The New York City Department of Health has come under fire for what some are calling a "how to" pamphlet on using heroin and other intravenous drugs correctly. The Department of Health created the pamphlet, titled "Take Charge, Take Care," in 2007 in an effort to help those who use injection drugs reduce the various risks associated with drug use.
Now there is a debate over whether the pamphlet does more harm than good.
"I think tips provided in the pamphlet are not good in terms of preventing anyone from going down the road. It's enabling a user, or potential user. It implies you can use heroin in a safe manner, which is false. There is no safe way to use heroin," said John Gilbride, special agent in the field division of the Drug Enforcement Administration.
The pamphlet consists of "10 Tips for Safer Use" and describes in detail various ways for users to engage in intravenous drug use. It reminds readers to use new syringes and dispose of old ones properly. It warns them not to share needles. And it suggests ways to prevent or treat overdoses.
Several pages of the pamphlet list information on where to obtain help for addiction or sickness, such as 1-800 LifeNet or 311, New York City's public information telephone line. It also provides information on where to obtain "O.D. Kits," which provide emergency medication in the event of a potentially fatal overdose.
The booklet includes "Tip #5: Prepare Drugs Carefully," which explains in great detail how to heat heroin for use, and "Tip #6: Take Care of Your Veins," which provides instruction on how to inject the drug properly.
There are many New York area officials who agree with Gilbride but some, mainly from a public health perspective, are strong defenders of the pamphlet.
Dr. Robert Heimer, a professor at Yale University's Division of Epidemiology Microbial Diseases, says he believes the point of the pamphlet is not to promote illicit drug use, but rather to improve the quality of life for drug addicts and reduce the cost of health care treatments that arise as a consequence of HIV infection or overdoses.
"The pamphlet is factually correct and medically appropriate. Its purpose is to educate about how to prevent against diseases like HIV and hepatitis. Addicts are going to use drugs because they are addicted to them. So in the meantime, it is the goal is to keep them as healthy as possible by showing them what to do safely, and reducing the spread of disease," Heimer said.
Gilbride said the pamphlet sends the wrong message to teens and encourages drug use. "Go talk to the parents of a teenager who has overdosed from experimenting or being addicted to heroin. What do you think their views are on some of these tips? Bring a friend? Jump up and down to get your veins ready? This is a 'how to' pamphlet on how to do drugs. These tips give a false impression. It's dangerous."
But advocates of the pamphlet say it does not encourage drug use. Dr. Don Desjarlais, director of research at the Baron Edmond Rothschild Chemical Department at Beth Israel Medical Center, says drug use in New York has actually declined in recent years.
"The pamphlet is part of a larger effort to get people in the city into drug abuse treatment, and injection drug use in New York City over the last 15 years during this effort has declined," he said.