Needle-Exchange Program Held Useful in Fighting AIDS, Drugs

An experiment in providing free needles to drug addicts not only reduced unsafe practices that transmit the AIDS virus but resulted in more addicts seeking drug treatment, a health official involved in the nation’s first needle-exchange program said Tuesday.

“I can’t emphasize enough the fact that nothing else works to reach these people like the exchange program,” said Holly Hagan, an epidemiologist for the Tacoma-Piece County Health Department in Washington state, in testimony before the House Government Operations subcommittee on human resources.

“We have observed statistically significant reductions in the mean frequency of obtaining and injecting with used syringes, and in the rate of passing on used syringes to other persons,” she added. “Sterilization with bleach has also increased.”

Needle-exchange programs, which are operating in fewer than a half-dozen U.S. cities, have met considerable opposition on the grounds that they condone or promote illegal drug use.

But Hagan said that the Tacoma program, which began in January, 1989, has neither caused an increase in illegal drug use nor encouraged individuals to begin injecting drugs.

“The rate of injection of persons using the exchange has remained stable,” Hagan said. “In fact, more persons decreased their drug injection than increased it.”

She said that participants in the program, who number 400 to 600 persons each week, “have been injecting drugs for an average of 15 years.”

Moreover, she called needle exchange “an effective bridge to drug treatment,” saying that more than 350 persons have entered drug treatment programs through the efforts of an outreach program operated in conjunction with the needle exchange.

“Sterile syringes bring them to us and there they are met by our highly skilled outreach workers who they see every day at the exchanges,” she said. “Rapport is built, and then the exchange users begin to trust. That’s when we can recruit them into drug treatment and offer help for them to redirect their lives.”

She called the program “our community’s model for public health strategies designed to reach people whose illegal lifestyles put them at risk of serious illness, but who are unable or unwilling to seek help.”

Meanwhile, a report released Tuesday by the Office of Technology Assessment, a nonpartisan analytical agency that serves Congress, said that methadone treatment programs can reduce intravenous drug use “and the risky behaviors” associated with HIV transmission, but that “methadone’s potential is not being realized.”

The OTA report said that policies to control the AIDS epidemic “must recognize” that only 10% to 20% of the estimated 1.1 to 1.8 million drug users in this country are in treatment programs at any one time. The report recommended that methadone and counseling be provided to intravenous heroin addicts who are on treatment waiting lists.