Pubdate: Wed, 05 Aug 2009
Source: Calgary Herald (CN AB)
Copyright: 2009 Canwest Publishing Inc.
Contact: http://www.canada.com/calgaryherald/letters.html
Website: http://www.canada.com/calgaryherald/
Details: http://www.mapinc.org/media/66
Author: Michael Gerson

NEEDLE EXCHANGE GIVES ADDICTS TIME TO CHANGE

The RV arrived at a corner near Washington's Marvin Gaye Park, known 
locally as "Needle Park." A steady procession of addicts came to the 
door, mounted a few steps and sat down. One by one, they dropped used 
needles into a container and received new needles in return, along 
with alcohol wipes and the small, bottle cap-like "cookers" in which 
heroin is heated.

Reggie Jackson, Teefari Mallory and Hazel Smith --staff members at 
PreventionWorks!, Washington's largest needle exchange program--are 
at the park twice a week, offering clean needles to prevent disease 
transmission, condoms, drug treatment referrals, AIDS testing and a 
few kind words: "You still play the guitar?" "You'll have a swollen 
hand if you keep going there." "Love you baby."

It is the eyes and arms of addicts that draw your attention. Eyes 
that are glassy, unnaturally bright or tired beyond exhaustion. Arms 
that are ulcerated sticks or purple parchment; with repeated use, 
needles become blunt and tear the skin. Some addicts adopt a 
defensive politeness-- "yes, sir"--and quickly leave. Others want to 
talk-- "I love plants and I love kids" --trying to provide hints of 
their humanity. They are America's least wanted.

They're also at the centre of a controversy. Needle exchange programs 
have always been controversial, with opponents arguing they send a 
mixed moral message about drug use. The House of Representatives 
recently passed an amendment banning exchanges in the District of 
Columbia within 300 metres of sites where children gather--which, if 
approved by the Senate, would effectively put programs like 
Prevention-Works! out of business: Staffers joke they could only work 
in graveyards or the middle of the Potomac.

This might make sense if needle exchange programs increased the 
number of addicts. But they don't. Dr. Anthony Fauci, the director of 
the National Institute of Allergy and Infectious Diseases at the 
National Institutes of Health, has reviewed the studies on needle 
exchange. "It does not," he says, "result in an increase in drug 
abuse, and it does decrease the incidence of HIV. . . . The idea kids 
are going to walk out of school and start using drugs because clean 
needles are available is ridiculous."

My experience in Washington was consistent with Fauci's view. Addicts 
who came for needles were generally older. Clean needles no more 
caused their addiction than the provision of clean shot glasses would 
cause alcoholism.

The main purpose of needle exchange, according to Reggie, the 
supervisor of the mobile unit, is to keep people alive until they can 
get clean, something that can take years.

Needle-sharing is the third-leading cause of HIV infection 
Washington. It is also a major contributor to the spread of hepatitis 
C, the main cause of liver transplants in the U. S. Reggie is well 
acquainted with these facts because, while an addict, he contracted 
both diseases. "If they had a truck like this in the '60s, '70s and 
'80s," he told me, "maybe I wouldn't have gotten infected."

The staff of Prevention-Works! builds long-term relationships with 
people no one else knows by name. Because of this, they have a good 
feel for when addicts are ready for treatment.

While I was in the RV, Reggie signed up two addicts for detox. 
Teefari used her own car to drive one addict, with whom she had been 
working for eight years, to treatment. "He's ready, ready to go," she 
said, fighting tears.

Critics say needle programs create a moral hazard by legitimizing 
drug abuse. But it does not legitimate drug abuse to help addicts 
avoid deadly diseases until they are ready for help. Instead, 
sacrificing their lives to send an "unmixed" moral message sends a 
troubling moral message: The unwanted have no worth.

Street addicts are connected to the rest of us by only a few 
invisible strands --people such as Hazel, Reggie and Teefari.

Those strands should not be severed.

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MAP posted-by: Keith Brilhart