Source: San Diego Union Tribune (CA) Contact: Website: http://www.uniontrib.com/ Pubdate: Fri, 3 Apr 1998 Author: Joseph Perkins, San Diego Union Tribune WHY NEEDLE EXCHANGE PROGRAMS ARE NOT THE ANSWER The Clinton administration made a sop to the loud and often acerbic AIDS lobby five years ago when it created the President's Advisory Council on AIDS. Now that pandering has come back to bite them. Two weeks ago, the council embarrassed the Clintonites by going public with a unanimous expression of no-confidence in the administration's commitment to fight AIDS. Now the council is calling for the resignation of Health and Human Services Secretary Donna Shalala, who has refused, so far, to bestow her blessing on controversial needle-exchange programs. A congressional moratorium on federal funding of needle exchanges expired Tuesday. That means that communities throughout the country will be free to use federal health money to pass out clean needles to junkies if Shalala certifies that such programs help stop the AIDS virus without increasing drug use. The AIDS lobby, unconcerned about the nation's drug epidemic, insists that needle exchange has no effect whatsoever on drug use. "The science is indisputable," claims Dr. Scott Hill, chairman of the president's AIDS council. Apparently, Dr. Hill is unfamiliar with a 1997 study published in the respected American Journal of Epidemiology. It found that junkies who participated in Montreal needle-exchange programs were more than twice as likely to contract the AIDS virus as those who didn't participate. Robert Maginnis, a senior policy adviser with the Washington-based Family Research Council, also cites the experience of Vancouver, Canada, which boasts North America's largest needle-exchange program. Since 1994, a recent study found, the incidence of AIDS transmission among intravenous drug users has rapidly increased in Vancouver, rather than decreased. So, clearly, the efficacy of needle-exchange programs is far from indisputable. And even if Dr. Hill and other needle-exchange advocates trot out their own studies to "prove" that needle-exchange "works," there remain profound moral and legal questions about passing out clean hypodermics and syringes to drug addicts. Indeed, it hardly seems moral, not to mention rational, to deliver a pitiable soul from one form of death -- AIDS -- to another -- drugs. It's like government saying that it's all right to pump your veins full of poison as long as you don't pass along the AIDS virus. Also, if the federal government sanctions needle exchange, allowing tax dollars to be used to dispense free needles, it will effectively decriminalize intravenous drug use. For one of the conditions of needle-exchange programs is that the junkie who turns in a dirty needle -- which he or she has used to shoot up with cocaine, heroin or LSD -- may not be arrested. That's why the director of the White House Office of Drug Policy Control, Gen. Barry McCaffrey, so strenuously opposes needle exchange. "As public servants, citizens and parents, we owe our children an unambiguous 'no use' message," he recently declared. "And if they should become ensnared by drugs, we must offer them a way out, not a means to continue addictive behavior." So how, then, to staunch the spread of AIDS through intravenous drug use, if not by needle-exchange programs? Simple. By attacking the real root of the problem, which is illegal drug use. This is best accomplished not by giving junkies clean needles, which only aids and abets their deadly habit, but by getting them into drug treatment programs. Maginnis, of the Family Research Council, cites a 1996 study of a Chicago treatment program which found that risky behavior by intravenous drug users could be significantly curbed without handing out needles. By providing health care, counseling, food and housing, the dangerous sharing of needles was reduced 85 percent among participants. This is the approach Shalala ought to embrace. It accomplishes the equally important public-health goals of treating hard-core drug abuse, while also slowing the spread of the AIDS virus among a high-risk cohort. It may happen that the Health and Human Services secretary bows to the political pressure of the president's AIDS council and certifies that needle-exchange programs do not increase illegal drug use. In that case, drug czar McCaffrey ought to resign in conscientious objection.