Pubdate: Sat, 2 Nov 2002 Source: North County Times (CA) Contact: 2002 North County Times Website: http://www.nctimes.com Details: http://www.mapinc.org/media/1080 Author: Rob O'Dell Bookmark: http://www.mapinc.org/find?137 (Needle Exchange) NEEDLE EXCHANGE PROPOSAL TO SURFACE AGAIN RIVERSIDE -- Because of a rapidly rising number of cases of communicable diseases in the region, the county health director will again ask the Board of Supervisors to approve a controversial proposal that would allow intravenous drug users to exchange dirty needles for clean ones. On Tuesday, Director of Public Health Gary M. Feldman will ask the supervisors to declare a local health emergency in the 7,200-square-mile county that would clear the way for a needle-exchange program. After his last plea to the supervisors in July, he was told to come back to the board with more information. A 1999 state law requires the board to make the declaration before a pilot program allowing addicts to exchange dirty syringes for clean ones could begin in the unincorporated areas of the county. Los Angeles, Santa Barbara and Ventura counties have similar programs in place, as does the city of San Diego. "Dirty needles are the prime mechanism in transmitting hepatitis C and contribute to the spread of AIDS and hepatitis B," Feldman said Friday. "We have a genuine epidemic of hepatitis C in this county." AIDS is a disease that attacks the body's immune system, and hepatitis C is a virus that attacks the liver to the point where it cannot perform its normal functions. Both diseases can be transmitted through needles, and both can be fatal, although there have been no reported deaths directly related to hepatitis C in the county since it began tracking reports of the virus in 1998. Feldman said the idea is to exchange dirty needles for clean needles in hopes of limiting the spread of hepatitis C and AIDS to other users by sharing the contaminated needles. Regional health statistics indicate there are an estimated 12,000 intravenous drug users in the county. "We have lives being lost and people being put in jeopardy every day," Feldman said. The county first started recording data on hepatitis C in 1999, when 1,635 cases were reported. According to regional health statistics, that number has since jumped to 1,808 in 2000, and 2,092 in 2001, an increase of about 28 percent since 1999. An estimated 1,250 cases of hepatitis C that were reported last year stemmed from needle use, health officials said. More than 4,000 cases of AIDS were reported in the county between 1990 and 2001 with nearly 2,100 people dying from the virus between 1983 and 1999, health officials said. Proponents of needle exchange programs say they have been successful in controlling the spread of disease without increasing drug use, but critics, including many law enforcement officials, object to such programs largely on ideological grounds. When the needle exchange program was last proposed to the board in July, several supervisors were cool to the idea. Some felt that the program would send the wrong message about drugs to youths -- that the board condones drug use. Third District Supervisor Jim Venable said he is adamantly opposed to the needle exchange program because using drugs is illegal, and the county would be, in effect, promoting illegal activity. "Needles are illegal, to me the whole (program) is illegal," Venable said. He added that law enforcement has programs to deal with drug use. "I'm not voting for it, period." Sheriff-elect Bob Doyle and District Attorney Grover Trask have been opposed to the needle-exchange program because they say such programs condone illegal behavior and undermine anti-drug efforts in the community. "If you can't beat the system, that doesn't mean you join the system," Venable said. "I don't believe that. You keep plugging away until you fix the system." But Feldman said there is no evidence that the needle-exchange programs promote drug use, and he points to the fact that 60 percent of new hepatitis C infections and 33 percent of new AIDS infections stem from injection drug use. Feldman said AIDS and hepatitis B rates are also experiencing increases, and said rates of all three diseases will continue to rise unchecked in the intravenous drug using community if nothing is done. As a result, he said, more people will die. The exchange program would be administered by the Inland AIDS Project, a privately funded nonprofit group that provides services for people who have communicable diseases such as AIDS and hepatitis C. The program is expected to cost more than $100,000 annually, all of which would come from private sources because state and federal dollars cannot be used to operate such a program, officials said. Each needle costs about 5 cents. If approved, the program would take about four to six months to be implemented, Feldman said. The Inland AIDS Project would dispatch a mobile van, two days a week, four hours each day, to an area of the county where intravenous drug use is prevalent. The initial target area is expected to focus along a strip of unincorporated land between Lake Elsinore and Perris, where intravenous drug use is considered to be more prevalent than other sections in the county, officials said. Substance abuse counselors would also be available along with a variety of information on treatment programs and other preventative measures. - --- MAP posted-by: Doc-Hawk