The MacNeil/Lehrer NewsHour

MR. LEHRER: Good evening. Leading the news this Tuesday, the kidnappers of two American hostages in Lebanon said they will soon send an important message and the Federal Reserve moved to cut interest rates. We'll have the details in our News Summary in a moment. Charlayne Hunter-Gault is in New York tonight. Charlayne.

MS. HUNTER-GAULT: After the News Summary, our major focus tonight is a debate over whether or not clean needles should be given freely to addicts to help stop the spread of AIDS. Next, a report on toxic danger to two of America's coastal wetlands. Correspondent Tom Bearden reports. And finally, essayist Jack Perkins marks the 75th anniversary of the National Park Service.NEWS SUMMARY

MR. LEHRER: The Islamic Jihad issued a statement today saying they will send an envoy to the United Nations Secretary General. They said he will bring within the next 48 hours a message of extreme importance. The Islamic Jihad is an Islamic terrorist group that holds two American hostages. Their message issued in Beirut had with it a black and white photograph of Associated Press newsman Terry Anderson, the longest held Western hostage. The group also holds American Thomas Sutherland. Today's statement said the hostage issue had been exploited by the United States and Israel. It said it was now time to try to resolve it. At the United Nations, Secretary Gen. Perez DeCuellar was asked whether his representatives had been negotiating with the Islamic Jihad.

SEC. GEN. PEREZ DE CUELLAR: No. I am sure that you are all very, very intelligent journalists and you have to realize that it is a very delicate subject and it is for me to avoid any mistake -- that's why I have to be extremely careful in what I say -- but I hope that what I am hearing is the beginning of the solution of the -- [background noise obliterating DeCuellar] calling for the release, and then as well it will be the beginning of for all those including myself who have been trying to solve the problem.

MR. LEHRER: President Bush left Washington this afternoon to begin his summer vacation in Kennebunkport, Maine, aboard Air Force One. He told reporters, "I do not want to make any statement of any kind that would contribute to the concern of the families involved. If something happens, so much the better." Charlayne.

MS. HUNTER-GAULT: Sec. of State Baker briefed the President today on his Mideast peace mission. Afterwards, Mr. Bush said he was much more optimistic. Meanwhile, in Jerusalem, Israeli Prime Minister Shamir said he would abandon the proposed peace talks if Syria insists on regaining the Golan Heights. Another obstacle to peace in the region is Israel's continued settlement of the West Bank. We get more in this report narrated by Vera Frankel of Worldwide Television News.

MS. FRANKEL: This hillside community in the Israeli-occupied West Bank was captured from Jordan in 1967. Today it's home to six Jewish families. More will arrive in the coming weeks, proof to some that Israel will never surrender territory so vital to Middle East peace.

RADUWAN ABU AYASH, Palestinian Activist: Such an action is the Reagan answer for Mr. Baker's proposals by the Israeli government which is no to the peace process in practice and yes to the peace process in appearance.

MS. FRANKEL: The Israeli government disagrees. It says one more or one less settlement will not affect the speed of peace negotiations. But despair among Palestinians that they have little to gain by the peace process is said to have led to this clash in the occupied Gaza Strip. With one Palestinian dead and a dozen injured, troops moved in to impose a curfew in the impoverished coastal enclave.

MS. HUNTER-GAULT: PLO Chief Yasser Arafat said today there would be no capitulation on who represents the Palestinians at the planned Mideast peace conference. Israel opposes any PLO participation or Palestinians from East Jerusalem. Turkey said today it launched an offensive against Kurdish camps in Northern Iraq. Turkish troops and warplanes pushed 11 miles into Iraq in an operation launched Monday. A Turkish government official claimed Kurdish guerrillas used the camp to launch cross border raids. The rebels had been fighting to set up a separate Kurdish state in Southeastern Turkey. There was no word on casualties.

MR. LEHRER: Yugoslavia's federal leaders declared a formal cease- fire in Croatia today. The country's official news agency said the truce was unconditional and covered all warring parties in that republic. European Community foreign ministers held emergency talks in the hague about the Yugoslavia situation. They appealed for support from the United States, the Soviet Union and other countries to end the fighting between the Serbs and the Croats. The Soviet Union warned the West against military intervention in Yugoslavia. A government statement in Moscow said such involvement would lead to a conflict involving all of Europe.

MS. HUNTER-GAULT: President Bush attacked opponents of Supreme Court nominee Clarence Thomas today. The NAACP and the Congressional Black Caucus have said Thomas doesn't represent the views of the black community. Two more groups, the Progressive National Baptist Convention and the National Bar Association, a group of black lawyers, added their names to the list of opponents yesterday. Mr. Bush accused those groups of engaging in what he called ideological attacks. He spoke at an anti-crime ceremony in Arlington, Virginia.

PRES. BUSH: Judge Thomas has tremendous support from a broad section, a cross-section of America. And that across-the-board support includes minority communities, overwhelmingly supported in minority communities I might add, and he's now manifesting itself in measurable ways. So when you hear about opposition to Judge Thomas from one beltway group or another, it's clear that they are simply out of touch with mainstream America.

MS. HUNTER-GAULT: A federal commission said today the government has failed to deal with the link between AIDS and drug abuse. The report by the National Commission on AIDS said about 1/3 of recent AIDS cases were associated with intravenous drug use. They recommended the legal sale of needles and other drug injecting paraphernalia, saying that restrictions have led to needle sharing among addicts and thus the transmission of the AIDS virus. We'll have more on this story right after the News Summary.

MR. LEHRER: The Federal Reserve Board moved to cut interest rates today. It did so by adding funds to the nation's banking system. The action caused a drop in rates banks charge one another for overnight loans. That could translate into lower rates for mortgages and personal loans. William Seidman called it quits today. Seidman is chairman of both the Federal Deposit Insurance Corporation and the agency that overseas the savings & loan bailout. Seidman said in a letter to President Bush he will leave office on October 16th, the last day of his term.

MS. HUNTER-GAULT: That's it for the News Summary. Still ahead, the debate over free needles to addicts, toxic wetlands, and a national park's 75th anniversary. FOCUS - AIDS & ADDICTS

MR. LEHRER: Needles are the subject of our lead story tonight, the needles drug addicts stick into their bodies. The National Commission on AIDS today endorsed the idea of providing free clean needles to addicts as a way of preventing the spread of AIDS. Critics say it is a way of spreading drug addiction. We hear both sides of that intense argument after a report on the largest needle exchange program in the country in Tacoma, Washington. Lee Hochberg of public station KCTS-Seattle is the reporter.

DAVE PURCHASE PASSING OUT FREE NEEDLE TO ADDICT: Stay alive now. Hear me?

MR. HOCHBERG: 52 year old Dave Purchase first appeared in this bleak neighborhood in downtown Tacoma three years ago with a tray table and a satchelful of sterile hypodermic needles. It was the start of a desperate effort to fight the spread of AIDS. Many of Tacoma's estimated 3500 IV drug users were sharing syringes to shoot illegal heroin or cocaine into their bodies. AIDS was spreading rapidly. Purchase offered to give the junkies clean needles in exchange for used, contaminated ones.

DAVE PURCHASE: People are dying. I mean, it's as simple as that. People are dying. You know, it's just because of the unusual nature of the virus they don't drop dead like the Black Plague in three months. It takes people who are being diagnosed with AIDS now got it on average seven and a half years ago.

ADDICT: Do you get many complaints about these little ones?

MR. PURCHASE: No.

ADDICT: They're better than nothin'.

DAVE PURCHASE: [1988] Yeah. Well, people don't like this.

ADDICT: I don't like 'em but they're better than nothin'. Same point you know.

DAVE PURCHASE: I'm workin' on the one cc ones.

MR. HOCHBERG: It wasn't clear if Purchase's campaign would stop the spread of AIDS through Tacoma. Critics doubted its legality and predicted it actually would encourage drug abuse.

GREG MYKLAND, Tacoma City Council: [1988] How can you fight a very severe drug problem in your community while at the same time you're giving new needles to people to continue their drug habit?

MR. HOCHBERG: For three years now, Pierce County health technicians have examined the needles users have returned to Dave Purchase. They measure for sero prevalence or the presence of HIV in the blood serum hoping to find out if the virus is spreading. They found that while sero prevalence among IV drug users has risen dramatically in most major American cities, it has remained stable and relatively low in Tacoma since the needle exchange began. Epidemiologist Holly Hagan.

HOLLY HAGAN, Epidemiologist: When we first started measuring sero prevalence in June 1988, it was less than 3 percent in drug injectors in Pierce County and now three years after the program has been operating, it has remained below 3 percent in Pierce County, drug injectors.

MR. HOCHBERG: As opposed to other cities, say New York City.

HOLLY HAGAN: Yes, as opposed to New York City where sero prevalence is 50 to 60 percent -- in other West Coast cities, it's been as high as 12 to 15 percent.

MR. HOCHBERG: Drug users in Tacoma's so-called shooting galleries like this patch of sticker bushes on an abandoned lot downtown say safer injection began in Tacoma as soon as Purchase set up shop.

MR. HOCHBERG: Usually when people shoot heroin, are they what - - they have one needle and a bunch of people and they're sharing it, is that it? They're all using the same needle?

IV DRUG USER: Are you talking here in Tacoma?

MR. HOCHBERG: Yeah.

IV DRUG USER: No. No. Everybody's got a needle.

MR. HOCHBERG: Everybody's got their own needle?

IV DRUG USER: Everybody's got their own needle. Yeah. Yeah.

MR. HOCHBERG: How about before the needle exchange program came along?

IV DRUG USER: Quite honestly, before the needle exchange came along, you would have two or three people using the same needle. I've seen some people before the needle exchange get into fights as to who goes first, who goes second, and literally fist to fist. [Pause] It's really changed a lot. God knows how many people's lives he saved. I mean, I can't say enough about the guy.

MR. HOCHBERG: What are you going to do with your needle now?

IV DRUG USER: Now I'll go downtown and see Dave and exchange it for a new one.

MR. HOCHBERG: The needle exchange has succeeded as a political experiment as well. When the bearded Purchase first got the idea to pass out needles on the street, civic leaders had seemed unsympathetic about IV drug users and AIDS.

MR. PURCHASE: I spent almost two hours in a discussion with a bureaucrat who was very early on into the conversation I could tell was not going to do a damned thing about it, was going to let them die. The next morning I began to think about what I could do.

MR. HOCHBERG: Purchase presumed that passing out drug paraphernalia on the street violated state law.

MR. PURCHASE: So I was as prepared to be arrested as I was to come back and do it the next day.

LT. MARK MANN, Tacoma Police: She's got some bleach and now she's digging for her outfit.

MR. HOCHBERG: Tacoma police though decided not to arrest him. Parked in a squad car across Commerce Street, patrol officer Mark Mann says with AIDS beginning to cut its way through Tacoma, it was in the city's interest to let the needle exchange flourish.

LT. MARK MANN, Tacoma Police: He's down here to help. He's down here to try to diminish some of the health hazards that go along with intravenous drug use, and the conclusion was we're not going to enforce a misdemeanor law against somebody who's attempting to help the big picture, the big picture of AIDS.

SPOKESMAN: Dave Purchase, who's Dave Purchase, that kind of hippie looking dropout from the '60s? He is clearly one of this nation's citizens of courage.

MR. HOCHBERG: Tacoma civic leaders also saw the big picture and embraced the program with funding, now up to $109,000 a year, enough to pay Purchase for his needles and give him a small salary. [CIVIC LEADER EMBRACING PURCHASE]

MR. HOCHBERG: Opposition from statewide conservatives later pushed the state attorney general to challenge the needle program and Tacoma leaders asked for a court ruling on its legality. Judge Robert Peterson decided under Washington State law public health officials have an overriding duty to fight AIDS, even if it requires distributing drug paraphernalia.

JUDGE ROBERT PETERSON, Superior Court: Balancing that with the stopping the spread of AIDS, I don't think that there's much of an argument, myself. I think that anything we can do to stop AIDS has just got to be done, or we're going to end up like some communities back East.

MR. HOCHBERG: Since that ruling, Purchase has used the street savvy he developed over two decades as a drug abuse counselor to earn the confidence of hundreds of addicts. He now distributes some 120,000 needles per year, bleach and alcohol wipes to disinfect needles, as well as condoms. Needles are even exchanged at the government-run county pharmacy. The health department estimates it needs to buy and distribute another million and a half needles per year to totally eliminate needle sharing in Tacoma. It's come under criticism of late for being overzealous in its efforts to do that. Purchase bought this van so he could take telephone orders and deliver needles to addicts' homes.

PURCHASE TALKING TO ADDICT ON PHONE IN VAN: And then I'll give you a call then and we can figure out where to meet.

MR. HOCHBERG: Money for the van came from an organization pushing for legalization of drugs. Tacoma's newspaper, which had supported needle exchange, chided him for accepting the money.

JOHN KOMEN, Tacoma News Tribune: That was going too far and it was almost like delivering pizzas. It appeared to us to be almost a pizza franchise approach to it, marketing of needles.

MR. PURCHASE: We do the two fundamental things that are important in this kind of a program. First, we do no harm. And secondly, we stop the transmission of that damn virus. The idea is to make it as accessible as possible, as simple as possible, save as many lives as possible. I mean, what's too far when it's life and death? The only too far is death.

MR. HOCHBERG: Today's recommendation from the Commission on AIDS will force other communities to consider whether they've gone far enough to stop AIDS and if needle exchanges like Tacoma's could help.

MS. HUNTER-GAULT: We turn now to a debate over whether or not needle exchange programs should be tried in other cities. One of the handful of cities that is giving needles to addicts is New Haven, Connecticut. John Daniels, the mayor of New Haven, is with us tonight to discuss that program as are three other people with differing views. Dr. Herbert Kleber is deputy director for demand reduction in the Office of National Drug Control Policy. He joins us from New Haven. Robert Stutman is a former special agent in charge of Drug Enforcement Administration's New York City bureau. He's now a consultant on drug treatment programs for businesses. Mr. Stutman joins us from Boston. Dr. Don Desjarlais is a member of the National Commission on AIDS which issued today's report. Dr. Desjarlais is also director of research for the Chemical Dependency Institute at the Beth Israel Medical Center in New York. And starting with you, Dr. Desjarlais, is the Tacoma program we've just seen what you have in mind in terms of the recommendations you made today?

DR. DESJARLAIS: The Tacoma program is one of the possibilities in terms of the recommendations we made today. I think it's important to point out that our first recommendation was for immediate accessibility of treatment, that no person with a drug problem who comes to a treatment program should be turned away, saying, I'm sorry, our program is full, please come back in a month or so.

MS. HUNTER-GAULT: It's treatment on demand that it's called.

DR. DESJARLAIS: Treatment on demand is one way of phrasing. Immediate accessibility of treatment is another way of phrasing it, meaning essentially the same thing. And then our second recommendation is that the present legal restrictions, such as prescription requirements for the sale of injection equipment or criminalization of possession of injection equipment should be removed. That would permit not only syringe exchanges for the communities that wanted them; it would permit over-the-counter sales. It would permit possible distribution without exchange at no cost. It would allow a lot of small scale experiments to be done and communities to decide for themselves what they want to do. The present laws really serve no purpose. No one has ever shown that these criminal restrictions on injection equipment reduce drug use in any way. But they do increase the sharing of injection equipment and, therefore, the transmission of AIDS.

MS. HUNTER-GAULT: And what convinces you of this interrelation between drug use in AIDS?

DR. DESJARLAIS: Oh, there the data are quite convincing. The federal data on AIDS cases indicate that about a third of the recently diagnosed cases come from sharing of drug injection equipment or having sex with a person who injects drugs.

MS. HUNTER-GAULT: How many people are we talking about?

DR. DESJARLAIS: A third of -- we're running several thousand cases of AIDS a month and approximately a third --

MS. HUNTER-GAULT: All over the country.

DR. DESJARLAIS: All over the country. In places like the East Coast, New York, Connecticut, it's a much higher percentage.

MS. HUNTER-GAULT: And this approach would do what?

DR. DESJARLAIS: Well, this approach would allow communities to develop their own safe injection types of programs. It may be over- the-counter sales. It may be syringe exchanges. It may be both of those. But it would really remove the legal impediments to reducing the sharing of drug injection equipment.

MS. HUNTER-GAULT: And the Commission's report today -- in the report you were very critical of the federal government's failure, I believe you said, to make these linkages. Is that right? And where did the government go wrong, or where are they going wrong?

DR. DESJARLAIS: There are lots of places where the federal government is going wrong -- in lots of places.

MS. HUNTER-GAULT: But on this --

DR. DESJARLAIS: On this specific issue, the federal government is not funding the amount of drug abuse treatment that is needed and Congress there specifically has not even provided what the President has asked for. The federal government set up a model -- Narcotics Paraphernalia Law -- which was then passed by most states which has led to the criminalization of drug -- possession of drug injection equipment. And there really -- it's very difficult to tell who in the federal government is responsible for the overlap between AIDS and drug use. Is it the Office of National Drug Control Policy? Is it the Public Health Service? Is it the National Commission?

MS. HUNTER-GAULT: But whoever it is is not making that --

DR. DESJARLAIS: There is not really a coordinated approach to dealing with both epidemics at the same time at the federal or even the state level.

MS. HUNTER-GAULT: Well, let's just ask Dr. Kleber about that. Is he right, Dr. Kleber, there's no coordinated attempt to do this and in the main -- the Commission said today that this linkage isn't even being made.

DR. KLEBER: Well, I would have to disagree with Dr. Desjarlais. The linkage is being made. Our national strategy very specifically addresses the linkage between HIV and drug abuse and we feel very strongly that the best way to deal with that is through the expansion and improvement of treatment. We know that AIDS is a fatal, if not potentially fatal, condition for everyone who gets it. On the other hand, drug abuse is also a potentially fatal condition. In the pre-AIDS era, studies showed that up to 40 percent of individuals who inject drugs are dead in 20 years after they start. So anything that helps an individual continue their injecting behavior it seems to me exposes them to all the other risks that drug abusers are exposed to, the risk of overdose, heart attacks, strokes, whatever, and you're diminishing one risk while at the same time potentially increasing another.

MS. HUNTER-GAULT: And so are you saying -- excuse me -- are you saying that that's the harm then in this -- in this proposal that the Commission is making?

DR. KLEBER: I'm saying that's a potential harm. Congress was very clear in 1988; what Congress said was that the federal government is forbidden to pay for syringe exchange programs. It didn't say that states and cities cannot do it, and, in fact, one of the wonderful things about our country is the diversity and we have no quarrel with Tacoma or New Haven or wherever trying these different models. What Congress said is that the federal government cannot pay for such activities until the Surgeon General certifies with the President that these programs are, indeed, effective. So when that standard is met and if these programs do show promise, our office will certainly consider asking the Secretary of Health & Human Services to convene a panel to see whether that standard of evidence has been met, that they are, indeed, effective.

MS. HUNTER-GAULT: And what's your --

DR. KLEBER: But until then --

MS. HUNTER-GAULT: What's your thinking about it?

DR. KLEBER: Up to now there is not that proof of effectiveness.

MS. HUNTER-GAULT: All right.

DR. KLEBER: One of the programs that's most frequently cited as working is the one in England and yet over 90 percent of the people taking part in that program have dropped out within a relatively short period of time. All of these programs are plagued by very high dropouts with the people most likely to remain in those who were least likely to share to begin with.

MS. HUNTER-GAULT: Mayor Daniels, your city has one of those programs. How successful is it?

MAYOR DANIELS: Oh, I think that we have -- we have the model and our program has only been in for seven a half months. And we have been very, very successful.

MS. HUNTER-GAULT: In what way?

MAYOR DANIELS: In cutting back the spread of AIDS amongst needle users within our, within our community. We have also gotten people to go into, go into treatment. In the seven month period that we have had this program we have given needles out to over 700 drug users. Of that number, we have now over 100 in our -- in treatment. Our model or our program goes a step further. Not only are we giving them clean needles, but also we have case workers and workers right there on the site giving counseling in AIDS and other kinds of health diseases. So we are looking at our program as a two-prong approach. No. 1, to stop the spread of AIDS within our community; and the community, both the Latin American community and also the Afro-American community, which are heavily hit hardest by the, by the AIDS virus in the city of New Haven, but our study has showed that we have reduced the spread of AIDS within our community by 33 percent.

MS. HUNTER-GAULT: That's interesting and I want to get back to Dr. Kleber on that data in just a moment, but let me just ask you this briefly. You were very much opposed to this approach as much as early as a year ago. What changed your mind?

MAYOR DANIELS: Two years ago. I was a state senator in Connecticut, and a bill was before the Senate to distribute free needles to drug users and I led the fight against that, against that bill because I was of the notion that we heard the councilman in Tacoma, Washington, that this would encourage further drug use, it would encourage young people to get involved within the -- in drugs. Upon being elected mayor, I met with a group of AIDS advocates who were very supportive of a needle exchange. I met with addicts. I had opportunity to visit a hospital, our newborn centers, and see babies who were born of mothers who had contracted AIDS through a drug user, and that convinced me that we needed to take a new approach, we needed to do something. Like the judge mentioned in Tacoma, Washington, that the disease was spreading rapidly in Tacoma, it was killing people, and he said he did not want -- we needed to do something to prevent what was happening back East. And when he was talking about back East, he was talking about cities like New Haven and New York where we were losing thousands and thousands of people. So I -- I just simply said we have to do something and although our approach I considered it a bandaid approach, but it's a bandaid that's very badly needed, badly needed, and if we can save one life, I think the program and the effort is worth it.

MS. HUNTER-GAULT: Bob Stutman, you've heard the mayor's argument and yet you've been opposed to this approach. Are you persuaded?

MR. STUTMAN: I'm still against the use of -- or the handing out of needles for a number of reasons. No. 1, I agree with Dr. Kleber, that this is two separate diseases. People die from the effect of drug abuse. Just as the mayor was convinced when seeing an AIDS - - an HIV positive infant being born saying that needles should be distributed -- I would be just as convinced seeing a drug addicted infant born and saying I will do everything I can to stop the spread of this particular disease, drug abuse. We know that the average age of heroin addicts in the United States has gone up over the past few years, and in a period of time where heroin availability has grown tremendously in the United States, I feel that one of the dangers of giving needles to anyone who wants 'em, who walks in the door and says I want a needle, is that those younger people who heretofore had not been trying heroin because of their fear of AIDS will try to experiment with heroin. And while we may incrementally cut down the number of people with HIV positive amongst the present users, I'm very afraid that the number of new users will continue to escalate because, in fact, we will have removed that fear of AIDS from those new users. In addition, the very practicality of the situation is difficult. One can't compare Tacoma with cities like New York, Miami, or Los Angeles. If we were to implement a meaningful program in New York City with about estimated 1/4 million heroin addicts, we would be giving out almost 400 million needles a year putting those on the streets and I would argue that that would be a far greater danger to any of the potential pluses we would come up with.

MS. HUNTER-GAULT: Mayor Daniels, what about that?

MAYOR DANIELS: Well, let me -- I just don't see -- have not heard of any evidence that would support his case whereby if we were to distribute needles that more and more young people would be taking up drug use.

MS. HUNTER-GAULT: Dr. Kleber, do you have any evidence on that?

DR. KLEBER: Well, the evidence is not in on either count. I would have to take issue with Mayor Daniels, who otherwise I respect greatly, that the New Haven experiment reduced the spread of HIV by 33 percent. What you had was a limited study going on for about six months and through a very complicated mathematical formula, there appeared to be less HIV positive needles among the people in the program than among people in shooting galleries, etcetera, and from that they calculated that there would be a 33 percent decrease in AIDS transmission.

MS. HUNTER-GAULT: And you say that's --

DR. KLEBER: Ignoring the fact that -- well, it ignores the fact that the people as shown in England most likely to take part in such programs were those least likely to be sharing in the first place.

MS. HUNTER-GAULT: But you made your decision based on a flawed experiment.

MAYOR DANIELS: No. I would -- in terms of the statistics and all the data, I would have to refer to the doctor here in terms of refuting Dr. Kleber's remarks.

MS. HUNTER-GAULT: What about that, Dr. Desjarlais? I was going to ask you -- Dr. Kleber said there was no evidence for either the -- either approach. What's your evidence that this really does work?

DR. DESJARLAIS: Well, there is a preponderance of evidence that syringe exchanges reduce the sharing of drug injection equipment from studies throughout the world. In Sweden, they followed 500 drug addicts for two years participating in the syringe exchange and found none of them became infected with HIV. In Amsterdam, they found that hepatitis B rates, which have gone down since they did a massive expansion of the syringe exchange program. Similarly, in San Francisco, which has a large semi-legal syringe exchange program, hepatitis B has also gone down. The London studies also indicate that the people who stayed in the syringe exchange, HIV sero conversions, are extremely rare or non-existent. It's clearly -- it's clear from the data that syringe exchange is not a panacea. It is not going to stop the AIDS epidemic. It clearly has to be linked to ready availability of treatment and, as Dr. Kleber mentioned, improvement in treatment has to be linked with condom distribution.

MS. HUNTER-GAULT: What about that, Dr. Kleber, his evidence that this does work?

DR. KLEBER: Well, let me first take up the point that Dr. -- that Mayor Daniels made earlier about getting -- the approach works to get people into treatment. In New Haven, a year or so before this study, there was an outreach study done using bleach and counsel and all that which was just as effective in getting people to seek treatment, so you don't need this to get people into treatment. You can get people into treatment through appropriate outreach, bleach, et cetera.

MS. HUNTER-GAULT: Do you accept that --

DR. KLEBER: As far as --

MS. HUNTER-GAULT: Just one second. Do you accept that, Mayor?

MAYOR DANIELS: I don't accept that when we have evidence that the needle exchange program is saving, saving lives.

MS. HUNTER-GAULT: All right. I just wanted to get a quick answer to that. Dr. Kleber, continue.

DR. KLEBER: By the way, that study was done not just in New Haven but in a number of cities across the country and it -- it showed fairly clearly that you could get many people into treatment through these outreach. As far as Dr. Desjarlais' evidence, I would have to say again they lack that critical element of the control group. Of course, people who don't share are less likely to get HIV positive. The question is: Is the average addict likely to take part in such a program? The average addict knows he can die in the next 20 minutes from an overdose and when he's under the influence of drugs. He may start with a clean needle, but if he's around a group of friends and has taken his fourth or fifth hit of cocaine in the last couple of hours, the likelihood that he's not going to share that needle sharply drops.

MS. HUNTER-GAULT: Dr. Desjarlais.

DR. KLEBER: So that we just don't know among that group whether, indeed, they are or are not sharing.

MS. HUNTER-GAULT: All right.

DR. DESJARLAIS: I think --

MS. HUNTER-GAULT: Just very briefly.

DR. DESJARLAIS: Dr. Kleber's analogy to an overdose is very appropriate because in this country if you have a heroin overdose or a cocaine overdose, you dial 911 and they'll send out an emergency ambulance to treat that overdose and they'll treat it pretty effectively, so we're willing to try to protect people from overdoses where it's a known consequence of drug abuse and clearly allows people who overdose to continue using drugs, because they don't die. I think we need to take the same approach to HIV. If we have a method that will help a reasonable number -- it's not necessarily all, but a reasonable number of drug addicts keep from getting exposed to HIV, we ought to implement that the same way that we would send out an ambulance to treat a heroin overdose.

MS. HUNTER-GAULT: He's right, isn't he, Bob Stutman?

MR. STUTMAN: Well, I believe he's right and he's wrong. And I'd like to make two quick points. No. 1, I'd like to know if there is any appreciable difference in achieving the same results as far as HIV positive between cleaning the works in bleach and using a new needle.

MS. HUNTER-GAULT: All right.

MR. STUTMAN: If in fact --

MS. HUNTER-GAULT: Let's get the answer.

DR. DESJARLAIS: The studies haven't been done. One of the reasons why we don't have all the evidence yet is because the federal government, Congress included, has refused to fund the research we would need to meet that scientific standard of saying syringe exchanges are a very, very effective way of preventing HIV. So we're caught in a Catch-22 of not having the evidence, but not funding the studies to collect the evidence.

MS. HUNTER-GAULT: Okay. What's your second point, Mr. Stutman?

MR. STUTMAN: Most doctors I know who are experts in the field feel that basically the bleach will kill the HIV virus, which means we can achieve the same result by utilizing the bleach tied to treatment programs, as Dr. Kleber said, as giving out needles. No. 2, if one wants to get addicts into treatment programs, I would proffer that the State of Connecticut could achieve a much greater result by simply saying everyone who was on parole who was an addict at the time of arrest must report to regular treatment and they would have a far higher percentage of addicts going into treatment.

MS. HUNTER-GAULT: Would that work do you think?

MAYOR DANIELS: I don't think so.

MS. HUNTER-GAULT: Why not?

MAYOR DANIELS: Well, I believe that those who are on drugs, and there are many people on drugs in the city of New Haven who are looking for treatment, but the treatment is not, is not there. So they continue to use drugs and to shoot up.

MS. HUNTER-GAULT: I want to ask Dr. Kleber about that. I was coming back to this point. Dr. Kleber, in material that I read related to New Haven and other places, it said that, you know, when addicts came for treatment, often the facilities were so overcrowded that they couldn't get treated anyway. Could you just respond briefly to that. Then I want to ask you why it is that the government hasn't funded, if you know, experiments with bleach, as Dr. Desjarlais just mentioned.

DR. KLEBER: Your first point is absolutely right. People are being turned away. There are waiting lists. That's one of the reasons we've tried to expand treatment. And unfortunately, as Dr. Desjarlais indicated in his initial comment, Congress has not given us the money we asked to expand treatment. In 1991, the President asked for $100 million additional to fund drug abuse treatment. Congress gave us 35 million. In 1992, we're asking for an additional 100 million and it looks like again we'll get no more than 1/4 to 1/3, so that I think that if we're going to get to that point where addicts can get treatment within a reasonable period of time, we're going to need the cooperation of Congress in appropriating the money. Otherwise, addicts will continue to be turned away.

MS. HUNTER-GAULT: But in the meantime, you don't see this as a bandaid, as the mayor referred to it as.

DR. KLEBER: I think the bleach --

MS. HUNTER-GAULT: You wouldn't accept it this as a bandaid, the free needles?

DR. KLEBER: I think that it's a bandaid that can leave the wound gaping open and the patient continuing to bleed. I think that, as Bob Stutman pointed out, bleach can accomplish the same thing. If you remember, if you have a sterile needle, but you're still sharing the water to -- or the cotton, as a lot of the addicts do, you're just -- you're also at high risk for transmitting HIV. Just giving the clean needle does nothing about the rest of the paraphernalia.

MS. HUNTER-GAULT: All right.

DR. KLEBER: And in a sense, lulls you into a false security. I think bleach doesn't give that message of promoting drug abuse and at the same time can be an effective way of killing the virus. Why not bleach?

MS. HUNTER-GAULT: All right. Let me just go back to Dr.Desjarlais in the final seconds of this conversation. You were one government appointed panel looking at this issue and you've come out with a recommendation that is diametrically opposed to what the government's top drug policy people believe is the way to go. What's going to happen?

DR. DESJARLAIS: Good question. I mean internationally there is no doubt that almost every government that's faced with an AIDS and drug abuse problem has adopted some form of legal distribution, either syringe exchange, over-the-counter sales, or both. Here in the United States there really is a growing movement to provide syringe exchanges in various cities. States like Connecticut, states like Hawaii have passed laws to permit syringe exchanges.

MS. HUNTER-GAULT: So you think --

DR. DESJARLAIS: That clearly the international and the national movement is towards providing legal access to drug injection equipment.

MS. HUNTER-GAULT: All right. Well, I wish I could get an answer from each of you on that question but we have to go and save it for another day. Mayor Daniels, Dr. Desjarlais, Dr. Kleber, and Bob Stutman in Boston, thank you for joining us. FOCUS - TOXIC WETLANDS

MR. LEHRER: Now a report on toxic waste, most particularly those generated by the oil and gas industry. Correspondent Tom Bearden reports on the situation in two very different states, New Mexico and Louisiana.

MR. BEARDEN: The coastal wetlands of Louisiana. Some say this is the most valuable wildlife habitat in the United States. It is certainly the most productive fishery. 40 percent of the country's seafood comes from here. It is also one of America's most valuable energy resources containing important reserves of oil and natural gas. Some believe that recovering the energy is destroying this vast marsh and most of South Louisiana in the process. Donald Lirette is a longtime environmental activist.

DONALD LIRETTE, Environmentalist: Every particular little location that oil field activity has occurred there has been subsidence of the ground and the killing of vegetation in every area.

MR. BEARDEN: Lirette says this cyprus forest was killed by toxic waste that spilled out of this now abandoned pit.

MR. LIRETTE: This pit still has a lot of the sludge and a lot of the stuff that was pumped in it from the production and every time we get a tidal flow that comes in and floods this area out, it just goes into the surrounding marsh. And when it goes into the surrounding marsh, it kills a little bit more marsh every time.

MR. BEARDEN: He says oil fuel wastes are a major factor in wetland loss which one study estimates at a staggering 100 acres every day. Oil wells are drilled with special fluids which are sometimes left in pits on the well site. A much larger volume of waste is called "produced water," highly saline fluid that comes out of the ground along with the oil. EPA says it contains benzine, lead, arsenic, barium, sodium, and sometimes radium. Produced water must be separated from the oil before it can be sold. It's done by heating the mixture in large tanks. In Louisiana, about 2/3 of the water is injected directly back into the ground, where it usually can't hurt anybody. But in the wetlands, it's often piped into a pit or a holding tank, where the solids are allowed to settle. Eventually the water is released into the surrounding marsh or bay. Between sixty and eighty million gallons of produced water are discharged in Louisiana every day. It's perfectly legal to do that. But is it safe? The oil companies say yes. Mike Lyons is an attorney for the Louisiana Mid-Continent Oil & Gas Association.

MIKE LYONS, Mid-Continent Association: The question is very simply size. Is there an impact? We're talking about produced water, which is basically salt water. We're talking about a discharge to the Gulf of Mexico which is salt water.

MR. BEARDEN: Maureen O'Neill, who heads the Louisiana Department of Environmental Quality, emphatically disagrees.

MAUREEN O'NEILL, Department of Environmental Quality: This is one of the most toxic effluents I have ever seen. We are talking serious, serious levels of toxicity where we are talking about very small, almost 3 to 4 percent of this effluent, you can water it down numerous times and it still is going to kill the little critters at the bottom that the fish feed off of.

MR. BEARDEN: And therein lies the heart of the argument. Is it hazardous or isn't it? The Louisiana Department of Environmental Quality thinks it is and says scientific studies verify that position. The oil companies say the science vindicates their claim. The United States government has declared it isn't hazardous, but critics say that's a political rather than a scientific judgment. In 1980, Congress temporarily exempted oil and gas effluent from federal hazardous waste regulations while it considered strengthening the nation's basic hazardous waste law, the Resource Conservation & Recovery Act, commonly known by its acronym, RCRA. Congress directed EPA to study the situation and report back on whether the exemption should be made permanent. It was an important question for the oil companies. Having to dispose of enormous quantities of waste under the extremely stringent standards of RCRA would be monumentally expensive and they contend impossible.

SPOKESMAN: If you removed our exemption on produced water discharges, in some cases, in perhaps many cases, we couldn't inject this water. We not only couldn't discharge it, we couldn't inject it. So what are we going to do with it? We can't leave it in the ground. There's not technology that I know of that allows us to produce oil or gas without producing the other liquids that come up in that formation and that's produced water. So our only alternative if we can't discharge it or can't inject is not to produce it.

MR. BEARDEN: In 19881, a EPA staff report concluded that some oil field drilling wastes were hazardous and ought to come under RCRA. But agency managers overruled that report and recommended the exemption be made permanent. Maureen O'Neill says that the exemption is a demonstration of the political power of the oil companies.

MAUREEN O'NEILL: That's what some of us would call linguistic de- toxification. They have lobbyists that go up there and they take terribly hazardous material that is in many cases radioactive that is full of cancer causing substances and they legally get it labeled non-hazardous. That doesn't mean that it isn't lethal in many cases.

MR. BEARDEN: EPA's justification for the exemption was the assertion that existing state and federal regulations were adequate to deal with oil and gas wastes.

KERRY ST. PE, Department of Environmental Quality: The bottom is full of oil.

MR. BEARDEN: Kerry St. Pe, a biologist at the Louisiana Department of Environmental Quality, disagrees. He showed us several examples of why he feels that way -- like this waste pit.

KERRY ST. PE, Department of Environmental Quality: Those levees are totally inadequate. I mean, they're almost non-existent in places.

MR. BEARDEN: St. Pe thinks he may have the statutory authority to deal with poorly operated pits, but saysthat really doesn't mean very much.

KERRY ST. PE: We don't have enough people to address these situations. We know they exist. We just simply do not have the people to address these problems one by one.

MR. BEARDEN: Could you guesstimate how many wells you might have around here that would be similar to this one -- that's like this?

KERRY ST. PE: I couldn't even give you a guess. It's --

MR. BEARDEN: A dozen -- hundreds --

KERRY ST. PE: Certainly in the hundreds, certainly in the hundreds.

MR. BEARDEN: Sometimes old oil storage tanks leak, overflowing their containment levee. It happened on this day, a substantial slick floating into the marsh. The slick is just the beginning. DEQ biologists said all the marsh grasses contaminated by this spill would die within days and the sediment their roots had been holding together would be completely eroded away within 30 days, another acre or two to add to the wetland loss. And St. Pe showed us several examples of tank platforms literally falling apart.

KERRY ST. PE: This facility doesn't appear to be active, it's not producing. It's obviously abandoned. You can see the condition of the barge.

MR. BEARDEN: So what happens to that?

KERRY ST. PE: It's been our experience that -- to note and observe that most of these types of operations just disintegrate and eventually fall into the water.

MIKE LYONS, Mid-Continent Association: I'll admit there are cases -- you can find cases where the oil and gas industry has failed environmentally. I imagine you could find a lot of them over a hundred years of production, but I think by and large the producer today is a responsible producer. He's trying as best he can to meet the environmental requirements that are set forth by the federal government and the state government. He wants to be environmentally responsible.

MR. BEARDEN: Do you see a lot of evidence out here that they are good stewards of the environment?

KERRY ST. PE: Well, I mean, it depends which company you're talking about. Overall, as far as the industry, entire industry is concerned, you know, we have a lot of examples that would suggest otherwise.

MR. BEARDEN: This spring, Louisiana adopted new regulations to force oil companies to phase out all produced water discharges over the next four years. The effluent would have to be re-injected back into the ground where it came from. The oil industry says they offered to do that on their own initiative before the regulations were proposed. They say they were willing to give up 425 out of 500 discharge sites in the marshlands, but they wanted to continue releasing produced water in open bays. Lyons says the industry offered to fund a million dollar scientific study to determine the impacts of those 75 sites. The offer was rejected.

MR. BEARDEN: Is this state being badly served by these regulations?

MR. LYONS: Yes, yes. The state of Louisiana is bordering on environmental extremism.

MR. BEARDEN: Lyons says complying with the new regulations will cost the industry a billion dollars and that the state will also lose millions in tax revenues.

MAUREEN O'NEILL: When they start saying that this is going to cost money and cost jobs, I just simply don't believe it. I believe we are creating clean-up jobs. There may be a few wells that will go out of business if you start looking at the cost-benefit ratio of things, but what about the seafood industry, what about the fact that this happens to be one of the -- also one of the most important industries in the state of Louisiana?

MR. BEARDEN: O'Neill and others are concerned that the state's highly profitable seafood industry is being hurt by oil and gas waste. Lyons says prove it.

MR. LYONS: We have had record catches of fish. We have actually increased fisheries' production over the same years we have increased produced water, surface discharge.

MR. BEARDEN: We repeatedly requested an interview with EPA administrator William Reilly to talk about the RCRA exemption; those requests were denied. An EPA spokesman said the agency had nothing to gain by talking about it and much to lose when next called to testify before Congress, for example, which was responsible for the exemption in the first place. The spokesman called this issue one of those Washington political black holes. Environmentalists say there are glaring inconsistencies in EPA's efforts to protect wetlands. In Colorado, developers are facing a stiff fine for filling in less than two acres of wetland, while Louisiana loses 50 times that every day. And although EPA's position is that existing regulations are adequate, an inspector general's report accused the EPA regional office responsible for Louisiana of not adequately enforcing federal regulations. The report pointed out that EPA had never issued a general discharge permit for oil and gas waste under the Clean Water Act even though such a permit had been required for 15 years. EPA did arrange an interview with Robert Wayland, the director of the Office of Wetlands, to talk about that. He says the permit has since been proposed. We asked why it took 15 years to reach the proposal stage.

ROBERT WAYLAND, Environment Protection Agency: I think that in many respects, the problem of production waste from individual facilities was not recognized as significant a problem as the oil -- as the oil and gas refining sources were, as steel production was, auto manufacturing, you very much had an orientation throughout the '70s and into the '80s of focusing on the very large volume discharges that in many cases included a chemical soup. Individual oil and gas production wells and facilities looked in relationship to some of those facilities to be minor in their environmental impact.

MR. BEARDEN: It isn't just Louisiana residents who are calling for more federal regulation. The EPA estimates there are over 800,000 crude oil and natural gas generating sites across the country. Environmentalists say each one of them has some form of waste pit, usually unlined, linking into groundwater supplies. These people in the tiny town of Cedar Hill, New Mexico, say waste pits and even the injection wells that Louisiana sees as a solution to its problem are responsible for contaminating their drinking water. Carl Weston says badly drilled and maintained production and injection wells have resulted in natural gas in his water well.

CARL WESTON: I found out one day when the kids were playing around flaring the lemonade. When you put sugar in it, it'd bring out more of the gas. I started looking --

MR. BEARDEN: Flaring the lemonade, what does that mean?

CARL WESTON: Flaring the lemonade. You make lemonade the old fashioned way, not a frozen can, and when you put sugar in, it makes more gas come out if there's gas in the water. And you light a match and hold it over the top, it goes -- shhh [making noise to demonstrate] --

MR. BEARDEN: Maxine Welch says her well water is now heavily contaminated with minerals.

MAXINE WELCH: This is how the toilet looks just after a couple of days of use if I don't scrub it every day with Lime Away. And you can see from the back of the tank what an absolute mess it is. Andbefore they put that well in, we did not have this problem. And let me show you the shower. It is just gross. That's all I can say for it.

JAKE HODDELL: This is an example of an unlined discharge pit.

MR. BEARDEN: Jake Hoddell says the sludge in the bottom of a waste pit near his home is contaminating his well. New Mexico has a pretty good national reputation for environmental regulation, but Hoddell says rural people are getting lost in the shuffle and need help from Washington.

MR. HODDELL: The honor system is not working. That's the big problem. We want this industry regulated under the Hazardous Waste Act, which they should be doing. All other industry, most other industry, is regulated under the Hazardous Waste Act.

MR. BEARDEN: Maureen O'Neill believes federal regulations are needed to prevent oil companies from following a "divide and conquer" strategy.

MAUREEN O'NEILL: When you don't have uniform regulation, what you tend to see sometimes are states playing off against each other. And people will go shopping for contamination rights.

CHARLES DiBONA, American Petroleum Institute: We aren't dividing and conquering.

MR. BEARDEN: Charles DiBona is the president of the American Petroleum Institute. He says the Interstate Oil Compact Commission, an organization of 29 oil producing states, studied the issue in 1990 and re-endorsed the state regulation concept.

CHARLES DiBONA, American Petroleum Institute: There were 29 governors that got together and put this volume together, and all said they together wanted to have the regulation of these activities administered at the state level. The issue is not whether there is regulation or new regulation. The question is whether that should be done by the states and whether there are adequate federal laws to permit the states to do that. And the finding of EPA is, yes, there are, and that with that regulation mostly in place, but with some improvements, there is no risk to human health or the environment.

MR. HODDELL: What is the Environmental Protection Agency protecting? That's my question. In our eyes, it's very clear that they are protecting the interest of big business.

SPOKESMAN: Sure, you can say we're powerful. We're important to this country. I assume we're powerful because we're important to this country. But to say that that loophole is there for political reasons I think is wrong.

SPOKESMAN: You can see the oil, the colored water. That's all produced water.

MR. BEARDEN: The Louisiana legislature recently rejected several attempts to repeal the new regulation, although the Department of Environmental Quality anticipates further attacks, and even though planning for the phase-out is well under way, it will still be four years before produced water discharges are completely eliminated. In the meantime, 80 environmental groups are now lobbying Congress to eliminate the hazardous waste exemption for oil and gas wastes. RECAP

MR. LEHRER: Again the major stories of this Tuesday, a terrorist group holding two American hostages in Lebanon was heard from. They issued a statement in Beirut saying an envoy was being sent to the United Nations Secretary General within the next 48 hours with a message of extreme importance. It led to speculation and hope of a hostage release. And the Federal Reserve Board moved to cut interest rates. Good night, Charlayne.

MS. HUNTER-GAULT: Good night, Jim. That's the NewsHour for tonight. We're sorry we were unable to bring you Jack Perkins' essay on national parks because our discussion ran longer than planned. We'll be backtomorrow night. I'm Charlayne Hunter-Gault. Good night.