Needle Exchange And the City

With the number of reported AIDS cases skyrocketing, cities across the country are adopting needle exchange programs, targeted at preventing HIV infection among a growing number of intravenous drug users.

And, with a needle exchange bill awaiting approval from the Massachusetts Senate and the House on Beacon Hill, Cambridge is soon likely to have a program of its own, according to state legislators.

After a surprise endorsement by House Speaker Charles F. Flaherty (D-Cambridge) who wholeheartedly supported the bill, the House's Health Care committee passed the needle exchange bill without opposition at a hearing on February 10.

If the bill becomes law, it would set up a one-year pilot program in selected cities throughout Massachusetts. A mobile van staffed with counselors and health care workers would supply drug users with sterile syringes in exchange for used needles. The Department of Public Health would oversee the program and track its progress.

"It will be a very controlled program," said Kate McCormack, spokesperson at the Department of Public Health. "There will be a one-to-one exchange so there will be no additional needles on the street."

If the proposed bill is passed Cambridge may be among the first communities to begin a pilot program, according to State Representative Byron Rushing (D-Boston).

"Cambridge is ready to go," said Rushing about the city's participation in a pilot program. "I've spoken to the mayor...If they [Cambridge] don't get chosen [in the state program], they will go ahead on its own."

Mayor Kenneth E. Reeves '72 could not be reached for comment. But according to Dr. Paul R. Epstein, M.D., chair of the Cambridge AIDS Task Force and instructor of medicine at Harvard Medical School, the task force was discussing a Cambridge needle exchange program for months.

"We are willing to do everything we can to stop the spread of AIDS," Epstein said. "It is more and more the consensus that needle exchange programs are an important part of the effort to stop the transmission of AIDS."

Cambridge has the third highest number of AIDS cases in the Commonwealth, behind Boston and Springfield. Roughly half of the people treated for AIDS or HIV at the Cambridge Hospital have been infected by IV drug use, Epstein said. Epstein stressed that the key to the program is that it is "an entree for help for substance abuse."

"We are exploring it, reviewing the actions of other communities...but if there is a lot of bad feeling in the community, we are not going to do it," Epstein said.

Although Rushing said he believed Cambridge would definitely institute its own needle exchange program if it is not chosen to participate in the state's pilot program, Vice Mayor Edward N. Cyr said "it's not clear what [the city] would want to do."

"I think it's a good program and someone should do it, but I'd be concerned if Cambridge were the only community involved in the pilot program," Cyr said.

Although the needle exchange bill is actually a compromise with a more radical bill that would have decriminalized over the-counter sale of syringes, its supporters are unsure of how it will be received on Beacon Hill and by Massachusetts communities. Rushing said cities may be afraid of such a radical pilot program because state support of a needle exchange program may send the "wrong signal" to drug addicts.

But adoption of this measure would not be like "giving alcohol to alcoholics," said Rushing. And with the number of HIV infected drug users growing, legislators and even Governor William F. Weld' 66, who reversed his opposition on the bill only a month ago, seem more willing to adopt more progressive action.

"It's worth taking the risk," said Health Care Committee Chair Senator Edward L. Burke (D-Framingham), a proposer of the original over-the-counter needle bill.