Needling Aids

While looking into the causes of the spread of AIDS (acquired immunodeficiency syndrome), New Jersey health experts discovered a deadly correlation. Nearly 60% of New Jersey's AIDS cases were drug related, a greater percentage than in any other state. While 53% of the 1,385 AIDS victims identified were drug users, an additional 7% were children or sexual partners of drug addicts. Studies indicate that more than half the drug users in northern New Jersey have been exposed to the virus, so anyone sharing a needle even once has a better than 50% chance of being exposed as well.

Those alarming numbers spurred a top state health official to offer a controversial proposal for curbing the spread of the fatal disease. Called "needle exchange," it would supply free sterile syringes to addicts in return for the dirty needles they have been using.

Trying out the idea in New Jersey occurred to Dr. John Rutledge, deputy commissioner of the state department of health, after a visit to Amsterdam, where such a program exists. A needle-exchange program would necessarily have to start small. Only about 15% of the state's estimated 60,000 addicts are in registered treatment programs or in touch with public-health street workers, who periodically enter "shooting galleries" to warn users of the dangers of AIDS. An initial research study would be inexpensive, said Rutledge, and could be paid for out of the state health department's existing budget.

Even so, the idea immediately ran into opposition when it was publicly suggested last week. Some fear that by providing clean needles, the state would only encourage drug use, a greater threat to public health than AIDS itself. Rutledge's proposal would attempt to guard against this by requiring tests to ensure that people who accept the needles are in fact hooked on drugs and not simply casual experimenters.

State law currently forbids sale of syringes without a prescription, and another regulation prohibits doctors from prescribing needles for anyone who may use them for illegal drugs. Because of the legal obstacles, the program would require approval from the state legislature. That does not seem likely right now, but Rutledge hopes attitudes will become more enlightened. As he notes, it is a sobering fact that addicts find it easier to get drugs than clean needles. That means the AIDS threat will grow every time an addict shoots up with a dirty needle supplied by a friend or a drug dealer.