Pubdate: Thu, 15 Jun 2006
Source: Washington Blade (DC)
Copyright: 2006 The Washington Blade Inc.
Contact:  http://www.washblade.com/
Details: http://www.mapinc.org/media/1754
Author: Joshua Lynsen
Bookmark: http://www.mapinc.org/find?143 (Hepatitis)
Bookmark: http://www.mapinc.org/meth.htm (Methamphetamine)
Bookmark: http://www.mapinc.org/find?137 (Needle Exchange)
Bookmark: http://www.mapinc.org/rehab.htm (Treatment)

D.C. GROUP OFFERS NEEDLE EXCHANGE TO METH ADDICTS

Prevention Works Clients Are Mostly Gay White Men

When a methamphetamine user approaches Kristen Degan, she offers a 
practiced response.

She regularly welcomes meth addicts to Prevention Works, a privately 
funded program in D.C. that operates a needle exchange program and 
encourages addiction treatment.

Degan, a program assistant who specializes in meth issues, counts the 
number of needles brought to her, disposes of them, then provides an 
equal number of clean needles in return. She also gives meth users 
several condoms, towelettes and antibiotic ointment.

Then comes the clear but gentle reminder: Drug addiction treatment is 
available.

"We try to remind clients of this without sounding too pushy," Degan 
said. "If someone's not ready to go into treatment, treatment isn't 
going to work for that person."

About five minutes after clients arrive, they leave via the same 
alley door behind 1816 14th St. NW. The hidden entrance makes drug 
users more likely to visit Prevention Works.

"It's a pretty busy alley, so I think people feel pretty comfortable 
walking through it," Degan said, "but it feels really anonymous."

The anonymous alley entrance, fast turnaround and other practices are 
designed to make Prevention Works more accessible to users of meth 
and other drugs. The clean needles are designed to prevent the 
sharing of needles, which has been the source of HIV transmission for 
all sorts of IV drug users.

Meth addicts comprise a small, but growing number of the program's 
2,300 clients. The users -- predominantly gay white men ages 25 to 34 
- -- are known for their reluctance to trust programs like Prevention 
Works. That's left Degan and other staff members struggling to 
determine how Prevention Works can best help meth users.

"This is our current challenge," she said. "We're not exactly sure 
what their needs are."

Meth use linked to HIV

As more users seek help from Prevention Works, police are fighting an 
increase in meth use and trafficking.

D.C. Police Sgt. Brett Parson, commander of the Gay & Lesbian Liaison 
Unit, said meth is particularly a problem among the city's white gay 
population.

"For the most part," he said, "if you're gay and white in the 
Washington area, you probably know somebody who's using meth."

Parson said the drug, which gives users an intense high followed by a 
depressive crash, is a recurring factor in arrests.

"Chances are, if we're making a drug-related arrest in the gay 
community," he said, "meth is involved."

James Millner, the Prevention Works board president, said meth is 
particularly problematic for gay men because sharing needles can lead 
to the spread of HIV.

He said meth also gives users prolonged boosts in energy and sex 
drive. People under its influence are reckless, irrational, and 
unlikely to practice safe sex, he said.

Millner said Prevention Works has worked for years to keep meth users safe.

"The ability to be ahead of the curve rather than play catch-up was 
important," he said. "This was a good opportunity for us to slowly 
and methodically work with the clients and make our services into 
something they want and will use."

Although the Prevention Works staff was initially unable to reach 
meth users, Millner said, a connection eventually was made.

"They sought us out," he said, "which indicates that there is a 
willingness, and an ability to work with crystal meth users to do 
things that will protect them from HIV, and Hepatitis B, and other 
blood-borne illnesses."

Degan said meth users first exchanged their own needles, but now also 
exchange needles used by friends.

"People are really interested in keeping their friends safe," she 
said, "and we feel very fortunate that people who are using the 
program are trusting us."

Trust fosters conversation

With that trust, Millner said, comes an opportunity for Prevention 
Works staff to encourage safer choices.

"Eventually, the staff and the volunteers get to know who these 
clients are, and know more about who they are and where they are in 
their life," he said. "It can be a very personal -- a very detailed 
- -- conversation about what that client needs at that point."

But that bond takes time, Degan said. In the meantime, Prevention 
Works can only offer a standard reminder that treatment is available.

The American Medical Association officially "encourages needle 
exchange programs," but the practice remains unpopular and 
controversial among some lawmakers and other public officials. AMA 
research shows that programs like Prevention Works do not encourage 
illegal drug use, and can reduce drug use through effective referrals 
to drug treatment.

The Bush administration affirmed in 2001 that it would continue a 
Clinton administration policy of not allowing federal funds to be 
used to pay for needle exchange programs. But unlike the Clinton 
administration, Bush did not raise objections to Congress' decision 
to bar the District of Columbia from using its own taxpayer-generated 
funds to support a needle exchange program offered by the 
Whitman-Walker Clinic.

Whitman-Walker was one of the first D.C. groups to carry out needle 
exchange programs to curtail the spread of HIV among injection drug users.

Beginning in 1999, Congress began adding annual "riders" to the D.C. 
appropriations bill that prohibits the city from using its own funds 
to support needle exchange programs. Fearing a possible cut-off in 
federal grants for other programs, Whitman-Walker discontinued its 
needle exchange program and helped launch Prevention Works, which has 
carried out the program since that time using private funds.

In recent years, the Senate has dropped the D.C. funding ban for 
needle exchange programs in its version of the D.C. appropriations 
bill. But House Republican leaders have insisted on keeping the ban 
in place, and a House-Senate conference committee each year has sided 
with the House.

D.C. Congressional Delegate Eleanor Holmes Norton said she is hopeful 
that the House will eventually drop the ban.

Parson said some District police officers also question the practice. 
But he noted the core mission of Prevention Works is to help people, 
so police support the program.

"I think any organization that is trying to -- in any way -- work 
with people who are addicted," he said, "and help them to more safely 
lead their lives is doing a good thing."

Millner said he values the ongoing cooperation that Parson and other 
officers lend.

"This is a program that reaches people that we would never reach 
otherwise," he said. "There's a personal conversation that can happen 
because there's trust that's built up over time."

Millner said the program is important to Washington -- and gay 
residents -- and needs to grow.

"If we're talking about reaching 2,300 clients a year, that's maybe a 
fifth of what we should be doing," he said. "But we just don't have 
the resources to do any more."
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MAP posted-by: Beth Wehrman