Pubdate: Mon, 14 Jul 2003
Source: News Journal (DE)
Copyright: 2003 The News Journal
Author: J.L. Miller, Dover Bureau reporter
Bookmark: (Needle Exchange)


State Laws Prevent Attempt To Slow Spread Of AIDS

Although intravenous drug use now accounts for the majority of new HIV
infections in Delaware, the state's drug laws have blocked attempts to
provide clean needles to slow the spread of AIDS.

The state senator whose district is hardest hit by AIDS said until
there is a groundswell of support for a needle-exchange program,
addicts will continue to share needles and the disease will continue
to spread.

"The fact is that Wilmington is in a crisis situation. It's an
epidemic," said Sen. Margaret Rose Henry, D-Wilmington East.

Delaware is one of just five states that require a prescription to
purchase a hypodermic needle, although pharmacy regulations in some
states require buyers to show a "medical need." Some states restrict
sales to adults; others limit the number of syringes that can be purchased.

From March 2002 through February, Delaware had the fifth-highest rate
of reported HIV cases in the country, behind Washington, D.C., New
York, Maryland and Florida. AIDS is the second-leading cause of death
among Delawareans ages 25-44.

Since the mid-1990s, Henry has tried to push legislation that would
establish a needle-exchange pilot program in Wilmington where drug
users could exchange contaminated needles for clean ones and be given
the opportunity for drug treatment.

Supporters of needle-exchange programs said that because needles are
often shared by addicts, the programs attack one of the main causes of
the spread of blood-borne diseases such as hepatitis C and AIDS.

But opponents - including President Bush - contend the programs
promote drug abuse, or at least implicitly condone it.

Bush, in a 2000 campaign statement, called needle-exchange programs "a
dead-end approach that offers despair and addiction."

Nonetheless, a needle-exchange program in Baltimore, which has an
estimated 59,000 intravenous drug users, has been credited by the
Maryland AIDS Administration with reducing the HIV infection rate by
24 percent since 1999.

State Lawmakers Oppose Idea

Baltimore's needle exchange began as a pilot program, but its success
convinced the Maryland General Assembly to make it permanent.

The Delaware General Assembly, though, has not been receptive to
Henry's idea. This year, Henry did not even introduce the

"The reason is I've received significant opposition from fellow
legislators who said I was promoting drug use," Henry said, adding
that she probably will reintroduce the bill after legislators return
to work in January.

"I've had the full support of City Council and the mayor to do a pilot
program in Wilmington, but we just couldn't get that done," Henry said.

The American Medical Association and the Medical Society of Delaware
support needle-exchange programs. So do the American Pharmacists
Association and the Delaware Pharmacists Society.

The public health benefits of making clean syringes available outweigh
the concern about providing drug users with the means to inject their
drugs, said pharmacist Pat Carroll-Grant, executive director of the
state pharmacists group.

In 2000, at least 127 needle-exchange programs operated in 32 states,
Puerto Rico and the District of Columbia, according to a survey by the
Baron Edmond de Rothschild Chemical Dependency Institute in New York,
which treats about 13,000 people yearly.

Political Changes Unlikely

The political prospects for a change in Delaware appear

In 1997, when Henry pushed to set up a pilot program in Wilmington,
Sen. Patricia Blevins, D-Elsmere, was one of several legislators who
raised concerns that needle exchanges could promote drug abuse.

Last week Blevins, who chairs the Senate Health and Social Services
Committee, said she has seen nothing that would change her opinion.

"I think our first line of defense needs to be reducing the number of
addicts in the state," Blevins said. "That certainly starts with drug
treatment and with prosecuting drug dealers. I think Delaware has done
a good job with that."

Although there are no reliable statistics on the number of
intravenous-drug users in Delaware, heroin-related deaths have increased.

In 1999, Delaware recorded 15 heroin deaths, according to the Office
of National Drug Control Policy. There were 21 deaths in 2000 and 32
deaths in 2001. The number of heroin-related admissions to adult
treatment programs has fallen from 2,393 in 1999 to 1,991 in 2002.

While there are scores of advocates for needle-exchange programs, some
question whether they are effective.

Dr. Eric A. Voth, a Topeka, Kan., addiction specialist and chairman of
the Institute on Global Drug Policy, a nonprofit organization that
promotes strategies aimed at reducing illegal drug use, said some
studies show higher HIV and hepatitis infection rates among addicts
who participate in needle exchanges than among those who do not.

Voth said evidence does not support claims that the Baltimore program
is successful. "Most people consider them, at least most people in the
drug prevention and treatment world, just a drastic failure."

Despite the resistance in the General Assembly, Delaware's law
enforcement community supports the idea of a pilot program here.

"Sen. Henry's heart is in the right place. She's basically trying to
eliminate disease as far as AIDS and hepatitis," said Newport Police
Chief Michael Capriglione, president of the Delaware Police Chiefs'

However, not all law enforcement officers favor needle exchange

"When you give them free clean needles, you've written them off. What
you've done, in essence, is you've told them what they're doing is
fine," said retired federal Drug Enforcement Administration agent
Wayne J. Roques.

Short of establishing a needle-exchange program, the General Assembly
could decriminalize syringe possession, according to Susan R. Weimer,
executive director of the Delaware HIV Consortium. Weimer said
nonprofit groups would then have the ability to develop their own
programs without state money.

"This would then allow any nonprofit organization to develop their own
program," Weimer said, adding that state funds would not have to be

Baltimore Rate Was Spiraling

The Baltimore program faced similar political opposition, and a
legislative initiative failed in 1992 and 1993.

But in 1994 the Maryland General Assembly, swayed by Baltimore's
spiraling AIDS rate, approved a pilot program - provided the city paid
for it.

Today, the Baltimore project has a budget of $600,000 and distributes
clean needles to about 14,500 drug users.

The program has more than 400 drug-treatment slots for participants
who want to kick the habit.

Michele Brown, the program's director, takes to the streets of West
Baltimore in a specially outfitted recreational vehicle to exchange
contaminated syringes for clean ones.

She said she sees success stories almost every day.

"Our needle exchange is a route to treatment," Brown said in a
telephone interview from a needle-exchange site. "Just yesterday we
were sitting in the van and this lady stopped by and thanked us. She's
been clean two years and has a brand new car."

Brown and other supporters said needle-exchange programs do not
encourage drug use because they only serve people who turn in a used

As for charges that the programs would lure youths into drug abuse,
the average age of the Baltimore participants is 41. In 2001, only one
participant was a minor.

According to the nonprofit Center for Innovative Public Policies, the
Baltimore program has reduced the number of needles discarded in the
street, cut the rate of needle sharing and increased the number of
people in drug treatment.

In Delaware, intravenous drug users and those who have sex with them
now account for more than half of new HIV infections, according to
data released last month.

Renee Beaman, who runs the Beautiful Gate Outreach Center at Bethel
AME Church in Wilmington, said in an interview last month that the
AIDS rate in her community justifies another look at needle exchanges.

"We might need to look at some new ways, this being one," Beaman said.
"Drugs are fueling this epidemic and we have to realize that and see
what we can do."
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MAP posted-by: Larry Seguin