A proposal to create a needle-exchange program for dru users in Baltimore was defended yesterday as a necessary tool to prevent the spread of AIDS -- and dismissed as a bad idea that would merely encourage drug use, particularly among the young.
"We've got a problem on our hands and we've got to take care of it," said David Vlahov, a Johns Hopkins University researcher who supports giving clean needles to intravenous drug users. He said the AIDS virus appears to be spreading faster among drug addicts in Baltimore than in other cities.
But Baltimore State's Attorney Stuart O. Simms opposed needle exchange, saying that it would lead to "confused" law enforcement policy and that he doubts the plan would be successful. Even if addicts received clean hypodermic syringes, said, "the needles could still be shared."
The proposal, which calls for a used needle to be exchanged for a clean one, was debated -- and rejected -- by the Maryland General Assembly this year. The issue was raised once again yesterday in a debate before the Governor's Drug and Alcohol Abuse Commission.
Dr. Neil Solomon, commission chairman, said he expects the panel to release a policy statement on needle exchange in August. Dr. Solomon said he was initially against the idea, believing such exchanges "send the wrong message to kids." But he said advocates of the plan persuaded him he should listen to more discussion.
Baltimore officials want to create a three-year pilot program that would serve up to 700 addicts, at a cost of $50,000 a year. About 10,000 of the city's estimated 40,000 IV drug users have tested positive for the AIDS virus.
By a vote of 11-13, the state House Judiciary Committee rejected a bill that would have allowed the pilot program, with opponents fearing it would amount to the state encouraging drug use. Approval of the legislature was needed to receive an exemption from the state's drug paraphernalia law, which prohibits unauthorized ownership of hypodermic syringes.
Similar needle exchange programs have been initiated in seven states and Washington, D.C., as well as eight other countries.
Baltimore Mayor Kurt L. Schmoke, a staunch proponent of the needle exchange plan, has said he will try to get federal officials to give the city permission to try it despite the rejection by legislators.
Discussion of the issue continued in small circles following yesterday's hour-long forum.
Dr. Vlahov and other proponents pointed to a Yale University study which found that a New Haven, Conn., needle exchange program was effective in reducing the spread of AIDS without increasing drug use.
"I believe needle exchange is wrong. I don't believe the statistics," countered Marshall M. Meyer, a retired Army officer who chairs the Governor's Executive Advisory Council. The panel is charged with making recommendations to the governor on a variety of issues.
William R. Caltrider Jr., a Realtor who serves on the drug and alcohol abuse commission, noted that the New Haven study showed that half the needles distributed were not returned for clean ones.
"I'm biased in favor of the program," said state Attorney General J. Joseph Curran Jr., a likely gubernatorial candidate. "We're on the edge of a health disaster. . . . The message is we're doing nothing."
But Mr. Simms argued that it would be better to boost spending for education and drug treatment than to embark on needle exchange.