Pubdate: Wed, 28 Sep 2005
Source: Charlotte Creative Loafing (NC)
Copyright: 2005 Creative Loafing Charlotte, Inc.
Author:  Karen Shugart
Bookmark: (Heroin)
Bookmark: (Needle Exchange)
Bookmark: (Treatment)

The Damage Done


Of the 184 US needle-exchange programs - a means of helping drug 
users reduce the risk of contracting and spreading deadly diseases - 
only two are in North Carolina, and neither are in Mecklenburg 
County, the state's largest metropolitan area.

"It's desperately needed," said Eloise Hicks, executive director of 
the Regional HIV/AIDS Consortium.

It's also entirely illegal. But that didn't stop Thelma Wright from 
starting a program in High Point. Stung by the havoc wreaked by HIV 
in her community, Wright began giving out clean syringes to drug 
users in 1999. She'd search areas around bridges, ravines and empty 
houses, where addicts, mostly street people or "soon-to-be street 
people," would shoot heroin. She'd crawl through windows and lift up 
mattresses to collect dirty needles. At first, users greeted Wright 
with skepticism. "But once they learn who you are, they're your 
friend," she said.

Wright is now co-chair of the Campaign to End AIDS, a national 
coalition of grassroots activists, and she wants to stir interest in 
needle-exchange programs throughout the state, particularly in 
Mecklenburg County.

A report to county commissioners in January 2004 found that a 
needle-exchange program could reduce transmission of disease in 
Charlotte. It got nowhere, of course, though some commissioners have 
voiced support. "Certainly, you want to discourage bad behavior, but 
you also need to be realistic," said County Commissioner Jennifer 
Roberts, who wasn't on the board then. "We need to look at it from 
the standpoint of saving lives."

Guilford and Buncombe counties have passed resolutions supporting 
exchanges. And a regional HIV/AIDS planning group, organized by the 
state at the behest of the Centers for Disease Control and 
Prevention, has come to a "general consensus" that a needle-exchange 
program would be helpful, said Brian Witt, a health educator with the 
Mecklenburg County Health Department.

But until the General Assembly authorizes such programs, all 
non-underground implementation is impossible. Democrats in the House 
of Representatives have sponsored needle-exchange bills during 
several legislative sessions without luck. A bill sponsored by Rep. 
Thomas Wright, D-New Hanover, never made it out of committee this 
year, though Thelma Wright (no relation) says there's an unlikely 
chance the legislature could take it up when they meet for a short 
session in May.

Several groups, including the CDC, the National Research Council and 
the National Institutes of Health have concluded needle-exchange 
programs work. But opposition remains strong among people who believe 
the exchanges condone or encourage illegal drug use. "I think some 
people can't get past that and look at the public health issue," Witt said.

Even among HIV/AIDS prevention advocates, needle exchange isn't 
categorically supported, Hicks said. And such initiatives give drug 
treatment professionals even more pause. Flay Lee, clinical program 
director at Hope Haven, personally believes needle-exchange programs 
can save lives, but said that's not a uniform belief among everyone 
at the treatment center.

Alice Harrison, president of Hope Haven, has mixed feelings. Harrison 
said she believes exchange programs delay people from getting clean. 
"As long as they can continue getting clean needles and using the 
drugs, they're not going to get treatment," she said. "I feel like 
the needle-exchange programs can make it easier to use drugs without 
the fear of contracting disease, which is something that may get 
people into treatment."

Still, she said, many users aren't thinking about the consequences of 
using dirty needles. "It's hard for me to condone a free exchange 
program. . . At the same time, if people are going to be using IV 
drugs, then we certainly want to stop the spread (of disease)."

Needle-exchange programs tackle only a small percentage of HIV 
infections. Of cases reported in 2004, only nine people listed 
intravenous drug use as the sole reason, while five men attributed 
their infection to drug use and gay sex, according to county health 
department data. But Witt suspects many more people who test positive 
may not tell him or other health workers that they shoot up. Last 
year, 157 new HIV infections were attributed to "unknown" or "other" 
causes. That's nearly half the reported cases.

Wright said she's heard Mecklenburg has a tendency to go it alone. 
But she hopes that through advocacy with the Campaign to End AIDS, 
she can find a local figure to push the issue. "I've been trying to 
get people to understand: This thing is across the board, and it's 
the only thing that North Carolina doesn't have in place to stop the 
spread of the disease." 
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MAP posted-by: Richard Lake