Pubdate: Wed, 09 Feb 2000
Source: Washington Post (DC)
Copyright: 2000 The Washington Post Company
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Author: Paul Schwartzman, Washington Post Staff Writer

OFFICIALS CONSIDERING NEEDLE EXCHANGE

When Prince George's is compared with Baltimore and other large cities, the
number of people suffering from AIDS- and HIV-related illnesses is
relatively low.

But the county's caseload is still high enough that County Council member
Thomas R. Hendershot (D-New Carrollton) last week proposed that Prince
George's create a needle exchange program that would allow drug addicts to
trade dirty needles and syringes for clean ones. The proposal, which has
provoked sharp disagreement among council members, has forced the council
onto murky political ground, particularly in a county with a vibrant
religious community. Health experts endorse needle exchange programs as a
way to reduce the spread of AIDS; critics argue that such initiatives
encourage drug use.

As a reflection of the council's wariness, Chairman Dorothy F. Bailey
(D-Temple Hills) last week took the unusual step of asking lawmakers to
delay for three weeks a health committee review of the bill so that she can
have three public forums on the issue.

"I want to take it to the community and talk about it," said Bailey, who is
leaning toward supporting the bill. "I want to hear from the faith
community because they're opposed to it. They may hear it as a promotion of
drug use."

Hendershot's proposal would allow intravenous drug users a one-for-one
exchange of dirty needles and syringes for sterile ones. The program would
be administered by the county's Board of Health and would cost $300,000 to
$400,000 annually, he said.

Hendershot's bill has drawn enthusiastic support from at least one council
member, Peter A. Shapiro (D-Brentwood). Others and County Executive Wayne
K. Curry (D) have said they want more information before they commit their
support. "I'm open to it," Curry said. "There is probably a public health
argument to be made, and I'm pragmatic about our needs."

Two council members, Isaac J. Gourdine (D-Fort Washington) and Walter H.
Maloney (D-Beltsville), are staunchly opposed. "The mere fact that you
provide people with needles to use drugs, I think in itself is wrong,"
Gourdine said. "Knowing the damage that drugs do to communities and to
individuals, it could give the impression that government is condoning the
use of drugs, and I would not want that to be interpreted that way by young
people."

Maloney said he fears that the program will draw drug addicts to Prince
George's from outside the area. "It will bring a lot of addicts into the
county," Maloney said. That's a contention health experts deny. He also
said that asking health officials to distribute needles for drug use is
tantamount to encouraging illegal activity. "It's aiding and abetting," he
said.

The issue first surfaced last fall after Curry asked the council to assess
the need for a needle exchange program in Prince George's. In 1998, the
Maryland General Assembly authorized the county to begin one as a way to
stem a rise in HIV cases.

As part of the council's review, the members heard a presentation on needle
exchange programs from the county's health officer, Arthur Thacher, as well
as experts from Baltimore, which has its own program.

Prince George's, which had 3,267 AIDS cases last year, is second in the
state behind Baltimore, which had 19,693, according to statistics from the
county's Health Department. Intravenous drug users account for about 30
percent of the AIDS cases, Hendershot said. Health officials have no
estimate for how much demand there would be in the county for a needle
exchange program.

HIV experts, such as Steffanie A. Strathdee, an associate professor at
Johns Hopkins School of Public Health who monitors Baltimore's needle
exchange program, said there is ample evidence that such programs have
helped reduce the number of AIDS and HIV cases in cities such as Toronto
and Vancouver, B.C. In Baltimore, she said, the HIV caseload has declined
35 percent since 1994 as a result of a needle exchange program.

And there is no evidence, she said, that needle exchange programs encourage
drug addicts to move to an area where they can get clean needles. "Drug
addicts move to a location to get drugs," Strathdee said. "They don't move
there for needles."

Shapiro said the legislation is a flawed, yet effective way of saving
lives. "Anything we can do to stop the spread of AIDS is the right thing to
do," he said. "This does not promote drug use; it stops the spread of HIV.
It's the ethical thing to do."

Council member Marvin F. Wilson (D-Glenarden) said as a short-term
solution, a needle exchange program makes sense.

"Some may think you're supporting people with a habit, but that's not our
intent," he said. "Our intent is to buy time, until we find something to
help them get off it. It's a sickness. You're not going to win with
everyone, but if you save a few, it's worth trying."
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