INTERVIEW WITH DR. PETER LURIE INTERVIEW

Dr. Peter Lurie is a Senior Researcher at the Institute for Health Policy Studies at the University of California, San Francisco.  He was part of a roundtable on Drugs and Public Health.  After the session, he was interviewed by Michelle Ling.

ML:  It seems to be clear from this discussion that drug addiction needs to be a medical issue, rather than a moral issue.  How can we affect that change?

PL: It's a really difficult question.  I think that young people have a part to play in the political process, and to the extent that people want to become involved in making their views clear to legislators, that's important.  But on a personal level, I think it's important to think about how you deal with other people in your own school or local community.  Don't brand people who are using drugs in a stereotypical way and if they seem to be having a problem with drugs, you should try to help them.

ML: I think that many young people are very aware of the AIDs crisis and it's connection with IV drug use, but programs like needle exchanges are still illegal.  How can we educate young people about the reality of the situation.

PL:  In the United States we still have difficulty talking in a frank, honest, non-judgmental way about sexual practices and the realities of drug use.  These issues should be put in a proper context, not in a hysterical context.  That's the kind of education that needs to take place. I think there is a place for students who feel that there is a lack of honest discussion to agitate for that kind of program within their schools or to peer led create groups that can educate people of the same age.

ML:  It seems to me that the teen population in San Francisco are very sophisticated in their knowledge and use of drugs. It seems that the issue of young people who are intelligent or who are not on the streets, is completely unaddressed.  As a medical health professional, have you observed young people, or people in general, who use drugs responsibly?

PL:  Well, it's obvious that there is a significant amounts of drug use going on, and it's equally obvious that there is a lot of knowledge out there about HIV transmission.  The problem is that knowledge alone is not enough to protect people.  Lots of people know that sharing a needle is a bad idea, but the problem is that there aren't enough needles to go around.

Lots of people know that if you have sex, you're a lot safer if you use a condom, right?  But people have difficulty converting knowledge into behavior.  Young people sometimes feel that they are invulnerable.  Unfortunately, the evidence suggests that more and more, it is young people who are getting infected. For example, in San Francisco most of the new infections are occurring with the gay youth in the age range of 15 to 30.

ML:  Are you optimistic about the decriminalization of needles?

PL:  Well, one has to be, because if not, one would give up hope, so one has to be.  But also, even though there have been multiple obstacles, the history of needle exchange also tells us that there have been multiple successes. 

There are a hundred needle programs in the country now.  They're not as big as they ought to be.  They're not open as often as they ought to be.  They're not handing out as many needles as are necessary.  But the fact is, it's happened and that's up from nothing 10 years ago.  That's a big accomplishment, particularly when you consider all the obstacles.  And it was accomplished with only limited legal reform and through activities that took place mostly on a grassroots level.  So although legal reform is absolutely necessary, it's also clear that much can be accomplished even without it.