Elsewhere in the United States, a small needle exchange project has successfully begun in Tacoma, Washington and another is close to starting in Portland, Oregon. But these are cities with small numbers of drug users, very low prevalence levels for HIV among them, and none of the super-heated drug war climate of today's New York. Indeed, these pre-AIDS zones may be the only areas in the United States in which such schemes can function. It is estimated there were about 20,000 addicts in New York City at the time. The law enforcement apparatus of that day, supported by the restrictive Harrison Narcotics Act of 1915, managed to close down that program within two years and, in New York and elsewhere in the United States, to imprison some doctors who tried to treat addicts.
Drug addiction is, among other things, a chronic disease.
But it is still not seen that way in the United States or in most of the world. The story of New York's needle exchange is simply another version of the enduring denial of this perspective. This time however, the long war on drugs has a new combatant AIDS - a global power with little regard for the local politics of the moment. By withholding needles from drug users in the midst of the AIDS epidemic, we still withhold acknowledgement of the disease status of addiction. But now, in a particularly perverse tactic of New York's war on drugs, we also delay effective intervention long enough for AIDS to finish the job it has already begun here with such devastating efficiency.