Column: The false compassion of needle exchanges

San Diego moved a step closer this week to joining the ranks of America's Sodoms and Gomorrahs -- cities that blithely hand out hypodermic needles to junkies, damning them to their deadly addictions.

What particularly offends is that the moral relativists on San Diego's City Council insist they are somehow making a bow to compassion. By providing the city's 20,000 or so intravenous drug users with clean needles, they reason, they reduce the prospect that these hard-core druggies will contract HIV.

Alas, this is what passes for enlightened public policy-making not only in America's sixth-largest city, but in cities throughout the once-fair land. No longer do city leaders attempt to discourage pathologies such as drug abuse. They aspire to nothing more ambitious than "harm reduction."

So they offer needles and syringes to any junkie who darkens their doors. And while they claim not to condone illegal drug use, they are only too willing to enable addicts to pump poison into their bodies.

Indeed, they even pass out "safe crack kits" advising junkies on how best to inject crack. And there are pamphlets instructing junkies in the most prudent way to shoot up: "Take care of your veins. Rotate injection sites."

Needle exchange advocates claim that assorted scientific studies "prove" the efficacy of distributing needles to junkies.

The most often mentioned "proof" is a 1995 National Academy of Sciences report that concluded: "Well-implemented needle exchange programs can be effective in preventing the spread of HIV and do not increase the use of illegal drugs."

However, in a well-documented 1998 article, published in Policy Review, the journal of the Heritage Foundation, Joe Loconte deconstructed the academy report.

First of all, the academy conducted no actual research of its own. It simply reviewed a number of studies, most of which the academy admitted were highly flawed.

In fact, two of three physicians who served on the academy panel that issued the needle exchange report said the studies they looked at did not, in fact, establish a scientific link between lower HIV rates and needle exchange.

"NEPs may, in theory, be effective," said Dr. Herbert Kleber, of the Columbia University College of Physicians and Surgeons, "but the data doesn't prove that they are."

But there is information out there that is beyond scientific dispute: An intravenous drug user is at far greater risk of dying from his or her drug habit than from HIV-related causes.

Indeed, a University of Pennsylvania study, which Loconte detailed in his Policy Review article, followed 415 intravenous drug users in Philadelphia over four years.

Twenty died during the study, only five from causes associated with HIV. The other 23 died from other causes, including overdoses, homicide, heart disease, kidney failure, liver disease and suicide.

Writing in the New England Journal of Medicine, medical professors George Woody and David Metzger concluded that, compared with the risk of HIV infection, the threat of death to drug addicts from other causes is "more imminent."

If needle exchange advocates refuse to believe this, they need only consider the deaths of John Watters and Brian Weil. These two prominent founders of needle exchange programs died not from HIV-related causes, but from heroin overdoses.

Oh well. At least they used clean needles.

And that is precisely the unspoken sentiment of needle exchange advocates, for all their professions to the contrary; for all their pretenses of compassion.

It matters not to them if junkies kill themselves on drugs (otherwise, why aid and abet their deadly habit?). As long as they don't spread HIV.

This is what putative progressives mean by "harm reduction." But what it really amounts to is social nihilism. For it is hardly rational, not to mention moral, to deliver people from one threat to health -- HIV -- only to condemn them to another -- drug abuse.

Enlightened city leaders, those who listen to the better angels of their nature, would not put themselves in the position of choosing the lesser of evils when it comes to the health of those whom they represent.

Rather than provide needles on demand to junkies, hoping they shoot up responsibly, they would devote city resources to treatment programs that enable drug addicts to overcome their deadly habit.

Joseph Perkins is a columnist for The San Diego Union-Tribune.

Copyright 2000, Newspaper Enterprise Assn.


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