The Chicago Tribune, 435 North Michigan Avenue, Chicago, IL 60611 - Sunday, August 24, 1997 Edition: CHICAGOLAND FINAL Section: COMMENTARY Page: 19 Word Count: 751
Clarence Page.

If so, there must be a lot of dopey people around these days.

Take, for example, the American Medical Association, the American Public Health Association, the U.S. Centers for Disease Control and Prevention and the American Academy of Pediatrics. All of them have endorsed programs that provide clean needles and syringes in exchange for HIV-contaminated needles and syringes.

Boy, what a bunch of dopes.

Or take the British medical journal, The Lancet. It published a five-year study in its June 21 edition that found the number of HIV infections rose 5.9 percent in 52 cities that did not have needle-exchange programs and dropped 5.8 percent in the 29 cities that did have needle-exchange programs. The net difference: "cities with needle exchange had 11 percent fewer cases of HIV infection each year than cities without the programs."

Dopey, right?

A few months earlier, the same magazine published another study that found Americans could have saved between $250 million and $500 million in health-care costs with the HIV infections that could have been prevented, if only the U.S. had a needle-exchange program similar to the one in Australia, which has embraced the idea.

Yep, the dopes are everywhere. The same day Bauer declared needle exchanges to be a dopey idea, Rep. Nancy Pelosi (D-Calif.) announced a bill to end the government's 9-year-old ban on federal funding for needle-exchange programs.

This came after a recent pronouncement by Health and Human Services Secretary Donna Shalala that needle-exchange programs really do slow the spread of the HIV virus. I guess that makes Pelosi and Shalala dopes, too. So, then, are all those mayors in the U.S. Conference of Mayors who recently called for an end to the ban.

On the other side, 10 states still ban such programs, and Bauer unveiled a new poll that shows 62 percent of Americans oppose needle-exchange programs.

That didn't surprise me, since most Americans don't know very much about these programs. But other polls indicate that, the more they know, the more they like the idea.

Those dopey needle exchange programs have been around for about a decade, plenty of time to study their effectiveness. So far, at least a dozen major studies show that the programs reduce the spread of the HIV virus and I have yet to find one that shows they encourage new drug users, unless it's being repressed by some dopey conspiracy in the medical community.

Quite the contrary, once the needle-exchanging drug users have been lured up out of the drug underworld, many have been lured right into treatment and rehabilitation programs to help them kick their habits.

Mohammad N. Akhter, executive director of the American Public Health Association, found that out in 1993 when, as health commissioner for the District of Columbia, he proposed a needle-exchange program. When the District's council heard that idea, the proverbial stuff hit the fan.

So, Dr. Akhter worked out a compromise that provided needles only to those who signed up for drug rehabilitation, for which there was a waiting list several months long--as the waiting lists are in every American city.

After a couple of years the program proved to be so effective at reducing the spread of the HIV virus and the almost-as-deadly hepatitis B virus that the council extended the needle program to drug users who were not signed up for treatment.

As a result, many were lured into treatment who otherwise might not have been reached, all because of the needle-exchange program. "If we had enough drug treatment and rehabilitation facilities, we would not need needle-exchange programs," said Akhter. "I know (needle exchange) is not the best choice, but all the other choices are worse."

So he supports the dopey idea, he says, just because it works, because there are not enough treatment facilities, and because many innocent lives are at stake.

Meanwhile, I find it curious that so many of the same people who oppose needle-exchange programs also oppose spending any additional money to reduce the long waiting lists faced by low-income drug users who want treatment but can't get it.

Yes, the idea of providing clean needles to junkies sounds pretty dopey, all right.

But not as dopey as some of the people who oppose the idea.

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