The clean needle debate

August 12, 1991

The traditional battles against AIDS and drug abuse came under scathing criticism this week when the National Commission on AIDS pointed out the obvious: Dealing with these twin scourges separately is myopic. The commission found that a full third of AIDS cases in this country stem from intravenous drug use -- either through sharing of infected needles or through sexual contact with an HIV-infected drug user.

The commission recommended a practical approach -- expanded drug treatment programs linked with needle-exchange programs so that everyone who wants help can get it.

Therein lies the controversy. Although research has shown that needle-exchange programs can help combat both addiction and AIDS, they remain paralyzed by the stigma of seeming an implicit endorsement of drug use. The problem is compounded by a state law that makes distribution of clean needles illegal.

The state contends it needs more time to study the issue. One approach might be a pilot project like the one recently completed in New Haven, Conn., where 700 addicts were given clean needles when they returned dirty ones. Researchers found the rate of HIV contamination dropped significantly over the seven-and-half month period of the study, and they estimated new HIV infections were cut by a third.

A similar project in Maryland might not yield such impressive results, but the link between intravenous drug use and AIDS is so well-established that the state's mandate for seriously rethinking its current strategy ought to be abundantly clear.

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