Riverside County to Air Needle Exchange Bid

Noting a surge in hepatitis C, Public Health Officer Gary Feldman is urging the Riverside County Board of Supervisors to give drug addicts access to clean needles.

The proposal pits the county’s top health officials against the sheriff and district attorney. Today, both sides will meet when the Board of Supervisors debates whether to allow a needle exchange program and whether to support proposed state legislation letting pharmacies sell syringes without a prescription.

“Everybody is polarized by the needle,” said Supervisor Bob Buster, who is skeptical about the merits of needle exchanges but favors a pilot program. “A needle is a powerful symbol for the underworld and drug use.”

Needles are often shared by drug addicts, spreading deadly blood-borne diseases such as hepatitis C and AIDS. Since the mid-1980s, programs that allow dirty needles to be swapped for clean ones have been established in cities across the nation. There are more than two dozen in California, including in Los Angeles, San Diego and San Francisco. The programs also offer disease tests and treatment referrals. Riverside County is home to an estimated 12,000 intravenous-drug abusers, according to the county Community Health Agency. About 60% of hepatitis C cases and 23% of AIDS cases across the county can be attributed to sharing syringes, rates higher than the state’s, according to county and state documents.

Backed by physicians and other health-care advocates, Feldman has twice urged the board to declare a public health emergency and allow a needle exchange program in Riverside County. Both times, his efforts have been fought by law enforcement leaders who say such programs promote drug abuse.

“Police and prosecutors know from our experience that needle sharing occurs as part of the drug culture, even when addicts have unused needles available,” said Dist. Atty. Grover Trask. Needle exchange, he said, “condones drug abuse and it mocks ... drug treatment.”

Experts are divided.

“There’s not a shred of evidence that it promotes drug use,” said Arthur L. Reingold, an epidemiologist and director of the Center for Infectious Disease Preparedness at UC Berkeley. “There’s no evidence that people start injecting drugs because needles are available.”

Feldman said the disease prevention benefits are not limited to drug abusers, because the infections they pick up are passed along to the general population. “It’s not as if the drug users aren’t sons, mothers, fathers and everyone else,” Feldman said. “They interact with non-drug users every day.”

But other physicians point to studies in Canada and elsewhere that they say show increased infection rates among exchange participants.

“The sad part of harm reduction is that it gives up on the drug addicts,” said Dr. Eric Voth, a Topeka, Kan., addiction specialist and chairman of the Institute on Global Drug Policy, of St. Petersburg, Fla. “The most compassionate thing we can do is try to separate the drug addict from the drug use.”

A panel formed by the Board of Supervisors to consider a needle exchange program is scheduled to deliver its report today. It will be a tough sell.

“I am absolutely against it,” said Supervisor Jim Venable. “I’m a very simple person -- what’s right is right and what’s wrong is wrong. Period. No middle-of-the-road situation when it comes to obeying the law.”

Feldman is pessimistic. “This board is not ready to endorse a needle exchange program,” he said.

As a backup, he’s trying to get the county panel to support state legislation that would allow pharmacies to sell 30 syringes at a time without a prescription. The bill, by state Sen. John Vasconcellos (D-Santa Clara), was approved in the Senate last week, and will soon be heard by an Assembly committee.