Source: Sacramento Bee (CA)
Pubdate: Thu, 23 Apr 1998
Author: Cynthia Hubert - Bee Staff Writer


A small group of Sacramento doctors and activists, arguing that the war on
drugs has backfired on addicts and the public at large, is quietly pursuing
a controversial "harm reduction" strategy to treat hard-core abusers.

Rather than emphasizing abstinence from drugs, as do most law enforcement
and treatment programs, the approach focuses on teaching addicts "safer"
drug use and working to improve their overall health and social

Toward that end, advocates are distributing more than 150,000 clean
syringes to injection drug users each year through an underground network,
panelists in a forum at UC Davis Medical School said Wednesday.

They have launched a campaign to reach out to drug abusers and teach them
methods for avoiding deadly infections and viruses, and plan to open a
weekly clinic in Oak Park next month to offer them basic medical care.

The nation's aggressive "war" on drugs has failed to reduce the number of
addicts, isolated them from drug treatment and primary health care and
contributed to the spread of diseases such as hepatitis and AIDS, the
panelists argued.

"Twenty years from now, people will be asking how the hell we could have
done this to our fellow human beings," said Dr. Neil Flynn, a prominent UC
Davis infectious disease specialist.

While acknowledging that abusing drugs is unwise, Flynn and the other
panelists said some addicts cannot get access to treatment or simply choose
to continue their habits. For them, it makes sense to teach "safe
injection" and provide clean needles to prevent the spread of disease, they

"You would certainly love to see everyone practice abstinence," said Dr.
Jack McCarthy, who has treated heroin addicts in the Sacramento area for
more than 20 years. "But there are those who cannot be abstinent, and for
them we need another set of strategies."

The strategy puts them at odds with law enforcement officials, who
emphasized that needle exchange is illegal and said it could lead to more
drug abuse.

"We stand firmly against exchanging needles and showing people how to use
them," said Sgt. Jim Cooper of the Sacramento County Sheriff's Department.
"It's an unlawful act and there is no way we can condone it."

Cooper, a narcotics officer for nine years, said Flynn and the other
panelists "have only seen one aspect of this problem. They have not seen
the entire toll."

"Law enforcement is not the only answer, but neither is looking the other
way," Cooper said. Addicts should still be locked up for breaking the law,
but should also get help for their drug problems, he said.

Likewise, Sacramento Police Department spokeswoman Michele Quattrin said
needle exchange "sends the wrong message."

But Eric Reininga, who runs an outreach center called Harm Reduction
Services for drug abusers in Sacramento, said few treatment programs are
available for addicts who are indigent.

"Find me a drug program that will take you if you're a hard-core addict and
have no insurance," he said. "It doesn't exist."

Reininga's center, with help from UC Davis and a grant from the California
Endowment, a private health-care foundation, soon will launch a pilot
program to identify indigent people with severe drug problems, test them
for infectious diseases and provide those who are willing to undergo
treatment with "coupons" linking them to local programs.

Next month, addicts who are indigent will be able to get primary medical
care on Saturday afternoons at the center. Volunteers will run the UC Davis

The clinic will be named for Joan Viteri, a Sacramento woman who died last
year from an infection contracted as a result of her heroin habit, said
Chase White, a medical student leading the effort.

Viteri had no insurance and delayed getting medical help for a virulent
infection, White said. "The clinic will be founded with the belief and hope
that people like Joan will be served," he said.

Harm Reduction Services regularly scours the streets for addicts, providing
them with condoms, bleach, pamphlets about safe needle use and referrals
for medical care. Although the center does not hand out needles, it helps
link addicts to people who do, he said.

While needle exchange is illegal in California, it occurs in most larger
cities, police sources said. Flynn said the Sacramento Area Needle Exchange
provides some 150,000 clean needles each year to addicts in the Sacramento

The Clinton administration this week endorsed needle exchange as a way of
reducing the spread of AIDS and other diseases, but it refused to fund such

Copyright ) 1998 The Sacramento Bee