Pubdate: Sat, 10 Jun 2006
Source: News Journal (DE)
Copyright: 2006 The News Journal
Contact: http://www.delawareonline.com/newsjournal/opinion/index.html
Website: http://www.delawareonline.com/newsjournal/
Details: http://www.mapinc.org/media/822
Author: Cris Barrish
Bookmark: http://www.mapinc.org/coke.htm (Cocaine)
Bookmark: http://www.mapinc.org/find?143 (Hepatitis)
Bookmark: http://www.mapinc.org/heroin.htm (Heroin)
Bookmark: http://www.mapinc.org/find?136 (Methadone)
Bookmark: http://www.mapinc.org/meth.htm (Methamphetamine)
Bookmark: http://www.mapinc.org/find?137 (Needle Exchange)

TO STOP AIDS 'BREEDING GROUND' NEEDLE EXCHANGE A MUST, MANY SAY

While Politicians Bicker, More Intravenous Drug-Related Infections Occur

Empty bags of heroin, orange syringe caps, needle plungers, spent 
lighters, stainless steel cooking spoons, bloody clothes and used 
condoms -- all surround a tattered bed in an abandoned Wilmington row house.

The second-floor bedroom, stinking of urine and feces, has long been 
a hideaway for drug addicts and prostitutes. Earlier that day, a 
worker clearing out the property had thrown out more than a 
half-dozen dirty hypodermic needles. In a nearby alley, a rusting 
needle lay in the wet dirt.

Basha Closic, a drug prevention specialist, winced as she tiptoed 
through the house in the city's Hilltop neighborhood, calling the 
mess a biological hazard and "breeding ground" for HIV/AIDS, 
hepatitis C and other infectious diseases.

"There's a bed for sex, needle sharing going on, and probably 
contaminated fluid all over the place," said Closic, program director 
at Brandywine Counseling in Wilmington.

To Closic, the decadence at the West Fourth Street "shooting gallery" 
is a textbook illustration of why Delaware needs a needle-exchange 
program for intravenous drug users.

Delaware remains one of only two states that does not have a program 
that allows drug users to swap used needles for sterile ones or to 
buy syringes in pharmacies without a prescription. The other is New 
Jersey, where Gov. Jon Corzine is trying to start a program.

HIV/AIDS infections from dirty needles is a major problem in 
Delaware. Through 2004, 48 percent of the state's AIDS patients were 
intravenous drug users or people who had sex with them -- fourth 
highest in the nation -- according to the Kaiser Family Foundation, 
which studies U.S. health issues. The national average is 31 percent.

In 2004, Delaware had the nation's sixth-highest AIDS infection rate 
from all causes, the foundation reported.

Closic and other advocates of needle exchange argue that if more 
addicts had access to clean needles, fewer people would contract HIV, 
the virus that causes AIDS. They also point to studies showing that 
infection rates drop and injection rates do not rise when addicts 
have ready access to clean needles.

Said Closic: "A stack of sound scientific data proves this works."

Police chief criticized

For nearly a decade, proponents of such a program in Delaware, led by 
state Sen. Margaret Rose Henry, have pleaded with lawmakers to 
approve one. Last May, Henry achieved a victory of sorts when her 
bill to start a pilot program in Wilmington, where heroin and cocaine 
are sold openly in some areas, passed the Senate 16-4. The bill is 
supported by Gov. Ruth Ann Minner, the state Division of Public 
Health and Wilmington Mayor James M. Baker.

But in the year since Senate passage, the bill has languished in the 
state House of Representatives, prevented from a hearing before the 
entire body by powerful foes such as Majority Leader Wayne A. Smith, 
R-Clair Manor.

Smith said needle exchange would condone and possibly increase 
intravenous drug use. "It totally defeats the message we have in 
trying to get young people not to use drugs anytime, anyhow, 
anywhere," he said.

But Smith may be losing his grip on the bill. On Friday, Speaker of 
the House Terry Spence, R-Stratford, guaranteed the bill will be 
debated on the House floor later this month.

Even though the program could reduce the spread of AIDS, which costs 
as much as $190,000 to treat one patient, Smith said he could not 
"excuse some behavior that is illegal under our code because there 
might be a health benefit."

Smith points to opposition by Wilmington police Chief Michael J. 
Szczerba as a key reason for his objection. Szczerba's position, 
however, differs from Baker and City Council, which passed a 
resolution supporting Henry's bill.

"He's in the dark ages about it," Henry said of Szczerba.

Szczerba, who said he is simply trying to save lives and stem the use 
of needles, bristled at the senator's characterization.

"If that puts me in the dark ages, I'll stay in the dark ages. This 
proposal would condone or facilitate illegal and dangerous activity 
but now you can add deadly to that," said the chief of Delaware's largest city.

Szczerba was referring to recent batches of heroin laced with the 
powerful sedative fentanyl, which is suspected in at least seven 
Delaware deaths.

Closic countered that the fentanyl cases demonstrate that users are 
going to inject heroin, methamphetamine and cocaine -- no matter the 
consequences -- and only strengthened the argument to provide clean needles.

"They are not stopping," Closic said. "They are addicts, and they are 
going to shoot up and we need to offer them a safe way."

'A ridiculous argument'

Aaron DeMaris, a recovering heroin addict who has used dirty syringes 
and is now in a methadone treatment program in Wilmington, agreed 
with Closic and many experts about the merits of needle exchange. A 
few years ago, DeMaris was in such a program in Rochester, N.Y.

Officials there gave users 12 clean needles, DeMaris said. "For each 
one you turn in you get two back," he said. "If you don't return them 
you don't get more needles. They are not laying on the streets for 
kids to find. It reduces the transfer of the disease."

DeMaris, 33, was astounded by the suggestion that needle exchange 
could lead more people to inject drugs.

"Nobody is going to say, 'Just because I can get a syringe, I'm going 
to start shooting dope,' " DeMaris said. "It's asinine, just a 
ridiculous argument."

Jon Willis, 56, a heroin addict who has used dirty needles, said he 
has seen friends die from AIDS after contracting the disease from shooting up.

"It's very important to be able to trade in needles, especially with 
the AIDS going around," he said. "Most people just throw them on the ground."

One addict and former prostitute, who spoke on the condition that she 
be identified only as Sally, said she has used old needles "but by 
the grace of God" has not contracted HIV.

"If you buy needles [on the black market], you don't know for sure 
that they are clean," she said. An exchange program would assure 
users "they won't get HIV or spread it around."

The three-year pilot program, which would be overseen by the Division 
of Public Health, also would offer counseling and treatment programs. 
"It can be a gateway to other services," said Paul Silverman, deputy 
public health director.

Baker understands Szczerba's concerns, but added, "Every effort we 
can make to save lives we should take."

Minner, in a written statement, also touted economic benefits of the 
program, which would cost $315,000 the first year for a specially 
equipped van, supplies and salaries for social workers and counselors.

"Drug users who contract HIV/AIDS ultimately end up needing expensive 
medical care at taxpayer expense," the governor said. "It is 
important that Delaware implement this program for the safety and 
benefit of our residents."

'Got to do something'

President Bush, whose administration will not fund such programs, has 
said they "signal nothing but abdication."

But advocates such as Bill Piper, director of national affairs for 
the nonprofit Drug Policy Alliance, said numerous studies have shown 
such programs are proven winners, noting that the American Medical 
Association and federal Centers for Disease Control and Prevention 
support improved access to clean syringes.

One report, by the National Institutes of Health Consensus Panel on 
HIV Prevention, said "an impressive body of evidence suggests 
powerful effects" from exchange programs. Those benefits include a 
reduction in risky behavior as high as 80 percent, and estimates of 
at least 30 percent reduction in HIV cases in intravenous drug users, 
the report said.

Those who think otherwise are misinformed, Piper said. "They are like 
people who think the Earth is flat despite all the science," Piper 
said. "A lot of things in drug policy are debatable, but needle 
exchange is not one of them. It reduces the spread of AIDS without 
increasing drug use."

A May report by the alliance said 185 programs are operating in 36 
states as well as Washington, D.C., Puerto Rico and American Indian lands.

Henry, who represents some of Wilmington's hardest-hit areas, said 
the program would be a savior for the city, especially the black community.

In Delaware, where 19 percent of residents are black, 66 percent of 
AIDS patients through 2004 were black, sixth highest in America. 
Nationwide, blacks comprise 12 percent of the population but 40 
percent of AIDS patients. The AIDS figures are from the Kaiser Family 
Foundation.

"I am desperate for this to pass the House," said Henry, D-Wilmington 
East. "People are going to use dirty needles. And so much of the AIDS 
women have is from sexual relations [with needle users]. It will save 
unborn babies from getting AIDS. And it's not just an issue in 
Wilmington, but in Greenville and everywhere. AIDS doesn't discriminate."

Needle exchange has won the support of traditional legislative 
hardliners like Sen. Robert Venables, D-Laurel, and Rep. Dennis 
Williams, D-Wilmington North, a former city police detective.

"If it's going to reduce the spread of AIDS, we've got to do 
something," Williams said. "I'm sure guys are lying and saying they 
are not having sex with anybody else. I have no recourse but to support it."

Venables, who called Smith "hardheaded," said common sense told him 
to vote for needle exchange. "I don't know what else you can do," 
Venables said. "It's certainly not working the way we're doing it."
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MAP posted-by: Beth Wehrman