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Fighting AIDS is not enough


It has been only nine months since Baltimore City began its needle exchange program. But the experiment to reduce the frequency with which AIDS is transmitted from one drug user to another by sharing the same hypodermic has already been declared a success.

That assessment is based on how many drug addicts are participating. So far, more than 2,300 persons have traded their used hypodermic needles for new ones. That's five times more than was predicted for the entire first year. But it's still only a fraction of the estimated 48,000 drug addicts in the city.

The higher-than-anticipated number of needle exchange participants could mean the estimate of addicts in the city is also low. After all, the greatest shortcoming of the needle exchange idea is its limited impact on the level of drug addiction. The program tries to steer addicts toward treatment while at the same time making it easier for addicts to get high without fear of AIDS.

This contradiction was one reason it took Mayor Kurt L. Schmoke two years to get approval to provide drug paraphernalia to addicts. Legislators understandably had problems with that concept. But the mayor rightly wanted Baltimore off the list of the four U.S. cities where AIDS is the leading cause of death among people ages 25 through 44.

Needle exchange works as an anti-AIDS program. Such programs have also been known to significantly decrease hepatitis infections and other diseases among addicts. But to reduce the number of addicts in Baltimore significantly, the city also must provide more drug treatment. There are only 5,700 treatment slots for the 48,000 addicts.

About a fourth of the people who participate in the needle exchange program want drug treatment. But many treatment centers turn them away because they don't have health insurance while other centers have waiting lists that are too long.

Court records indicate 85 percent of the felony crimes committed in the city are related to drugs. Unemployed addicts who are trying to finance $50- to $75-a-day habits usually resort to stealing or some other crime to come up with the cash. That's $876 million worth of thievery a year.

But AIDS costs the city a lot, too. And not just lives. David C. Condliffe, executive director of the Drug Policy Foundation in New York, says one addict with AIDS can infect 10 other people within six months. Treating those victims, from infection to death, costs the public about $57,000 each.

Baltimore must fight both AIDS and drug addiction. The success of the needle exchange program is good reason to find more money to put into drug treatment in the city as well.

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