Cingles Info

City considers needle collection program that some say won't work
By Adam Gorlick, Associated Press Writer | May 13, 2006
WORCESTER, Mass. --At the rate Lenny Carlson says he shoots heroin into his
veins, the needles don't last very long.
After four fixes a day, he's lucky to go five days without dulling the point so
much that it won't puncture the skin on his arms. And when he's done with his
"dirty works," as junkies call their used needles, he throws them on the
sidewalk.
"That's all you can do," said the 52-year-old, who blames his Hepatitis C on
sharing needles off and on since 1969. "What else am I going to do with my dirty
works?"
City health officials say they have an answer: Operation Yellow Box. Unique to
Massachusetts and modeled after a now-defunct program in Baltimore, the
Worcester proposal would set up secure boxes at five indoor locations around the
city where intravenous drug users could dispose their used needles.
The idea is to get needles off the streets where they threaten children who
might be tempted to pick them up and sanitation workers who have to.
But unlike the state's four needle exchange programs in Northampton, Cambridge,
Boston and Provincetown, turning in a used syringe in Worcester wouldn't get you
a new one.
By proposing a drop-off only program, organizers hope to skirt the heated debate
surrounding needle exchange programs, often critized by residents and
politicians who say giving a junkie a clean syringe is condoning his behavior
and contributing to crime.
The Worcester City Council has voted against needle exchange proposals several
times in the past few years.
"This should in no way be construed as a needle exchange program," said James
Gardiner, director of the city's Department of Health and Human Services, which
has asked the city council to consider approving Operation Yellow Box. "But we
need to find a way to better collect needles and protect people in the community
from them."
Gardiner says the proposal will also provide the chance for social service
workers to help wean junkies from their dope.
The five yellow disposal boxes would be placed inside health centers, AIDS
outreach facilities, the public health department and a homeless shelter --
places where addicts already go for services. Once they're in the door, Gardiner
said outreach workers will be able to educate them about the needle disposal
program and the dangers of drug use.
City health officials said they haven't figured out how much Operation Yellow
Box would cost, but state funding would be available for the program, said Donna
Rheaume, a spokeswoman for the state Department of Public Health.
Barbara Haller, chairwoman of the city council's health committee and an
opponent of needle exchange, said she's open-minded to learning more about the
proposal.
But she says it will take a lot of convincing before the city council would
approve it.
"I don't know if this has any real value, or if its just feel-good policy and a
backdoor into needle exchange," Haller said.
Possession of a hypodermic needle without a prescription is currently illegal in
Massachusetts, creating a black market where some diabetics are willing to sell
their syringes to junkies for about $5 a piece.
The cost may seem minimal, but it cuts into an addict's budget for a $20 bag of
dope. With that in mind, many junkies are unwilling to discard a syringe until
it's completely useless. And by that point, it may seem like a bad idea to carry
worthless contraband to a disposal site and risk being caught by police.
"I suspect the demand for the needle will be greater than the desire for an
individual to appropriately dispose it," said David McCloskey, director of the
PIP homeless shelter, one of the proposed drop box sites.
And without the incentive of getting a clean needle in exchange for a dirty one,
many are skeptical that the program would work.
"Junkies don't give a crap," said David Tolka, 48, who says he always threw his
used needles down the sewer so children wouldn't find them. Now homeless, Tolka
says he drinks heavily but stopped using heroin three years ago. Still, he says
he sees plenty of intravenous drug use every day in the city's Main South
neighborhood.
"Nobody's going to throw their works in a box unless they get a clean needle,"
he said. "They just care about the fix."
Still, advocates say trying something that might get infected needles out of
circulation is better than doing nothing.
"One issue that comes up over and over again is that contaminated syringes are
being disposed of in public places -- in parks, in sewers, wherever," said Joe
McKee, deputy director of AIDS Project Worcester. "These boxes are one way to
address that issue short of needle exchange. It takes contaminated needles out
of the community and off the street."
Baltimore ran a similar drop box program for 15 months starting in 1996.
The effort resulted in the collection of 2,971 needles that were deposited in
specially converted mailboxes located in public places known to have high rates
of AIDS victims and drug users.
About 150 of the needles were randomly tested, and nearly 11 percent of them
were contaminated with HIV, said Kima Taylor, Baltimore's assistant commissioner
of health promotion and disease prevention.
The program was discontinued because city officials decided to focus its money
and energy on a needle exchange program, which had already been in place since
1994.
Don Des Jarlais, a research director at New York City's Beth Israel Medical
Center, said drop box programs haven't been widely implemented around the
country, and aren't as effective as needle exchange.
"It's worthwhile to set the boxes up, but there hasn't been an overwhelming
response to those programs," said Des Jarlais, who has written studies for the
U.S. Centers for Disease Control showing that needle exchange programs curb HIV
transmission. "Even where the programs are working well, it's probably only a
minority of disposed syringes that are going into these boxes."
Lenny Carlson, who says he only recently started shooting heroin again after
staying clean for 18 months, put it more bluntly.
"Unless you give a junkie a clean needle, he's not going to just give you a
dirty one," he said.
http://www.boston.com/news/local/massachusetts/articles/2006/05/13/city_consider\
s_needle_collection_program_that_some_say_wont_work/