Source:   Chicago Tribune
Contact:    August 24, 1997 Sunday

IT'S TIME TO RETHINK THE BATTLE PLANS; GIVE NEEDLE EXCHANGE A CHANCE

By:  Clarence Page. 

Dateline: Washington

   Holding up a fist full of hypodermic syringes, Gary Bauer, president of
the Family Research Council, declared needleexchange programs to be "a
dopey  idea."

If so, there must be a lot of  dopey  people around these days.

   Take, for example, the American Medical Association, the American
Public Health Association, the U.S. Centers for Disease Control and
Prevention and the  American Academy of Pediatrics. All of them have
endorsed programs that provide  clean needles and syringes in exchange for
HIVcontaminated needles and syringes.

   Boy, what a bunch of dopes.

   Or take the British medical journal, The Lancet. It published a
fiveyear study in its June 21 edition that found the number of HIV
infections rose 5.9 percent in 52 cities that did not have needleexchange
programs and dropped 5.8  percent in the 29 cities that did have
needleexchange programs. The net difference: "cities with needle exchange
had 11 percent fewer cases of HIV infection each year than cities without
the programs."

    Dopey,  right?

   A few months earlier, the same magazine published another study that
found Americans could have saved between $250 million and $500 million in
healthcare  costs with the HIV infections that could have been prevented,
if only the U.S. had a needleexchange program similar to the one in
Australia, which has embraced the idea.

   Yep, the dopes are everywhere. The same day Bauer declared needle
exchanges to be a  dopey  idea, Rep. Nancy Pelosi (DCalif.) announced a
bill to end the government's 9yearold ban on federal funding for
needleexchange programs.

   This came after a recent pronouncement by Health and Human Services
Secretary Donna Shalala that needleexchange programs really do slow the
spread of the HIV virus. I guess that makes Pelosi and Shalala dopes, too.
So, then, are all those mayors in the U.S. Conference of Mayors who
recently called for an end to the ban.

   On the other side, 10 states still ban such programs, and Bauer
unveiled a new poll that shows 62 percent of Americans oppose
needleexchange programs.

   That didn't surprise me, since most Americans don't know very much
about these programs. But other polls indicate that, the more they know,
the more they like the idea.

   Those  dopey  needle exchange programs have been around for about a
decade, plenty of time to study their effectiveness. So far, at least a
dozen major studies show that the programs reduce the spread of the HIV
virus and I have yet to find one that shows they encourage new drug users,
unless it's being repressed by some  dopey  conspiracy in the medical
community.

   Quite the contrary, once the needleexchanging drug users have been
lured up  out of the drug underworld, many have been lured right into
treatment and rehabilitation programs to help them kick their habits.

   Mohammad N. Akhter, executive director of the American Public Health
Association, found that out in 1993 when, as health commissioner for the
District of Columbia, he proposed a needleexchange program. When the
District's council heard that idea, the proverbial stuff hit the fan.

   So, Dr. Akhter worked out a compromise that provided needles only to
those who signed up for drug rehabilitation, for which there was a waiting
list several months longas the waiting lists are in every American city.

   After a couple of years the program proved to be so effective at
reducing the spread of the HIV virus and the almostasdeadly hepatitis B
virus that the council extended the needle program to drug users who were
not signed up for treatment.

As a result, many were lured into treatment who otherwise might not have
been reached, all because of the needleexchange program. "If we had
enough drug treatment and rehabilitation facilities, we would not need
needleexchange programs," said Akhter. "I know (needle exchange) is not
the best choice, but all the other choices are worse."

   So he supports the  dopey  idea, he says, just because it works,
because there are not enough treatment facilities, and because many
innocent lives are at stake.

   Meanwhile, I find it curious that so many of the same people who oppose
needleexchange programs also oppose spending any additional money to
reduce the long waiting lists faced by lowincome drug users who want
treatment but can't get it.

   Yes, the idea of providing clean needles to junkies sounds pretty
dopey,  all right.

   But not as  dopey as some of the people who oppose the idea.