Cost and fear hinder needle exchange

By GEOFF CUMMING

All sorts of people saunter in and out of the unassuming bungalow which houses the "exchange."

The white weatherboard building nestled between warehouses in Ponsonby is where intravenous drug users go to swap used needles and syringes for new ones.

The clientele includes smartly suited young women, spiky-haired youths, male bodybuilders in their 40s. Most are European men, ranging in age from 20 to 50.

Ten such needle exchanges operate nationwide, aiming to ensure needles are used just once before safe disposal.

Business is booming on the back of increased demand for injected amphetamines, morphine and other recreational drugs.

But figures show that the majority of IV drug users steer clear of exchanges - making it more likely they will reuse equipment and contract hepatitis B and C.

It also increases the chance that they will stockpile used needles before dumping them in the community - where they can be picked up by children.

While buying and selling needles and syringes is not illegal, their possession is.

National needle exchange programme coordinator Simon Nimmo says fear of prosecution and the cost of needles and syringes encourage their reuse and stockpiling.

He wants the law changed so that possession is no longer an offence. And he wants the exchange of old needles for new to be free of charge.

Two recent incidents where children were pricked by dirty needles - at a Mairangi Bay bus shelter a fortnight ago and in an Avondale reserve this week - are relatively unusual, says Mr Nimmo.

"In Kings Cross you get syringes all over the footpath - this wouldn't even make the news in Sydney. The Avondale find is an aberrant event.

"Drug users in New Zealand in the main are very well informed and responsible about safety issues."

Set up in the late 1980s in response to the HIV-Aids epidemic, the national exchange programme prides itself that New Zealand has the world's lowest rate of HIV infection among IV drug users - less than 1 per cent.

But the return rate for syringes is estimated to be only 30 per cent.

Users caught with needles and syringes can be prosecuted under Section 13 of the Misuse of Drugs Act.

A "gentlemen's agreement" with police means that users caught with equipment on their way to or from the exchange will generally be let go. But Mr Nimmo says about 100 people a year are prosecuted for possession of needles and syringes nationwide.

"If residue of, say, morphine is found in a syringe, people can go away for 10 years. There is considerable fear that people will get caught."

He says police also use Section 13 of the act to detain users while they search, "which usually leads to drugs charges."

In Australia, needles are available free but there is no incentive to return them, says Mr Nimmo.

"New Zealand has the only exchange programme in the world where people have to buy equipment - everywhere else, it's provided free. While it is user pays, people have an economic motive to reuse - so used needles and syringes remain in the community for longer."

The programme has piloted the free exchange of needles in Wellington for two years and this has now spread to Palmerston North and Dunedin. Return rates there have shot up to more than 100 per cent higher than those in Wellington.

Overseas, most exchange programmes manage at least a 75 per cent rate of return. But our Government has baulked at the cost of implementing free exchanges nationwide, says Mr Nimmo.

"The high usage rates in Auckland and Christchurch mean that a lot of money would be involved."

The programme's records show it sold fewer than one million needles nationwide last year.

The Ministry of Health maintains that it is over to individual exchanges to introduce incentives, such as free needles in exchange.

No ministry official was available to discuss the policy issues.

The programme is finalising a report for the ministry on the return rate in various centres.

Detective Senior Sergeant Colin McMurtrie, head of the Auckland Drug Squad, rejects suggestions that police take advantage of the Misuse of Drugs Act. He said the police did not enforce the law on possession unless there were other circumstances.

"We don't go out and actively locate people with syringes - finding syringes when we are dealing with people in relation to drugs is a more likely scenario," he says.

"We don't sit outside the needle exchange places looking for heroin addicts."

But Karen Blacklock, manager of the Auckland Drug Information Outreach Trust's programme in Ponsonby, says illicit drug users naturally fear being caught carrying a syringe while possession remains illegal.

"For someone who may already have a drug conviction, it's a significant worry."

The Ponsonby exchange does what it can to remove the stigma and suspicion which surround the taking of illegal drugs.

A sign in the hallway marked "exchange" points visitors to a room which could be any suburban doctor's waiting room - wooden floors, a couple of couches and lots of pamphlets about safe drug use.

Amid small talk with the friendly young guy behind the counter, used needles are placed in a sealed box for disposal and new equipment purchased at a discount price. Customers are given a plastic bottle to safely carry the goods.

In this informal setting, the transaction seems completely normal, and far from the seedy, underworld image of drug-taking.

The exchange supplies about half the needles and syringes in Auckland. A few dozen chemists with "sharps bins" provide the rest, at slightly higher prices than the 60c a syringe (with return) charged by the Government-funded exchange.

Around 10,000 Aucklanders are estimated to illegally use a needle and syringe. The three paid staff and 10 volunteers at the Auckland Drug Information Outreach Trust see about 50 users a day, 365 days a year.

Many are bodybuilders taking banned steroids.

Outside the 10 am to 10 pm opening hours, users can buy needles from a dispensing machine out the back, using a Pin number.

Morphine and amphetamines are the most commonly injected drugs. Heroin supply has dried up in recent years, in contrast to Australia.

Needle exchanges operate in Hamilton, Tauranga, New Plymouth, Palmerston North, Napier, Wellington, Nelson, Christchurch, Timaru and Dunedin. A new centre will open in Whangarei in a couple of months, and there are plans for Greymouth, Wanganui and Invercargill.

Sales among the country's estimated 60,000 drug users last year grew 18 per cent to 877,749. A few years ago, up to 70 per cent of users had hepatitis C, most through sharing needles.

But Mr Nimmo says this figure has fallen to about 45 per cent with the success of the exchange programme.

West Auckland is one area where usage rates have climbed significantly, worrying officials who want an exchange opened in the area.

Karen Blacklock believes the bag of up to 300 syringes deposited in an Avondale rubbish bin was probably left by one user or a small group of users.

"It's not something that the vast majority of drug users would do. Most drug users in this country are very responsible and care about the community."

But the two recent incidents in Auckland highlight the potential for disaster.