Westport to begin needle exchange

For the first time in nearly a decade, leaders of a Massachusetts town have voted to start a campaign encouraging illegal drug users to swap their tainted needles for clean syringes, an effort designed to reduce the spread of HIV, hepatitis C, and other blood-borne illnesses.

Concerned by drug use in the region, Westport's Board of Selectmen voted unanimously Monday night to implement a needle-exchange program.

By yesterday, the decision had ignited a firestorm of protest, with outraged callers flooding phone lines of talk radio stations, selectmen, and the drug treatment center that has agreed to run the initiative. They complained that the exchange would increase crime in the town and encourage drug use. One caller to WSAR in Somerset suggested that the five selectmen who endorsed the needle exchange should be taken out and shot.

The four Massachusetts communities with longstanding needle-exchange programs -- Boston, Cambridge, Northampton, and Provincetown -- all have histories of embracing expansive social and public-health policies.

Westport is the first town outside that orbit to adopt needle exchange, and it sits between two much larger cities, Fall River and New Bedford, that are confronting twin epidemics of drug use and HIV. Both have rejected needle-exchange programs.

''This means that people are seeing this as a realistic public-health policy that works, and it's not about progressive politics or conservative politics," said Rebecca Haag, executive director of the AIDS Action Committee of Massachusetts, New England's largest private provider of HIV prevention and education services. ''It's about doing the right thing to save people's lives."

But if yesterday's phone calls are any indication, plenty of people in Westport felt it was expressly the wrong thing.

''I'm tired. This has been a tough day," said Elizabeth Collins, chairwoman of the town's Board of Selectmen, who was inundated with calls both at Town Hall and at home from angry constituents.

Callers, Collins said, voiced fears that crime would follow drug users to and from the site where they will turn in used needles and pick up clean ones.

Still, she said, her training as a registered nurse left her with no sensible option other than voting for needle exchange, especially in a small town of 14,000 where about 43 percent of HIV cases can be traced to the use of injectable drugs.

''As a retired healthcare professional, it was one of my duties to preserve life," Collins said. ''I have to say that by doing a needle exchange, it would seem to me that we would be saving a great deal of lives."

The HIV epidemic in Massachusetts has different profiles in different parts of the state. In Boston, the burden falls disproportionately on gay men.

But in the hardscrabble fishing cities of Southeastern Massachusetts, AIDS is a disease of injecting drug users.

In New Bedford, from 2001 through 2003, two of every three newly diagnosed HIV patients contracted the virus because of dirty needles. In Fall River, it was 58 percent. In both cases, the figures are substantially above the statewide average of 25 percent.

Nancy Paull witnesses the consequences as chief executive officer of Stanley Street Treatment & Resources, a substance-abuse treatment center on the state's southern coast.

Paull said that despite decades of work in the field, she initially was hesitant to embrace needle exchange.

''I believe," she said, ''that the best kind of life for anybody is a life abstaining from addiction."

But in recent years, Paull said, she has witnessed the spread of drugs and disease in ways she had never imagined.

There was, for example, the teenager who celebrated his 16th birthday while in the detox center at Stanley Street.

So, Paull said, she underwent what she described as a metamorphosis and agreed to run Westport's needle-exchange program.

''It has taken me a long time to get to this place," Paull said. ''But over the years, I have seen that recovery is not a one-shot deal. We need to keep people safe until they can get recovery, and we need to prevent the spread of disease."

The needle exchange will take place in a building on heavily trafficked Route 6 in Westport and will be open to any user in the region.

Paull said she hopes that within a month, users will be able to come into the office and get help to kick their habit, receive treatment for any disease they might have, and obtain clean needles.

As part of a legislative mandate, the state Department of Public Health will underwrite the campaign, providing up to $30,000 in the current fiscal year.

Since needle-exchange programs began in the early 1990s, nearly 14,000 addicts have enrolled, and in 2004 about 615,000 clean needles were supplied in the four participating cities, said Kevin Cranston, director of the state HIV/AIDS Bureau.

''Our experience across the programs has been remarkably mundane and calm," Cranston said. ''I wish I could say there are dramatic tales that attend needle exchange, but participants really bend over backwards not to create any controversy for the program."

Statewide, injection drug users have constituted a shrinking proportion of newly diagnosed HIV cases, Cranston said, and that decline has been even steeper in the communities with needle-exchange campaigns.

Stephen Smith can be reached at stsmith@globe.com.