XSource: Rocky Mountain News XContact: October 30, 1997 Author: Michael Balfe Howard Note: Michael Balfe Howard is a former editor of the Rocky Mountain News. His column appears Thursday. Problem's never been needles, it's been the drugs. Geeze. Slam Fire. Shoot up. These are terms synonymous with injecting heroin or cocaine or some other illicit drug. They are not exactly household words unless ... If you're not familiar with the implication of these terms, ask your representative on City Council who soon might be asked to act on a plan to offer clean needles to drug addicts. Mayor Webb's health advisers believe, probably correctly, implementing a needle exchange program will reduce the spread of a number of communicable diseases, many of them fatal. Here's the rub: Anyone who has ever injected heroin knows that a dirty needle never is the problem. The problem always is the drug itself. The more you use, the more you need. The more you need, the more you use. The other inescapable fact: Illegal drug use and sex have a lot to do with one another. So there it is. Plain and simple, and the hell with B S about maintenance levels. Addiction exists in the body and the mind. Drug addicts themselves stopped caring about AIDS or hepatitis C a long time ago. Or A and B for that matter. What counts is the fix. The health department may care about dirty, dull needles, relatives and loved ones may care, but the drug user shares no selfsame concern. Are fatal diseases spread by sharing unclean drug paraphernalia? Of course they are. Does that mean we must pretend that four people didn't die of heroin overdoses within a week last month in Boulder alone? I am aware of the many arguments for legalizing drugs now sold illicitly, and invariably they seem selfserving, empty and void of discernment. One thing I also know is that nobody ever kicked a heroin or cocaine habit while simultaneously injecting drugs. Tapering off with some kind of Nicotrol patch is a delusion with which every drug addict lives. Such an idea is absurd. But try to tell the dogooders so. And you'll be deluged in a tidal wave of compassion like that demonstrated by the Swiss last month who gave a thumb's up to their government's efforts to make heroin more easily available for "the hardened addict.'' Every addict is "hardened.'' Lest anyone forget, Denver already has a foothold in the drug business with its methadone program. Methadone is the heroin substitute, which, of course, was the antidote to morphine addiction. Methadone is served up by health care professionals in a cup or vial in clinics around Denver. In the words of a former director of Denver's Health and Hospitals, "You might think of methadone as a kind of Prozac for drug addicts.'' Listen to the words of a recovered addict who used to buy it illegally on the street. "Methadone, well, it was not my favorite drug. But it would have been good. On second thought, a great one. A really potent narcotic if you had enough of it.'' According to a doc friend who never had trouble getting his hands on the drug, the only justification for a methadone program is that it may reduce some crime. "But you never get clean or sober on a methadone program. And in that sense, it is kind of a death sentence.'' So here we are, once again, with a societal tradeoff: condemnation to a life of drug dependency, methadone and attendant hopelessness, or clean needles. Boulder, San Francisco and 69 other enlightened cities already have instituted needle exchange programs. The justification: "harm reduction.'' What's that mean? Since drug use doesn't ever dissipate, the argument goes, its impact can be minimized. If that correlative doesn't work for you, try this, "Drug addicts are no different from the rest of the population. Some are very irresponsible. Some are very responsible.'' That's the opinion of Dr. Stephen Koester of the University of Colorado Health Sciences Center. But he should remember one thing: all drug addicts are unable to differentiate the true from the false. In that sense, one and all, they are pathological liars. While a City Council committee studies the needle exchange program, I wonder if the winos in town, you know, alcoholics, are going to lobby the city for an upgrade from Mad Dog to Jack Daniels and Stoly. For the truth is, as any physician can tell you, the latter highend brands of alcohol are a lot easier on the liver and innards than those cheap highpowered wines laced with red dye #2 or Vitalis or Listerine. What's next?