Pubdate: Wed, 26 Jul 2006 Source: Mountain Xpress (Asheville, NC) Copyright: 2006 Mountain Xpress Contact: http://www.mountainx.com/ Details: http://www.mapinc.org/media/941 Author: Michael Harney MAKE HARM REDUCTION THE GOAL Though appreciative of the June 28 Mountain Xpress commentary, "Consider This: Low-cost Solutions to the AIDS Crisis" by Brian Elderbroom of the Common Sense Foundation, complete credit [should not] be given to the efforts of the Needle Exchange Program of Asheville for lower HIV-infection rates or case numbers in Western North Carolina. As coordinator of NEPA since its 1994 inception, I know that we have reached only a small [portion] of the actual number of [intravenous] drug users in the region. We exchange several hundred needles per month on average [through] our continual but illegal operation - illegal due to the inability of the North Carolina General Assembly to enact any of the bills introduced over the years that would have made needle exchange legal. Brian is correct that "North Carolina law prohibits needle exchange programs, despite the overwhelming research demonstrating their effectiveness." The most current legislative effort, HB 411, stipulates four criteria to be met before any North Carolina county may operate a needle exchange program. Even before the bill has passed, Buncombe County demonstrated that it could meet three of them, and Guilford County demonstrated that it could meet all four. Still, our General Assembly men and women are not swayed to vote in favor of this scientifically proven HIV/hepatitis-prevention education strategy. We [could] amend our paraphernalia laws in reference to injection equipment, potentially saving millions of health-care dollars [for] treatment and care of newly infected people each year. The savings in paying for prevention efforts up front far exceed the cost of care as a result of new infections (estimated by the N.C. Department of Health to be $300,000-plus per HIV infection). Moreover, NEPA has never advocated for state funding. Private funding sources exist; North Carolina just has to make the operation of needle-exchange programs legal. So, I am grateful to Brian for his piece in this paper, but I am also grateful to the many local businesses that provide distribution access to free condoms and other accoutrements of HIV/STD/hepatitis prevention and education. Finally, though a bit ironic, gratitude must be given to the ever-present and overly employed crack pipes in Asheville. You see, as crack [became] the more accessible drug-of-choice in WNC, fewer people have been injecting drugs. Crack use may lead to behaviors (including unprotected sex) that pose risks for HIV/STD/hepatitis, but crack moves us away from needle use. I am still in favor of providing clean needles to folks who cannot access them. I will always be that advocate. [But] there are other HIV/STD/hepatitis-prevention efforts and variables helping to keep our numbers low. Think of harm reduction as the goal. Accept people where they are on that spectrum. Support healthy interventions like comprehensive needle-exchange programs, and let's continue to move forward with other important issues facing our communities. Michael Harney NEPA Coordinator Asheville - --- MAP posted-by: Richard Lake