Needle exchange effort wins support New Haven program finds HIV down among addict clients

September 06, 1993|By Richard O'Mara | Richard O'Mara,Staff Writer

NEW HAVEN -- Four times a week a van rolls away from the city health department's outreach office here loaded with hope, charity and good intentions.

And needles. Lots of needles.

Aboard the van are three or four social workers. They are bound for the city's worst parts, determined to get these needles into the proper hands -- the shaky grasp of New Haven's heroin and cocaine addicts.

About 2,500 are so afflicted here, about 2 percent of the city's population, probably a lower rate than in Baltimore. Baltimore doesn't have a needle exchange program but, with political support from City Hall and, more recently, from Gov. William Donald Schaefer, seems headed in that direction.

In addition to the needles, the van carries little bottles of antiseptic bleach, pure water, condoms, alcohol wipes, cookers (little caps to heat heroin in), cotton -- just about everything an injecting drug addict might need to protect himself or herself from the HIV virus that opens the door of the body to AIDS.

These supplies are liberally dispensed -- free. Everything, that is, but the needles, which are very carefully dispensed -- but still are free.

Needles are bar-coded and numbered. An addict who brings in three old needles gets three new ones. One addict, an unhappy-looking man named Felix, thin as a stick figure, brought in 24 needles and left the van with 24 new ones.

"He's lost a lot of weight," community health worker Mark Kinzly observed of Felix, who has been exchanging needles at every opportunity for almost three years, though he doesn't appear likely to be doing it much longer.

"Every week we pick up the papers and see our own clients in the obituaries," said Dominick Maldonado, also a community health worker, "Last week, we lost two."

The van also carries literature, a library of pamphlets on the self-protective strategies against acquired immune deficiency syndrome.

Taken together, the van and its contents constitute the New Haven Needle Exchange Program.

This is what Mayor Kurt L. Schmoke wants to set up in Baltimore, or some variation of it. Now that Governor Schaefer has acquiesced, it is likely to come into being.

And it's none too soon, according to one of Mr. Maldonado's clients, who boarded the van in a neighborhood called The Hill and declared:

"Baltimore needs this program. When I lived in Baltimore near Erdman Avenue, I saw they got a lot of IV [intravenous] drug abusers there. It could save lives."

His name was Beep. Or at least that's the name he was registered under. Most addicts use code names and are encouraged to do so. One calls himself George Bush.

When Beep went to Baltimore with his girlfriend, he carried a little travel kit of clean needles and other necessities, because such things -- "works," the addicts call them -- are illegal in Maryland.

Sale of syringes legal

Not here. A year ago, encouraged by the success of the needle program in reducing the incidence of AIDS among addicts, the Connecticut Legislature legalized the sale of syringes without prescription by pharmacies. Now addicts have a choice: They can pay for their needles (about 50 cents each), or continue to get them free from the needle exchange.

The legalized sale of needles has reduced the traffic through the van by about half, said Mr. Maldonado. He is the soft-spoken boss on the van; he refers to the addicts as "clients" even as they call themselves "dope fiends."

Mr. Maldonado has been with the program since it began in November 1990, on a $25,000 grant from the Connecticut Legislature.

The start-up money was not surrendered readily. In fact, in 1988 when the New Haven Health Department asked the state for funds to set up the program, it got the same answer the Maryland General Assembly gave Mayor Schmoke.

"I was told flat out, don't come back," recalled William P. Quinn, head of the New Haven Health Department.

After about 1 1/2 years of hard lobbying by Mayor John C. Daniels, Police Chief Nick Pastore and the medical community, including doctors at Yale University's hospital, the legislature finally came across.

More positive choices

"From November 1990 to November 1991, 900 people enrolled in the program," said Mr. Quinn. "We expected 300."

To date, about 1,600 have registered. The monthly average of clients is about 300. Some have died; some have dropped out; others have made more positive choices.

"The number that is most pleasing to us is that one out of four of them have gotten into treatment," Mr. Quinn said. "People actually come to our needle-exchange vans and ask us to get them into treatment programs."

The New Haven needle exchange is not the first in the country, but it is the first legal one in the Northeast and the most thoroughly evaluated. Most of that was done by Professor Edward Kaplan of Yale's School of Organization and Management.

He showed that since the program started, the incidence of human immune deficiency virus infection among the participating addicts has dropped 33 percent as shown by testing of needles returned.

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