Baltimore's health commissioner said yesterday that the city will soon dispense clean needles to about 1,000 drug users to prevent them from spreading the AIDS virus through shared syringes.
Dr. Peter Beilenson said the pilot program will operate from a center staffed by health educators and nurses who will not only exchange clean needles for dirty ones, but also provide a variety of health services.
These will include tests for tuberculosis and sexually transmitted diseases and referrals to programs aimed at getting addicts off drugs. He said the details of the program will be worked out later this month.
His announcement caps several years of statements by Mayor Kurt L. Schmoke that a needle exchange may be the only way to make inroads into the epidemic among Baltimore's drug users. About one-quarter of the city's 40,000 addicts carry HIV (human immunodeficiency virus), and four more are infected every day.
The city has been frustrated in launching a program because a state law prohibits the possession and distribution of syringes and other drug paraphernalia. Earlier this year, the state legislature refused to exempt Baltimore from the law.
But yesterday, Mr. Schmoke told 500 people attending a celebration of the city Health Department's 200th anniversary that he intends to find a way to overcome the legal barrier and start a needle exchange soon. He did not, however, say how that would be done.
"We are looking at a couple of ways to implement the program," Mr. Schmoke said. "We are still not getting to the IV drug community in the way we should."
Later, Dr. Beilenson told the Convention Center crowd that "we're trying to do everything possible" to begin a program. In a private interview, he released the first sketchy details, saying the program will serve between 700 and 1,000 addicts at an annual cost of about $160,000.
In the past several years, about 16 cities in the United States have adopted needle exchange programs of varying size, according to The Drug Policy Foundation of Washington. Kevin B. Zeese, the group's vice president, said Baltimore would be only the second to combine a needle exchange with services aimed at getting addicts off drugs and improving their overall health.
"Needle exchange by itself is nice but when tied into a health policy, it's cutting edge," Mr. Zeese said. "It's an empowering tool for drug users and lets them know society cares about them and they can start caring about themselves."
He said a program in New Haven, Conn., reduced by one-third the rate at which addicts spread the AIDS virus through needle sharing. The program, begun in 1990, started to provide other health services four months ago.
Dr. Beilenson said he also plans an assault on another health problem -- the city's low rate of childhood immunization. The department won a $150,000 grant from the Annie E. Casey Foundation to devise a computer system that would track every child who is not receiving immunizations on schedule.
The task is monumental because it means tracking all children from birth through their third year of life -- about 35,000 youngsters at any given time -- and their progress in getting immunized against nine diseases.
Health officers would contact the parents of all children who are not receiving their vaccinations and help link them to services. About half of all city children are not properly immunized by age 2, according to surveys.
Dr. Diane Dwyer, chief of the state's center for clinical epidemiology, said Maryland has applied for a federal grant to begin a statewide tracking system.