Health Officer Sees Benefits in Free Needle Exchanges

Despite the potential controversy, Ventura County should consider starting a free needle-exchange program to help stem the spread of HIV virus and hepatitis among drug addicts, maintains a top county health official.

Public Health Officer Robert Levin said he is “seriously considering” suggesting county supervisors approve a plan to provide clean syringes to addicts. At this point, Levin added, he has found no good reason why such a program should not be instituted.

Supervisors from Los Angeles and Santa Barbara counties recently authorized similar programs by declaring public health emergencies. But in more conservative Ventura County, supervisors may be hesitant to engage in what some argue is an inducement to drug use.

“What is the need? Are we encouraging anything?” asked Supervisor John Flynn, who said he would be willing to consider the issue despite his concerns. “It’s a question that deserves to be answered.”

Although backed by the Los Angeles Police Department, such a program could prove unpopular with local law enforcement.

“I see what public health people are trying to do, but I also see it makes drug use safer, and that encourages use,” Ventura County Sheriff’s Sgt. Bob Garcia said. “From a narcotics officer’s perspective, that’s one less deterrent.”

This is the first time the Ventura County Public Health Department has so seriously considered such a program, versions of which have been in effect in San Francisco and Los Angeles for years. Recent legislation signed by Gov. Gray Davis in October, while not directly supportive of the programs, protects local needle exchanges from criminal liability.

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That law went into effect in January and is greatly watered down from a bill that would have combined needle exchange with drug treatment. It did, however, pique interest in the possibility of an exchange effort here.

“I’m serious about it, and I’m leaning in [the] direction” of recommending such a program, Levin said. “I’m concerned that anything can be a political hot potato, and part of my desire is to do this in a thoughtful, educational manner to make it as objective as possible.”

Levin cautioned it could be six months before he makes such a recommendation to the Board of Supervisors. He said he is searching for any potential downside to such a program.

Garcia said it was impossible to know just how many Ventura County residents are intravenous drug users. He added, however, that in a week his department makes 40 to 50 arrests for heroin possession. Most use needles to inject the heroin. Garcia estimated heroin possession represents as much as 25% of drug arrests.

Since 1983, about 10% of the 807 acquired immune deficiency syndrome cases in the county are directly attributable to intravenous drug use, said Edie Brown, director of AIDS Project Ventura County.

About 1,000 to 4,000 people are believed to be infected with the HIV virus in Ventura County, according to the county’s AIDS surveillance program, run by the Public Health Department. The department tracks the number of people tested at county clinics but its figures do not include those requesting confidentiality or those who are tested at private care facilities.

Backers say needle exchanges can be a tool both in solving a public health problem, and in forcing drug users to come into contact with on-site counselors who might be able to offer help.

But opponents argue such a program amounts to an endorsement of injected drug use, and fear the type of clients such an operation might bring to clinics. When Davis signed the bill last October, he warned such programs send “the wrong signal to our youth.”

Levin dismissed those concerns, and said several studies support such programs and do not suggest needle exchanges glamorize drug use or encourage new drug users. He cited endorsements from the surgeon general and various police agencies.

The Ventura County Sheriff’s Department has not taken an official position on the practice, spokesman Eric Nishimoto said.

“Our position is we won’t interfere with public health decisions,” he said. “We’re just going to continue enforcing the laws.”

But even some potential supporters say they are not convinced yet that such a program is necessary here.

“We don’t have anyone who can say, ‘You have 500 IV drug users here.’ [In Los Angeles], they have shooting galleries. Here, it’s done in private homes,” said Brown, who is also a member of the county AIDS Advisory Commission. “How many people are we talking about?”

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The commission, made up of political appointees, is studying the issue and will discuss it at a meeting Thursday. Levin, chairman of the group, would ultimately be responsible for recommending the Board of Supervisors first determine there is a public health emergency, as required by law.

Levin said he would not approve such a program in this county unless it included access to health care and counseling toward drug treatment or abstinence. He said it would not be expected to cost the county much, because nonprofit programs would be willing to step up and handle the service.

That is the way it happened in Santa Barbara County, where supervisors approved the program earlier this year. There, the policy passed with little fanfare or public outcry.

Before, “we would really have had to put ourselves out on a limb under paraphernalia laws,” said Rafael Cosio, who has run Santa Barbara’s program since June. “But, this isn’t a drug issue. It’s a public health issue.”