New York City has obtained state permission to give clean hypodermic needles to drug addicts in what is believed to be the nation's first attempt of its kind to curtail the spread of AIDS, health officials announced Sunday.
Dr. David Axelrod, state health commissioner, dropped his earlier opposition to the proposal because it was modified to require addicts receiving free needles to enter drug treatment programs, Axelrod spokesman Peter Slocum said.
The program, developed by city Health Department officials and approved by the state Health Department on an experimental basis, would "use the offer of a free, clean needle as a carrot" to lure addicts into treatment programs where counselors could then try to persuade them to quit, Slocum said.
"It's a small-scale experiment to be extremely carefully monitored," said Francis Sheehan, a spokesman for Gov. Mario M. Cuomo.
The program would involve between 200 and 400 intravenous drug addicts at first and could be expanded if successful, said Dr. Stephen Joseph, city health commissioner. Addicts will be chosen for the program, planned to begin in April or May, from waiting lists at methadone maintenance clinics.
Slocum said the program could include several thousand addicts later this year if officials determine that the free needles helped to lower the number of addicts and reduce the transmission of AIDS.
"It would not be just walk in the door, get your needle and turn around," Slocum said. Rather, the addict would get the needle during a drug treatment session and could exchange it for a clean one at a subsequent session, Slocum said.
"The key thing is not to share the needle," Slocum said. "It doesn't matter if you get the needle from the city or on the street."
Slocum said he believed the program to be the first of its kind in the United States. Joseph said much of the spread of acquired immune deficiency syndrome is caused by sharing of needles by addicts and by drug users having sex with others. He said addicts in the program also would be told to use safer sex methods.
The city has at least 250,000 intravenous drug users and more than half carry the AIDS virus, Joseph said. The number of infected addicts rises about 8% a year.
New York state has about one-third of the more than 40,000 known AIDS patients in the United States and most of those are in New York City. A state Health Department study found that one of every 60 women who gave birth in New York City in December carried antibodies to the AIDS virus.
The program is expected to cost between $200,000 and $250,000, Joseph said.
He said similar programs in Amsterdam and England "have been able to show no increase in drug addiction and a decrease in needle sharing. But the data isn't in as to whether they can show a decrease in infection."
But, he said: "Amsterdam is very different from the South Bronx."
An addict in the program would be issued an identification card that contained his photograph and fingerprint, and returned needles would be tested for blood types that differ from the addict's blood type, the New York Times reported Sunday.
The program, which has been opposed by law enforcement officials who believe that it would encourage intravenous drug use, does not need the approval of the Legislature.