphy and Police Chief David Bejarano.

"If we are trying to make San Diego the city that has the lowest crime rate 
in the nation we should not support a needle exchange," said Murphy, a 
former judge.

"We're also concerned again about the message we're sending children," said 
Bejarano. "We're sending a message that encourages drug abuse."

Whittaker believes that through secondary distribution networks, he may 
reach as many as a quarter of the estimated 23,000 heroin addicts in the 
county. Just as important is the disposal of thousands of dirty needles 
each week that would otherwise be discarded under bushes or on sidewalks or 
on the beach where they pose a huge public health hazard.

"Use Until Numbers Wore Off"

"Before Brent came on the scene, I would reuse needles until the numbers 
wore off," said Bill, who has been injecting heroin for 25 years and uses 
the drug four times a day.

Bill distributes clean needles to five other addicts. On this day, he re 
ceives 1,000 clean needles and gives Whittaker a large plastic container 
stuffed with 2,000 used syringes.

Donna, who said she was 43 but looked at least 20 years older, said she 
would often share needles if she could not find new ones before Whittaker 
came on the scene. With scars on her skinny arms and bloody tracks on her 
legs, she looked like a picture of ill health.

"Sometimes I got them from someone with a diabetic card. But if I couldn't, 
I found them where I could," she said.

In 2000, the U.S. Surgeon General reviewed all the peer-reviewed scientific 
studies of clean syringe programs since April 1998 and concluded that they 
were "an effective public health intervention that reduces the transmission 
of HIV and does not encourage the use of illegal drugs."

A survey of 81 cities worldwide estimated that HIV prevalence declined by 
almost 6 percent in cities with clean needle programs but increased by a 
similar amount in cities without such programs.

But conservatives argue that needle exchanges grant intravenous drug users 
all the needles they want and effectively create police-free zones in which 
addicts and dealers can network.

"This is not compassion. It is ill-conceived public policy. This is not 
'saving lives' but abandoning them, consigning countless thousands to 
drug-induced death on the installment plan," wrote Joe Loconte in an essay 
for the conservative think-tank, the Heritage Foundation.
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MAP posted-by: Beth