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Clean Needles For Addicts Help Curb AIDS Spread With AIDS Meeting Rdp, Bjt

June 15, 1988

STOCKHOLM, Sweden (AP) _ Four years of providing clean syringes and needles to drug addicts in Amsterdam has produced a significant drop in needle sharing and may have helped curb the spread of AIDS, researchers said Wednesday.

Furthermore, the needle exchange program did not lead to increased drug use, as critics of such programs had feared, said Ernst Buning, a psychologist with the Amsterdam Municipal Health Service in the Netherlands.

Speaking at the Fourth International Conference on AIDS, Buning said the program gave health workers an opportunity to tell addicts how to lower their AIDS risk, and the counseling was a critical component of the exchange program.

″Our conclusion is that the needle and syringe exchange helps addicts to use drugs safely,″ he said.

The first U.S. needle exchange program will begin soon in Portland, Oregon, under the sponsorship of the American Foundation for AIDS Research.

The foundation announced the program last week and said it was designed to determine if needle exchanges curb the spread of AIDS among addicts.

In a separate report to the conference, Don Des Jarlais of the New York State Division of Substance Abuse Services said drug-related AIDS cases in the United States are increasingly linked to cocaine rather than heroin. He said the trading of sex for drugs among crack users created the ″potential for further catastrophe″ by spreading the epidemic.

Drug-related AIDS is also spreading to parts of the developing world where illicit drug shipments originate, Des Jarlais said.

The reason for the growing link between AIDS and cocaine injection may be partly due to the frequency with which cocaine users must inject themselves, Des Jarlais said.

Heroin users may inject themselves three or four times per day, Des Jarlais said. But cocaine users may inject themselves as often as every 15 minutes until their cocaine supply is exhausted, he said.

″That can lead to almost continuous sharing of drug injection equipment and a much greater likelihood of viral transmission,″ he said.

The needle exchange program in Amsterdam reaches about 5,000 of the city’s 7,000 intravenous drug abusers, Buning said. Last year, 700,000 needles and syringes were exchanged, he said.

Interviews with 148 intravenous drug abusers showed that about half of them were participating in the needle exchange, using clean needles 90 percent of the time, Buning said. The other half participated in the program rarely or not at all, he said.

Among those participating, only 10 percent were sharing needles and at highest risk of AIDS, Buning said.

Among non-participants, 24 percent were sharing needles, he said.

AIDS, or acquired immune deficiency syndrome, is a disease in which a virus attacks the body’s immune system, leaving victims susceptible to a wide variety of infections and cancers.

The disease is transmitted primarily through sexual contact and the sharing of needles and syringes by drug abusers. Various reports at the AIDS conference have identified drug-related AIDS as one of the most rapidly growing components of the AIDS epidemic.

Other means of transmission include transfusions of tainted blood or blood products and the passage of the disease from mother to child at or before birth.

The spread of AIDS among cocaine abusers, which Des Jarlais said has been observed in New York City and San Francisco, is also of concern because of the difficulty of treating cocaine addiction, Des Jarlais said.

As of June 6, the U.S. Centers for Disease Control had reports of 64,506 cases of AIDS in the United States, 11,914 of which, or 18 percent, were among non-homosexual intravenous drug abusers.

Des Jarlais noted the hopeful sign that the overall spread of AIDS among drug abusers appears to be slowing. In San Francisco, 15 percent to 20 percent of cocaine and heroin abusers have been infected with the virus, but that figure has not increased for about 18 months, he said.

In New York City, 55 percent to 60 percent of the drug abusers are infected, and that figure has been stable for about three years, he said.

″We have seen substantial behavior change in a variety of cities,″ Des Jarlais said.

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