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Pushing a Needle-Exchange Agenda

"Harm reduction" might prick suburban concscience

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County councilor Vince Gastgeb isn't sure that giving needles to drug addicts is a good idea. But there's one point the Bethel Park Republican does want to share.

"I'm not on this crusade because I'm a neophyte homophobe from the suburbs," he says.

It might be tempting to think otherwise. The South Hills haven't been brimming over with tolerance lately. Upper St. Clair's school board recently ended a vaunted international-studies program -- because, board members feared, it taught Marxist and anti-Christian values. In South Park, terrorist-fearing residents recently thwarted plans to build a Turkish cultural center. And now Gastgeb has proposed suspending a program that, according to backers, saves lives and takes drug needles off city streets.

Since 2002, the nonprofit group Prevention Point Pittsburgh has been allowing drug users to swap dirty needles for clean ones. The goal is to reduce blood-borne infections including HIV and hepatitis-C, which can be spread when addicts share used needles. And until now, the program has generated little controversy: Prevention Point Pittsburgh uses no tax dollars, and its weekly needle-exchange programs take place in Oakland, miles outside Gastgeb's district. Still, on March 20, Gastgeb proposed an ordinance suspending "[a]ny and all needle exchange programs" until their "effectiveness, legality, and utility" can be proven.

"We were blindsided by this," says Prevention Point Pittsburgh Executive Director Renee Cox. "We first heard about [Gastgeb's bill] from reporters. County Council had never sought any information from us before."

What's changed? Partly it's an old story in the drug trade: a battle over turf.

"We've had a tug-of-war with the county health board for four or five years," says Gastgeb. The county's nine-member health board is charged with "formulating rules and regulations for the prevention of disease." While council approves board appointees, Gastgeb says, it should have a larger role in setting health policy.

"There have been serious tensions between council and the health board," agrees county Councilor Bill Robinson. Robinson supports needle exchange, but says, "I do think we need a review of the program."

The rules governing needle exchange are especially murky. State law prohibits having needles without a prescription; unauthorized needles are considered drug paraphernalia. But in Philadelphia and Pittsburgh, health officials waived the law by declaring that dirty needles represent a "public health emergency."

That declaration gives Cox's group some legal leeway. But not everyone sees the point. "This is still an 'emergency' four years later?" Gastgeb asks.

"If you live in my district, I'm sure you see very little good come of" needle exchange, he adds. "There's bewilderment in suburban communities. There's some shock that these programs exist, and that nobody knows why."

Well, somebody knows why. "We absolutely see people from Bethel Park," says Cox. Last year, in fact, a candidate running for school board there claimed Bethel's high school was known as "Heroin High." In a May 2003 Pittsburgh Post-Gazette story, local officials acknowledged an "explosion of heroin-related cases," and police cited three nonfatal heroin overdoses in the previous month alone.

Bethel Park officials, however, handle such problems differently: In 2002, school police began prowling high school lockers with drug-sniffing dogs.

Gastgeb isn't proposing such measures, at least. And his bill may even be a good thing. For starters, it probably won't pass. Gastgeb says he intended the measure to sit in committee until the program's effectiveness can be determined. There are "credible" studies to support needle-exchange elsewhere, he notes. If the numbers look good locally, "We could credibly tell people in Hampton or Upper St. Clair that this is the program, and we should be proud of it."

At the very least, we ought to tell people in Hampton or USC that it helps their neighbors -- whether they want to admit it or not.

We're not doing addicts any favors if we conceal our efforts to help them. That just allows others to pretend drug use is merely an issue for ghetto-dwellers. It lets them come up with "tough-love" solutions for others, while buying treatment for themselves.

As Gastgeb himself says, sooner or later, a challenge to needle exchange "was going to happen. Maybe I was the catalyst, but it was only a matter of time." As we've seen recently, intolerance and ignorance can crop up in affluent communities too. And when that happens, it's usually the bystanders -- schoolkids, misunderstood Turks and the addicts down the street -- who pay the price.

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