San Diego Grapples With Needle-Exchange Issue

To the things that set this region apart from most urban areas, add this: San Diego County has no official needle-exchange program for drug addicts.

The American Medical Assn., the National Institutes of Health, and the Centers for Disease Control and Prevention say such efforts can reduce the spread of disease without increasing drug usage, but San Diego’s conservative political leadership has been steadfast in its opposition.

A bill signed by Gov. Gray Davis in 1999 authorizes such programs, provided there is governmental oversight and they are part of a drug treatment effort.

Despite a dramatic rise in hepatitis C and fears among health professionals that the disease--commonly passed along by dirty needles--could spread to non-drug users, the needle-exchange issue is no longer under discussion at the all-Republican county Board of Supervisors, which sets county health policy.

The San Diego City Council in October took a tentative step toward authorizing a needle-exchange program. Council members, who set health policy in the state’s second-largest city, voted 5 to 2 to proclaim a state of health emergency because of the rising rate of hepatitis C and HIV infection.

But the first action taken in December by newly elected Mayor Dick Murphy and four new council members was to rescind that declaration, which under state law can be a precursor to a needle-exchange program.

“I’m not going to aid and abet criminal activities,” Councilman Jim Madaffer, elected in November, said last week. “I’m not going to give a gun to everybody so they can put in the bullets and kill people.”

The feeling among many San Diego politicians is that much of the nation--including Los Angeles, San Francisco and a long list of cities from New York to Honolulu--is following a dangerously misguided notion about drug use.

Needle-exchange programs “are simply wrong because they send a mixed message to our youth about the dangers of drugs,” said Board of Supervisors Chairman Bill Horn. “Neither the county nor I will ever aid and abet drug usage in this or any other way.”

Activists at the San Diego-based Alliance Healthcare Foundation, a nonprofit group involved in numerous public health issues, find the opposition of Horn and others dismaying. The group has been pressing for a needle-exchange program since 1993.

“We reside in a politically conservative community which does not view science as a way to make decisions to guide public health or safety decisions,” said Ruth Lyn Riedel, the foundation’s chief executive director and a former public health faculty member at the University of Washington. “They are more concerned about what they see as moral and ethical concerns.”

Riedel’s group has offered to pay for the program so that public money need not be spent.

Dr. Robert Ross, until recently the director of the county’s Department of Health and Human Services, told reporters near the end of his tenure that needle exchange was the most controversial issue he faced with the supervisors.

When he worked for the public health department in Philadelphia, he supported programs providing clean needles and syringes for addicts. When he worked in San Diego, he did not.

Despite the 4-4 vote last month by the council, the issue of needle-exchange programs in the city is not dead. The council established a task force whose members plan to visit needle-exchange programs in Los Angeles and Baltimore.

And, at the risk of arrest, health activists not linked to the Alliance Healthcare Foundation have run a clandestine needle-exchange program for several years. But without public support, the effort is limited.

Needle exchange has become an issue in a Feb. 27 special election to fill a vacancy on the council from the blue-collar 8th District, which includes downtown.

Although there could be other vote-shifting among council members, the 8th District winner could provide the fifth vote to reinstate or permanently abandon the health emergency proclamation.