The Washington Post

Friday, August 9, 1991

AIDS and Drugs

politically appointed body created to help

Congress and the administration formulate
4 consistent national policy on the epidemic, has
just Issued a report on the increasing coincidence
of substance abuse and AIDS. The report is short
00 practical responses, but the figures it presents
on its dimensions are Startling. About a third of
ail adult and adolescent AIDS cases are related to
drug abuse, whether caused by the reuse of
infected needles, by sex with drug users who are
infected or by unsafe sexual conduct while under
the influence of drugs. Seventy percent of pediat-
ric AIDS cases are related to maternal exposure
linked to intravenous drug use. Blacks and His-
panics account for 71 percent of drug-related
cases.

The commussion rightly believes that the gov-
€rnment must direct more attention to these
cases, which are on the rise. But four out of five
of-its recommendations offer no blueprint for fast
aetion. There is the perennial call for “better
coordination” of efforts by the federal govern-
ment, the universal demand for more research
money and the always-to-be-hoped-for treatment
that is not only available on demand but in
convemient locations for all addicts. Even more
lofty 1s the injunction to eliminate all social
problems—poverty, dilapidated housing, poor
nutrition and lack of access to medical care—
“that promote licit and illicit drug use in Ameri-
can society.” No one will argue with those goals,
but surely there are practical Steps that can be

T HE NATIONAL Commission on AIDS, a

taken more quickly to address the connection
between AIDS and drugs.

The commission does offer one such step that
is likely to cause a furor: the removal of all legal
barriers to the purchase and possession of drug
injection equipment. Ten states and the District
of Columbia have laws requiring prescriptions for
purchase of syringes. The list includes a number
of jurisdictions—California, New York, New Jer-
sey, Pennsylvania and the District—where
drug-related AIDS is a major problem. In many
additional states, according to commussion mem-
ber Don DesjJarlais, possession of any kind of
drug paraphernalia can be prosecuted. These
laws inhibit the distribution of clean needles and
of bleach vials that help to reduce the sharing of
dirty needles. Does a decrease in needie-sharing
reduce the incidence of AIDS? The report does
not provide an answer, but Dr. DesJarlais cites
studies conducted in England ‘and Sweden and
experience in such cities as Seattle, San Francis-
co and New Haven that suggest this approach
works.

There are valid objections to government
sponsorship of programs such as clean-needle
distribution or giving out condoms in prison,
which appear to condone disapproved or illegal
activity. These are not easy decisions to make,
but they are necessary in this crisis. This com-
mission recommendation might at least help con-
trol the spread of the virus in this high-risk
population.

 

Page A20