If you've been injecting drugs for at least five years, there's a 90-percent chance you have the hepatitis C virus, say public-health advocates. And if you have the virus, there's a 70-percent chance you'll develop chronic liver disease, and a 20-percent chance liver cancer or cirrhosis will kill you.
Since the beginning of the AIDS epidemic 25 years ago, injection-drug use has directly or indirectly accounted for 36 percent of all AIDS cases in the United States, according to the Centers for Disease Control. That's not just out-dated historical data. Of the 42,156 new cases reported in 2000, 28 percent—nearly one-third of them—were related to injection-drug use. And injecting has a disproportionate impact on women.
Study after study says syringe-exchange programs cut down the spread of blood-borne and sexually transmitted diseases such as hepatitis C and HIV, the virus that causes AIDS. According to a 1997 report from the National Institutes of Health Consensus Panel on HIV Prevention, “An impressive body of evidence suggests powerful effects from needle exchange programs.... Studies show reduction in risk behavior as high as 80 percent, with estimates of a 30 percent or greater reduction of HIV in [injection-drug users].”
Also in 1997, a study in the Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology reported that the cost of each HIV infection prevented by needle-exchange programs is between $4,000 and $12,000. That sounds like a lot, but not when you compare it with the estimated cost of treating someone with HIV: $190,000.
Given all this, one wonders why every town in America doesn't have a needle-exchange program up and running today. The answer is because there are too many backward, right-wing ideologues holding public office and getting in the way.
Such was the case last year when San Diego City Councilmembers Brian Maienschein and Jim Madaffer managed to kill this town's pilot needle-exchange program simply because the convictions of City Councilmembers Ralph Inzunza and Mike Zucchet left the council shorthanded. Five votes were needed to keep the vital public-health program going, and the council was able to muster only four.
This, in spite of a scientific survey showing that residents of the neighborhoods in which the program operated were overwhelmingly supportive of it, and that such a program actually seems to help cut down the use of injected drugs—thanks to the extensive education and health-service referrals that come with the clean needles—debunking what's usually the stated reason these political ideologues are against it. When you add the fact that many more needles were turned in to program operators than were handed out—helping to rid our bushes, streets and dumpsters of the dangerous implements—we can't think of a single reason to oppose it.
Maybe even Maienschein and Madaffer can be convinced to change their thinking—hell, even Jesse Helms, one of the U.S. Senate's most extreme right-wingers of the last 50 years, was finally convinced (by a rock star, of all things) to support sending money to Africa to help fight the spread of HIV.
But, thankfully, their votes might not be needed. You see, the City Council's been at full strength since early February, and Ben Hueso voiced support for the program during his campaign. If he votes yes when a proposal for a permanent program come up next month, he'll join Councilmembers Toni Atkins, Donna Frye, Scott Peters and Tony Young. Councilmember Kevin Faulconer, reportedly on the fence, has agreed to take a personal look-see at the parked motor home from which needles would be exchanged and listen to the proponents. Since one of the two locations is in his district, a “yea” from Faulconer would be nice. Vote yes, Mr. Faulconer—it's the right thing to do.
The City Council will take the issue up on July 11, which, in our view, is several months too late. Every day without the opportunity to exchange a dirty needle for a clean one is another chance to spread disease. And it's not only drug users who are affected. Those folks meet other people. And those folks meet people. And so on. It gets closer and closer to home, no matter where home is.
A mandatory report by a committee charged with evaluating the program was done more than a year ago, but changes to state law and restructuring of city government required some additional tweaking. However, it's been four months since the City Council regained full strength. Program proponents are being diplomatic in acknowledging that city officials have had a lot on their plates, what with the pension mess and budget hearings and all—they're just happy they have a mayor in Jerry Sanders who's a strong supporter of the program.
So are we, but we think that more effective multitasking could have gotten the proposal to the City Council sooner and probably saved some lives.