Massachusetts News Special Report
By Paul Joseph Walkowski

February 1--An act expanding the distribution of hypodermic needles by pharmacists and wholesale druggists to persons under 18 years of age is now before the House Ways & Means Committee, headed by Rep. Paul Haley (D). 

The bill is the result of three different efforts to create a mechanism for the distribution of syringes and needles to drug addicts. It expands the state’s pilot needle exchange program. It is a redraft of bills sponsored by Senators Robert Travaglini and Rep. Thomas McGee (R), and Reps. Dennis Murphy, Byron Rushing, Gloria Fox, and Christopher Hodgkins. 

The state’s needle exchange law as it is currently written prohibits the possession of a syringe or hypodermic needle except by licensed individuals such as physicians, pharmacists, wholesale druggists, embalmers etc. The proposed change allows the sale and possession of such devices to the general public. "Hypodermic syringes, hypodermic needles and any other instrument adapted for the administration of controlled substances by injection," the bill reads, "may be sold in the commonwealth to persons who have attained the age of 18 years and only by a pharmacist or wholesale druggist." The change is significant.

Since the state authorized the establishment of a pilot needle exchange program in 1993 in Boston and Cambridge, to stem the rise in AIDS cases from illegal drug abuse, an average of 4,800 syringes a month have been distributed to 6,275 "client" drug users. The state also distributed over 4,846 bottles of bleach, 85,643 alcohol wipes, and 45,080 condoms, along with various educational leaflets. 

The issue of needle exchange has been a contentious one ever since it was first proposed. In 1986 Boston resident Jon Parker risked arrest when he began distributing needles to drug addicts in violation of state law prohibiting the possession and distribution of syringes. In 1988 the Boston City Council passed and the mayor signed into law a pilot program for Boston. In 1992, a Needle Exchange Advisory Task Force was formed under the guidance of Dr. Alanzo Plough, former Director of Public Health of the Boston Department of Health and Hospitals. It wasn’t until 1993, however, that a pilot needle exchange program was adopted by the state legislature. That program became section 27 of chapter 94c of the general laws--the measure now being expanded in House Bill 4358. 

The effort to get free syringes and needles into the hands of drug abusers has been ongoing and widespread. As of April of 1995 there were 68 needle exchange programs in 46 cities and 21 states in the United States. The cumulative distribution of needles for drug users has been estimated in the Morbidity and Mortality Weekly Report as high as 8 million syringes.

With so many needles being distributed, two questions plague opponents of the measure: will giving needles to drug users increase crime by drug addicts; and is the program a successful treatment for AIDS? While the report commissioned by the Massachusetts Department of Public health, titled Final Report: First year of the Pilot Needle Exchange Program in Massachusetts, states that the pilot program in Massachusetts did not produce a noticeable increase in crime committed by drug addicts using the program, it did not address the issue of the trade in illegal drugs, principally, heroin, that the needle exchange program survives on. In Boston 20% of drug abusers use heroin as "speedball" and 70% inject heroin alone. The drugs they obtain are all from illegal sources, drug experts point out, feeding an illegal drug industry, built on murder, corruption of elected officials, prostitution and expanded use into our schools. 

There are critics of needle exchange programs. In an op-ed piece for the New York Times, James L. Curtis, professor of psychiatry at Columbia University’s medical school and the director of psychiatry at Harlem Hospital stated that places in Harlem where needles are distributed become "magnet[s] not only for addicts but for dealers as well. . . The indisputable fact is that needle exchanges merely help addicts continue to use drugs." Janet Lapey of Drug Watch International says such programs often become "buyer clubs" for addicts that attract both users and dealers. 

David Murray, director of research for the Statistical Assessment service group in Washington, noted in a Wall Street Journal piece, "The evidence is far from clear that needle-exchange programs protect against HIV infection. Most studies have had serious methodological limitations, and new studies in Montreal and Vancouver have revealed a troubling pattern." According to Murray, the better the study, the less convincing the results that needle-exchange programs work.

The dispute over this controversial program is not just local. It caused a rift in the Clinton administration between the President’s drug czar, Barry McCaffrey, and White House advisors over lifting a ten-year ban on using Federal money to finance needle exchange programs. McCaffrey was thought to have had a major influence on the President’s decision to back down from lifting the ban. 
 

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