Clean Sticks

In the meantime, addicts keep using without...

By Andrea Makshanoff, On-line Forty-Niner

May 14,1998

Studies show clean needle exchange decreases the risk of HIV and do not promote drug use, but the federal government refuses to fund such programs.

 

Governments, both local and national, are giving lip service to the concept of needle exchange programs, but have their hands tied by politics, lack of funds or state laws making such distribution illegal.

 

Recently, the Clinton Administration, in a April 20 statement by Secretary of Health and Human Services' Donna Shalala, declined to lift the nine-year ban on funding needle exchange programs.

 

This refusal to support programs came despite six government-requested and partially government-funded studies that proved the conditions required to lift the ban.

 

Meanwhile, an increase of injection drug use among non-typical users, such as middle-class youth, and the fact that more than half of all AIDS cases that involve children are directly related to unclean needles, is bringing the AIDS epidemic closer to middle America's home.

 

The City of Los Angeles, in spite of the criminalization of needle exchange, has been able to support and partially fund these types of programs.

 

With the Los Angeles Police Department's cooperation, one of the very few needle exchange programs in Southern California, Harm Reduction Control, helps intravenous drug users get clean sticks.

 

Los Angeles Mayor Richard Riordan was able to do this by declaring the city in a "state of emergency" for its epidemic of intravenous drug usage.

 

So did San Francisco, Berkeley, Santa Cruz, and six other California communities, according to Harm Reduction Control's executive director, Renee Edgington.

 

It is estimated that there are 200,000 injection drug users in Los Angeles County, and the numbers is quickly escalating, she said.

 

By declaring the epidemic an emergency, Riordan has been able to temporarily circumvent state laws hampering needle exchange programs, and allow Harm Reduction Control's Clean Needles Now program, known as CNN, to operate freely.

 

In Los Angeles clients of CNN, granted they carry Harm Reduction Control cards, can move freely between their homes and the centers with dirty and clean needles.

 

They can do so without being arrested by the Los Angeles police, Edgington said.

 

Epicenter of an epidemic

Edgington is frustrated by Long Beach's inability to start a needle exchange program.

 

"Long Beach was the first city to bleach teach outreach," Edgington said.

 

He said that Long Beach is an "epicenter of the epidemic among injectors." He said about 5 per cent of CNN's clients come from Long Beach and said the city is a drug production center for crystal methamphetamine.

 

"It's the place singularly in L.A. that needs needle exchange the most, I think," Edgington said.

 

In 1995, the City of Long Beach, in alarm over the local increase of AIDS infections and injection drug users, directed its department of health and human services to provide a information on needle exchange programs for the prevention of HIV infections.

 

That study showed a cumulative AIDS incidence rate in Long Beach of 588.17 per 100,000 of population for the years 1981 through June 30, 1995.

 

This rate was second only to San Francisco County, which reported an incidence rate of 2,566.76 per 100,000 of population.

 

Of the Long Beach AIDS cases, 14.2 per cent had a risk of HIV infection that included injection drug use, said the report.

 

Also according to the Long Beach city report, 36 percent of the 476, 899 AIDS case reported as of June 30, 1995 were reported to be associated with injection drug use.

 

Of the 35,683 cases thought to be transmitted through heterosexual sex, 48 percent occurred among non-using sexual partners of injection drug users.

 

Of the 5,925 pediatric AIDS cases, 42 percent were among children whose only risk factor was their mother's usage.

 

An additional 19 percent of pediatric AIDS cases were attributed to their non-injecting mother's sexual contact with an intravenous drug user.

 

That 14 percent figure of injection drug use still applies to the 3,100 Long Beach HIV cases in 1997, said David Souleles, the preventive health bureau manager of the city's department of health and human services.

 

According to a city memorandum dated Jan. 16, 1996, that study was presented to the Long Beach City Council on May 16, 1995.

 

On Dec. 5, 1995, the council recommended that "the city sponsor legislation regarding legal exchange of injection equipment in a research or experimental context to reduce the spread of HIV among injection drug users."

 

Basically, this means the city would pursue needle exchange only when legislation allows it to do so, said Diana Bonta, director of health and human services. In Sacramento every year since, that legislation has been defeated.

 

Getting nowhere

 

At this time there is no clean needle exchange in Long Beach, nor is there one at the Student Health Services of Cal State Long Beach. Hence, a Long Beach or CSULB intravenous drug user has to travel a distance to find clean needles. CNN in L.A. is the closet program available - more than 20 miles away.

 

The City of Long Beach has gone on record to support three different bills sponsored by Sen. Diane Watson to legalize needle exchange, and has sent that message to Sacramento lawmakers.

 

However, in all cases Gov. Pete Wilson has vetoed.

 

The most recent bill was SB 885, which Watson, on the March 13 KCRW-89.9 FM radio show "Which Way L.A.," said she is not willing to push through again this legislative session.

 

Edgington said that in 1994 Harm Reduction Control and Long Beach legislators had seriously discussed setting up a needle exchange program in the city, but talks he said proved to be a waste of time.

 

"They wanted it to be a research-driven needle exchange," Edgington said. "They wanted to give them one or two each time they came. Eventually they didn't do anything at all."

 

Edgington said he feels that the Long Beach program coordinators only wanted to have access to current injectors - a population that can bring in valuable research dollars. The drug addicts that are more commonly accessed are in rehabilitation, and do not provide the same sort of case study, she said.

 

"Becoming a state of emergency in California, like Oakland, Marin, San Francisco, Berkeley, would give Long Beach the cover that it would need," Edgington said.

 

"As a research component sanctioned by the state, it can get a legal waiver because of research, though it doesn't mean getting any funding."

 

CNN: as clean as can be

 

CNN is a prime example of what a little funding and city support can accomplish.

 

The CNN program has been operating since 1993 from the bright yellow stucco storefront at 1602 Cahuenga Blvd., said James Hulse, one of the founding volunteers.

 

Hulse said they operated from a street corner during their first years, and still, weekly on Thursday evenings, they hand out syringes on a street near McArthur Park in Los Angeles.

 

With a permanent facility, CNN is able to offer services other than clean needles, such as family planning services, free birth control, and STD and pregnancy screenings.

 

After the needle exchange hours, Narcotics Anonymous meetings are held there, and current users, even those that are high, are welcomed.

 

At CNN, volunteer Hulse dispenses the accessories: condoms, both lubed and unlubed, cookers, wire ties for holding the cookers, cotton and tourniquets.

 

"Some people come in and say they really would like to stop and we've even taken them to detox. They come in ready to get a lecture, so we don't do that," Hulse said.

 

The volunteers tell users about the medical services available, including screening for AIDS and sexually-transmitted diseases in a big white motor home, just across the street.

 

"We want to protect people," Hulse said. "We find that some people don't know what they are doing, don't know the difference between a vein and an artery."

 

Currently in California, syringes can be dispensed by doctors and pharmacies only. Wayne Sugita, the director of the County of Los Angeles drug and alcohol program, said because of the illegality, the Board of Supervisors has specifically not addressed needle exchange programs.

 

California is one of only 10 states, according to Hulse, where citizens cannot purchase needles legally. He said Gov. Wilson has been an obstacle.

 

Yet even after he leaves office, because of term limits, a whole new set of politicians will have to be educated.

 

Supporters of needle exchange anticipate the change in leadership after the gubernatorial elections, however at least one candidate, Attorney General Dan Lungren, has gone on record opposing needle exchange.

 

Democratic primary candidates for governor, Lt. Gov. Gray Davis and U.S. Rep. Jane Harman, both said they would support needle exchange, however Harman will require certain conditions.

 

Harman had opposed the outright ban on federal funding for needle exchange that was passed in the House of Representatives on April 29, said Harman campaign aide, Colleen Haggerty.