[Hpn] Few Inroads for Needle-Trading Programs
Sat, 23 Jun 2001 16:34:04 -0700
The New York Times
June 23, 2001
Few Inroads for Needle-Trading Programs
By CAREY GOLDBERG
LYNN, Mass., June 20 ‹ That February night, Gary Langis was doing his usual
thing. That is, he was delivering sterile hypodermic needles to two heroin
addicts here, and picking up dirty needles to be sure they were disposed of
A former addict himself, whose wife died of AIDS she contracted from drug
use, Mr. Langis said he felt compelled to make such deliveries often,
working with an underground group of needle-exchange volunteers called the
New England Prevention Alliance.
Needle exchange is explicitly legal in Massachusetts only in a handful of
cities running pilot programs, and Lynn, a northern suburb of Boston, is not
one of them. As he walked away from the delivery, Mr. Langis was arrested.
A jury quickly acquitted him this month of illegally distributing syringes,
but the dispute is not really over.
"It's a violation of the law," said Lt. Tom Reddy of the Lynn police. "If
they were to come back and distribute needles again, they would be arrested
again for it."
Mr. Langis's case highlights the continuing conflicts over needle exchange
in spots around the country, conflicts that tend to pit public health
officials against law enforcement officials, town liberals against town
conservatives, raising moral charges all around.
The scientific consensus in favor of needle exchanges has steadily
solidified. Last month, the Centers for Disease Control and Prevention
issued findings that needle-exchange programs, which now number more than
130 in at least 31 states, "are an effective public health intervention that
reduces transmission of H.I.V. and does not encourage the illegal use of
But many localities remain unconvinced, fearing that needle exchanges only
increase drug use and the crime associated with it. Matthew Straight, a
councilor from Fitchburg, Mass., who opposes a needle-exchange bill being
considered by the State Legislature, said, "I feel this bill decriminalizes
drug use, and only supports the habit."
In Massachusetts, one of the most liberal states in the country, only four
cities, including Boston, have opened needle exchange programs. Several
cities that were offered grants to start exchanges turned the money down,
and several where drugs contribute most to the H.I.V. rates have voted down
needle exchanges, either by referendum or City Council action.
The result, in Massachusetts and other states, is a patchwork unusual for
criminal law: a town where it is legal to distribute needles sits next to a
town where distribution remains a crime. And national experts say such
patchworks exist across the country.
"It is common to have states where localities decide," said Allan Clear,
executive director of the Harm Reduction Coalition, a nationwide network of
groups that advocate on behalf of drug users and needle-exchange programs.
Those states include California, he said, where cities like San Francisco
and Santa Cruz have legalized needle exchanges, while San Diego and Orange
County have not. Even in New York, Mr. Clear said, where needle exchanges
have run legally in Manhattan for years, Staten Island continues to oppose
them, as does New Jersey next door.
The lack of legal approval in so many spots, Mr. Clear said, has kept
probably about half of all needle exchanges in the country technically
underground, though some have the tacit approval of authorities.
Such town-to-town inconsistency frustrates public health officials and
advocates for people with AIDS. They argue that H.I.V. knows no boundaries.
In Massachusetts, they also point out that in the towns that have needle
exchanges, H.I.V. transmission caused by injected drugs now constitutes a
significantly lower percentage than in towns that ban the exchanges.
The bill before the Massachusetts Legislature would make needle exchange
legal everywhere in the state. A similar bill passed last year but was
vetoed by Gov. Paul Cellucci, who said the issue should be left to local
About a dozen states at a time are usually considering such needle-exchange
laws, and two or three have enacted them each year for the last several
years, according to the National Conference of State Legislatures. Several
states, including New York, have also recently passed laws to legalize the
purchase by the public of a limited number of syringes in pharmacies.
The United States Surgeon General's office and the Department of Health and
Human Services have endorsed needle-exchange programs, but the federal
government provides no money for them.
At a hearing this month on the proposed Massachusetts needle-exchange law,
the public health commissioner, Howard Koh, told lawmakers that of the 700
to 800 new H.I.V. infections reported in the state every year, more than
half of those infected contracted the virus through drug use. Drugs have
become the disease's "primary engine" in the state, Mr. Koh said; in some
cities, nearly three-quarters of H.I.V. carriers got it from needles.
Here in Lynn, an old seaside city nicknamed by some the City of Sin, the
issue of needle exchange raises similarly conflicting views ‹ and the debate
becomes even more urgent when set against the backdrop of the city's growing
According to state statistics, 604 people who were admitted to publicly
financed substance-abuse programs in Lynn in 1997 reported using a needle
for drugs; that number rose by nearly 29 percent in 2000, to 777. And those
were only the people coming for treatment.
Deaths from heroin overdoses have also been on the rise, and the city has
increased enforcement and set up a task force to try to stop the trend.
But Lynn has also made great strides in recent years toward revitalization,
said Timothy Phelan, a city councilor at large, and many here fear a needle
exchange somewhere downtown would mean a setback in the city's efforts to
boost itself, Mr. Phelan said. Elderly residents worry that they would be
mugged walking to the supermarket, he said, and there is "a strong Nimby
element ‹ not in my backyard."
Aside from economics and crime, Mr. Phelan said, "My strong personal belief
is that if you provide the needles, I personally think you are exacerbating
the problem of drug use. It's like, when I'm in Boston, I'll walk by a
homeless person on the street begging for money, and you can see a couple of
empty bottles next to them. I won't give them money because I think they'll
buy another bottle, but I've given them my brown bag lunch before."
His City Council colleague Deborah Smith Walsh supports needle exchange as a
way to keep addicts healthy and get them into treatment, but Ms. Walsh said
she was very aware of being in the minority.
"Lynn is an old urban community," she said, "and because of that, it's quite
parochial and conservative in its thinking. So I think it's difficult for
people in the community to look upon a needle exchange program as a positive
type of treatment."
"Quite a few people look upon needle exchange as enabling an addict," she
said, and it will take a great deal of education about the research on
needle exchange to convince them otherwise.
It is akin, Ms. Walsh said, to the public education that has been needed to
bring acceptance of teenage pregnancy programs and condom distribution.
Lieutenant Reddy of the Lynn police said the police opposition to needle
exchange stemmed from the view that what was at issue was a tradeoff between
helping addicts and protecting the nearly 100,000 people who make up the
rest of the city's population.
The experience of other police departments, Lieutenant Reddy said he had
heard, is that needle exchanges bring in more addicts and thus more pushers,
and that they all linger, increasing the crime rate.
"Why do innocent people have to suffer because of the conscious decision of
someone who chose to take criminal action?" he asked.
The Lynn City Council has passed an ordinance specifying that a needle
exchange can come to the city only with its approval. Unless the Legislature
passes the statewide bill, no one expects that to happen soon.
So the stage seems set for the next needle-exchange arrest. Such arrests are
rare around the country.
"We're going to continue our mission," Mr. Langis said. "Our mission is
completely clear, that we will provide sterile injection equipment to
at-risk populations, no matter what ZIP code they live in."
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