- The Washington Times - Sunday, August 5, 2001

BALTIMORE Patricia Adams shuffles toward the gleaming Winnebago as it rolls to a stop near a weed-choked city lot.
It's the needle-exchange van, with its daily offering of free syringes to Baltimore's more than 50,000 trembling heroin addicts.
Miss Adams, who turns tricks to support a $50-a-day habit, draws the line at sharing needles. Too many of her friends have contracted AIDS and died that way.
"Thank God I'm still negative," said Miss Adams as she rifled through her purse for spent syringes to turn in for new ones. "I always use new tools, and I don't share."
But the half-dozen junkies gathered this afternoon at the corner of Westwood Avenue and North Mount Street are the exception, according to a study published this month in the Journal of Acquired Immune Deficiency Syndromes.
As part of an HIV study of 1,600 persons who either use drugs or know people who do, 740 reported injecting drugs.
About 85 percent of the drug users said they buy their own needles which could be contaminated with HIV or hepatitis C from questionable sources, Johns Hopkins University researchers found.
Only 4 percent said they obtain needles exclusively from the city's $200,000-a-year needle-exchange van, said Carl Latkin, the Hopkins professor who headed the study.
Nearly one-third got needles from four different sources.
And a quarter of respondents said they sold needles to others. Of those, four out of five said it was easy to fool customers into thinking a used needle was new.
"The vast majority of people are getting needles off the street," Mr. Latkin said. "It's cause for concern.
"[The needle exchange] is giving out huge numbers of needles. There are just huge numbers of drug users. The demand really outstrips the supply."
Part of the problem is the needle exchange program is not convenient enough for addicts, who buy needles for $1 from other users trying to raise money, Mr. Latkin said.
The city's public health officer, Peter Beilenson, said he had not read the study but said the 7-year-old program appears to be successful it hands out more than 1 million needles a year.
"I don't know what they're talking about," Mr. Beilenson said. "I can tell you we have 13,000 enrollees, so people are using it. We're the sixth-busiest needle exchange in the country."
Nationwide, emergency room visits following drug use rose to a record high of more than 600,000 last year, spurred by an increase in heroin-related visits.
Throughout the 1980s and 1990s, Baltimore ranked among cities with the most visits. But the numbers dropped last year from 14,172 cases to 11,505, the Substance Abuse and Mental Health Services Administration reported last week.
Part of Baltimore's decline is due to increased treatment centers and the needle-exchange program, which helps save lives, Mr. Beilenson said.
The mobile needle-exchange program has grown since 1994 from two daily stops to 12, program specialist Lamont Coger said.
It takes in used needles from 300 to 400 people a day and exchanges them for new ones, Mr. Coger said.
Needle-exchange workers also conduct AIDS tests and pass out condoms, tourniquets and clean heroin "cookers" along some of the meanest streets in Baltimore.
On a recent outing in west Baltimore, drug dealers mingled with addicts who scurried from the van with new drug paraphernalia.
"Look out on that corner," said Mr. Coger, pointing through the window of the van. "They're selling drugs out there. That ain't a social gathering.
"We give them everything they need to inject drugs safely, except the drugs."
The concern is that HIV and hepatitis C are highly infectious and can be transmitted through used needles.
Mr. Latkin said 60 percent to 80 percent of all users have potentially deadly hepatitis C. The city's research indicates that 30 percent of intravenous drug users have HIV, the virus that causes AIDS, Mr. Beilenson said.
Mr. Latkin said a cure for the problem would be to require syringe makers to add safety seals or wrap all syringes individually, making it difficult for needle sellers to pass used needles off as new.
Spending more on programs like the needle exchange could also help.
"Such a change may cost a bit more, but clearly has the potential to decrease transmission of HIV and other blood-borne diseases and save lives," Mr. Latkin said.

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