Pubdate: Mon, 5 Jan 2004 Source: Ocean County Observer (NJ) Copyright: 2004 Ocean County Observer Contact: http://www.injersey.com/observer/ Details: http://www.mapinc.org/media/1212 Author: David G. Evans, http://www.mapinc.org/author/David+Evans Bookmark: http://www.mapinc.org/find?137 (Needle Exchange) NEEDLE EXCHANGE PROPOSALS FEATURE MANY FLAWS The New Jersey Legislature will consider bills to provide needles to drug addicts and needle give-away programs called "needle exchange programs." These programs give clean needles to addicts when the addicts return dirty needles. The concept is that, if addicts get clean needles, it will cut the spread of the AIDS virus HIV because addicts will not share dirty needles. These ideas, while well intentioned, will only cause more public health problems and divert resources from better methods of preventing the spread of AIDS. The science is uncertain. Supporters of needle exchange frequently gloss over gaping holes in the data -- holes that leave significant doubt about whether needle exchange decreases HIV transmission. It would be imprudent to take a key policy step on the basis of yet uncertain and insufficient evidence. Treatment should be our priority. Treatment has a documented record of reducing drug use as well as HIV transmission. Our fundamental obligation is to provide treatment for those addicted to drugs. Needle exchange should not be funded at the expense of treatment. HIV is transmitted primarily through high-risk sexual contact, even among intravenous drug users. Contrary to prior assumptions, a recently released 10-year study found that the biggest predictor of HIV infection for both male and female intravenous drug users is high-risk sexual behavior, not sharing needles. High-risk homosexual activity was the most significant factor in HIV transmission for men and high-risk heterosexual activity the most significant for women. The study noted that, in the past, we assumed that HIV-positive intravenous drug users had been infected through dirty needle-sharing. This study proves that this assumption is very suspect. Indeed, the use of needle exchange programs to address a problem caused primarily by high-risk sexual behavior would seem to be highly misguided. Needle exchange programs do nothing to ameliorate the impact of drug use on disadvantaged neighborhoods. Needle exchange programs are normally located in impoverished neighborhoods. These programs attract addicts from surrounding areas and concentrate the negative consequences of drug use in these neighborhoods, including criminal activity. HIV, regardless of how it is contracted, is not the primary cause of death for intravenous drug users. A study conducted at the University of Pennsylvania followed 415 IV drug users in Philadelphia over four years. Twenty eight died during the study. Only five died from causes associated with HIV. Most died of overdose, homicide, suicide, heart or liver disease, or kidney failure. Supporting needle exchange programs will send the wrong message to our children. Provision of needles to addicts may encourage drug use. The message sent by such government action would be inconsistent with the goals of our national youth-oriented anti-drug campaign. Most citizens oppose needle exchange programs in their communities, and are concerned about the prospect of dirty needles being discarded in public places. These fears are not without merit. Needle exchange programs distribute millions of needles every year, and there is little or no accountability for needles once they have been distributed. A survey showed that, in 1998, more than 19,397,527 needles were handed out, and at best 62 percent were exchanged, leaving 7 million to 8 million needles unaccounted for. Carelessly discarded needles create a well-documented public hazard. Needle exchange programs will only make a bad problem worse. We should focus instead on drug treatment and reducing high-risk sexual behavior. DAVID G. EVANS Pittstown - --- MAP posted-by: Richard Lake