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Six panelists debated the effectiveness of intravenous needle exchange programs at a forum sponsored by the Harvard AIDS Institute yesterday.
Speaking before an audience of approximately 90 people in the School of public Health's Snyder Auditorium, the panelists discussed such programs' role in limiting the spread of AIDS and the possibility that they may exacerbate drug abuse problems.
Edward Kaplan who served as principal investigator for New Haven's needle exchange program, said that the programs "lead directly to a lower rate of infection even if people don't change their behavior."
But Robert Stutman, former dierector of the New York division of the Drug Enforcement Administration, said that needle exchange could increase drug abuse.
"One of the things that causes people to stay away from drug abuse is the fear of dirty needles," Stutman said.
"We want to control AIDS, but not at the expense of increasing an other debilitating disease," he stated.
Kaplan said, however, that needle-exchange programs in Holland, Canada, Britain and the U.S. have not led to an increase in the number of addicts.
"No evidence exits suggesting that drug abuse has increased," he said, adding however that there is imperfect evidence that the number of addicts has stayed the same.
Other panelists said that the exchange programs are important for users who want therapy but are unable to obtain treatment slots.
Neil Sullivan, chief policy adviser to Boston Mayor Raymond Flynn, argued, "For the individual addict not to be allowed access to needle exchange while waiting for treatment is a public health crisis."
Needles Can 'Keep People Alive'
David Mulligan, commissioner of the Massachusetts Department of Health, said clean needles can "keep people alive" when drug treatment is not available.
"Needle exchange is a stop-gap measure. Treatment is the real goal," he said.
Holly Hagan, principal investigator of the syringe exchange program in Tacoma, Washington, said the programs can counter drug abuse.
The Tacoma exchange "is a place for recruitment for drug treatment," Hagan said.
"The exchange meets the mutual goals of HIV and drug abuse prevention," she stated.
Two members of the audience who have worked for exchange problems said they agree with her views.
"The number one question we get at our needle exchange is where people can get treatment," said Liz Highleyman, a member of Boston's "I.V. League."
Patricia Case, a doctoral student at the School of Public Health and a former member of San Francisco's Prevention Point, said exchange is often the "first life-affirming step in a career of drugs."
Sullivan said that the Massachusetts legislature recently passed a bill requesting the implementation of a pilot needle exchange program. Currently such programs are illegal in the state.
The Ways and Means Committee is considering the bill at present and will report its decision next week.
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