New York City's top narcotics prosecutor said Tuesday that a city Health Department brochure that teaches intravenous drug users how to shoot up safely is wrongheaded because "there is no safe way to inject heroin."
Special narcotics prosecutor Bridget Brennan said the two-year-old brochure was brought to her attention by someone who received it at a meeting about drug abuse and the courts.
She said the person "thought it was kind of disturbing that information like that would be so widely distributed."
"There is no safe way to inject heroin," Brennan said. "Heroin is a poison. It's a toxic substance."
Health officials, however, said the pamphlet saves lives by preventing overdoses, infections and the spread of HIV and hepatitis. The pamphlet is distributed at homeless shelters, jails and syringe exchange programs.
The city's Department of Health and Mental Hygiene printed about 70,000 copies of the handout, which reportedly cost $32,000.
It offers tips for safe drug use such as "prepare drugs carefully," ''take care of your veins," ''find the vein before you try to inject," and "tie off to make your veins visible."
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The word "heroin" does not appear, but heroin is the most frequently injected illegal drug. Some drug users inject other substances including cocaine. The pamphlet also advises users to seek help getting off drugs.
"We target this pamphlet towards the people who are at risk," said Dr. Adam Karpati, executive deputy health commissioner.
The brochure was briefly available on the department's Web site, but it was removed Tuesday.
"Our main goal is always to help people who are using illicit drugs stop using," Karpati said. "However, we know that people will continue to use drugs."
Karpati said the brochure is part of a successful long-term strategy to prevent overdoses and infections. He said fatal drug overdoses fell 25 percent in New York City between 2006 and 2008.
Like needle-exchange programs for addicts, the brochure is an example of the so-called "harm-reduction" approach that seeks to lessen the negative consequences of drug use. Daniel Raymond, policy director for the New York-based Harm Reduction Coalition, said the goal is "to keep people healthy until they can get into recovery."
"Nobody ever started to use drugs because they picked up a pamphlet," Raymond said.
But Calvina Fay, executive director of the St. Petersburg, Fla.-based Drug Free America Foundation, called the New York City brochure "a horrible misuse of public dollars."
"It plays up the illusion that drugs can be used safely if you just know how," Fay said.
She said she doubted that addicts would follow the pamphlet's step-by-step instructions.
"Most people know that drugs are harmful. But when you're addicted to it, you don't care," Fay said.
Brennan said she supports "well-managed" needle exchange programs but the brochure "doesn't appear to fall into that category." She said she was especially concerned because of a glut of heroin on the market in New York City and its increased use among young people.
