Needle exchanges found to be effective Expand programs, U.S. study urges

October 01, 1993|By New York Times News Service Staff writer Jonathan Bor contributed to this article.

WASHINGTON -- The federal government's first comprehensive study of whether giving clean needles to addicts can help prevent the spread of AIDS has concluded that it does and that the government should finance a significant expansion of such programs.

The panel reviewed programs in the United States, Canada and Europe in which drug abusers can turn in a used needle and get a fresh, sterile one. The chief object of these programs is to end the drug abuser's need to share syringes that may have become contaminated with blood carrying the human immunodeficiency virus.

The panel concluded in its report released yesterday that needle-exchange programs have not resulted in any measurable increase in drug abuse in their neighborhoods. It also found that addicts in exchange programs share needles less often and are more likely to clean their needles with bleach.

Needle-exchange programs in the United States have been in a legal limbo over the past five years. A patchwork of state and federal laws, including a ban on federal financing of such programs and state laws that prohibit the possession of needles or purchase of needles without a prescription, severely restrict such initiatives in 47 states and the District of Columbia.

Despite that, there are at least 37 programs around the country, the report said. Fourteen operate illegally, although sometimes with local government support. The programs that are legal either operate in states where needle-exchange prohibitions do not exist or where special exceptions have been written into law.

Between them, these programs have given out more than 5.4 million needles since they began in 1988.

But to make a significant impact on the AIDS epidemic, said the lead author of the study, Dr. Peter Lurie of the University of California at San Francisco, hundreds of millions of clean needles would have to be dispensed.

"Cities with HIV infection rates as high as Baltimore's would benefit greatly from having such programs," said Dr. Lurie.

The study comes at a time when the administration of Mayor Kurt L. Schmoke plans to launch a pilot program that would distribute clean needles to about 1,000 drug addicts in Baltimore, where about a quarter of the estimated 40,000 intravenous drug users are infected with HIV.

Public health officials have been eager to try exchange programs as the infection has continued to spread among drug abusers. Of the more than 300,000 Americans with acquired immune deficiency syndrome, one-third are believed to have been infected either through contaminated needles or through sex with an infected addict.

Needle-exchange programs have often been opposed by community and church groups who fear they will foster drug abuse or attract addicts. The study will bolster the argument that the programs reduce needle sharing without increasing drug use. The panel noted that needle-exchange programs reach and provide care and education to many addicts who otherwise have no contact with medical and social programs.

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