Clean shot

Deregulating the sale of hypodermic needles is a common-sense approach in the fight against AIDS

AIDS does not conjure the same mind-numbing terror that it did a few years ago. That's good. Unfortunately, this lessening of blind fear has been accompanied by a worrisome drop in the seriousness with which the disease is taken. The widely publicized new miracle drugs that have extended the lives of many people with AIDS have created the false impression that the crisis is over, or at least diminished substantially. The truth is that these drug regimens are prohibitively expensive and difficult to administer, putting them beyond the reach of vulnerable populations such as drug addicts and those without health insurance. Then, too, such treatment does not work for everyone, and may not be a long-lasting solution even for those who have been fortunate enough to be restored to health.

Prevention, in other words, remains the most important weapon in fighting AIDS.

Earlier this month, AIDS-treatment advocates and public-health officials testified before the legislature's Joint Committee on Health Care in favor of a common-sense proposal that would allow adults to buy hypodermic needles without a prescription. The sharing of dirty needles is the principal route by which HIV, hepatitis B, and hepatitis C are passed from one drug addict to another -- and, through subsequent sexual contact, to their non-drug-abusing partners as well. For well over a decade, clueless conservatives have succeeded in limiting clean-needle exchange to a handful of pilot programs. Deregulation would remove such political impediments, making it possible for any adult to buy a needle, for as little as 50 cents, at any pharmacy in the state.

The case for deregulation is compelling. According to advocates, Massachusetts is one of just eight states that require a prescription to purchase a needle -- and these eight states account for 59 percent of all needle-induced AIDS cases. In addition, at least 43 percent of AIDS cases diagnosed in Massachusetts in 1997, the latest year for which figures are available, were related to intravenous drug use -- more than any other cause. Tellingly, the infection rate is considerably lower in Boston, where needle exchange is available, than in New Bedford, Springfield, and Worcester.

EDITORIAL

Heart of darkness

Deregulation is backed by a wide range of experts and activists, including the American Medical Association, the Centers for Disease Control and Prevention, the National Academy of Sciences, and the National AIDS Commission. In Massachusetts, the legislation has been endorsed by the more than 60 agencies that make up the Massachusetts AIDS Policy Task Force. Deregulation is also supported by the Massachusetts Department of Public Health, whose commissioner, Dr. Howard Koh, calls the legislation a key to DPH's "ability to address the HIV epidemic at all levels -- through education, public-information campaigns, outreach programs, and providing barrier-free access to sterile injection equipment."

Deregulation might seem like a no-brainer. But if it is to become a reality, advocates must overcome the objections of people such as Evelyn Reilly, executive director of the Christian Coalition of Massachusetts, who calls it "a bad idea," and Lea Cox, president of Concerned Citizens for Drug Prevention, who testified that deregulation would only lead to more drug abuse. "There must be a return to zero tolerance," she said. This is a totally nonsensical and uninformed position. What Reilly, Cox, and their ilk fail to understand, or care about, is that the unavailability of clean needles leads not to abstinence but to disease -- affecting not just drug addicts but their partners and children as well.

The Joint Committee on Health Care is considering two deregulation bills, House 972 and Senate 535. They are virtually the same, except that the House bill applies to people age 17 and older and the Senate bill sets the minimum age at 18. The co-chairs of the committee are Senator Richard Moore (D-Uxbridge), who can be reached at (617) 722-1420 or by e-mail at RMoore@senate.state.ma.us, and Representative Harriette Chandler (D-Worcester), at (617) 722-2130 or Rep.HarrietteChandler@state.ma.us. Contact them and urge them to support these sensible measures to protect public health.

At press time, the Joint Committee on Health Care was preparing to report out favorably a bill that would allow anyone 18 or older to purchase needles without a prescription. According to Senator Richard Moore (D-Uxbridge), co-chairman of the committee, the action was expected to take place on Thursday; three other bills related to clean needles were scheduled to be acted upon as well. But though the imprimatur of the committee is an important first step, the full House and Senate must follow through in a timely manner by passing this legislation, and Governor Paul Cellucci must sign it into law. The Phoenix urges the legislature and the governor to support this sensible measure to protect public health.

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