NEWS ANALYSIS -- 1245 WORDS EUROPE'S DRUG WAR TARGETS MORE DEADLY MENACE THAN NARCOTICS EDITOR'S NOTE: Flush with victory from the Gulf war, America finds itself still very much embroiled in the war that never seems to end, the one on drugs. Yet Europe is increasingly going its own way on drug policy, spurred by fears of an enemy more deadly than any narcotic: AIDS. Its approach, known as "harm reduction," is saving lives. PNS correspondent David Beers recently visited European cities that have pioneered this approach in recent years. Beers is a senior editor of Mother Jones, where his lengthier look at harm reduction appears. BY DAVID BEERS, PACIFIC NEWS SERVICE The drug control buzzword in Europe these days is "Harm Reduction," a logic that spurns legalization but also abandons the U.S. metaphor of war. Its success is declared by police and health workers alike because it draws drug users above ground while keeping in check a far more deadly menace than any narcotic -- AIDS transmitted by dirty needles. In harm reduction embracing Holland, government figures show the nation's addict population, smaller per capita than the U.S.'s, is aging and not growing. HIV rates among injectors in the big cities levelled off at 20 percent three years ago. (In New York the HIV rate among junkies is around 60 percent.) In England's Liverpool, a harm reduction pioneer hard hit by heroin, that rate is now 1.6 percent. Harm reduction approaches take sometimes startling shape, as a recent visit to The Netherlands and Liverpool revealed: * Aggressive needle exchange. Backed by a well-endowed national health system, 40 Dutch cities have syringe exchange programs. Amsterdam alone swaps nearly a million syringes a year through clinics and vans that crisscross the city, dispensing the heroin substitute methadone, clean needles and AIDS advice. The mobile approach reaches skittish users and also defuses citizens' "not in my neighborhood" attitudes toward permanent clinics. In Rotterdam the health department has installed vending machines to serve needle users when clinics are closed. Pop a used needle in the syringe-shaped slot, and out slides a wrapped, sterile replacement. In Liverpool, the government-funded needle exchange got started in 1986 by swapping bags of used needles with a major dealer. The state issues plastic boxes to heavy users and even sellers, so they can transport dozens of dirty needles safely back to the clinic, and get more. * Health centers for on-going addicts. "Drug services in this country have been aimed at people who want to stop," says Allan Parry, a founder of Liverpool's Maryland Center. "Now, because of AIDS, we have to reach drug users who want to carry on. And that means we have to change our services to suit their lifestyle." So his health clinic sends savvy workers out to find drug users and not only swap needles and hand out condoms, but teach them less dangerous ways of injecting. The Center first attracts addicts by offering syringes, then ends up treating abscesses and other conditions they would rarely have revealed to the regular health care system. *A Junky "Union." The Dutch government pays drug addicts to fight for their rights, giving nearly $100,000 a year to the Amsterdam Junkybund (Junky Union) ensconced in an old canalside office. Headed by non-drug using Rene Mol, addicts press for late-night needle exchanges and less police harassment. The Junkybund also advises the government on its drug programs and helped work the bugs out of the needle vending machine. * Public places where drug use is allowed. In Rotterdam, Father Hans Visser makes a spacious lavatory in the basement of his church available to addicts, and refuses to speculate on what goes on in the stalls. His logic is that "it is better than doing it out on the streets," and gives a chance to reach drug users with treatment and AIDS information, as well as religion. Motivated by similar logic, Switzerland allows addicts to shoot up openly in a city park. Holland's famed "coffee shops," where technically illegal cannabis can be bought and smoked, are sanctioned refuges because, as Dutch officials explain, they "split the market" so that a marijuana buyer won't be urged to try more dangerous stuff. Coffee shops caught purveying harder drugs, like cocaine or heroin, are promptly shut down. * "Flexible" drug enforcement. Holland's "drug czar" Eddy Engelsman, perhaps Europe's leading harm reduction proponent, argues that severely criminalizing drug use just drives it underground, making health and crime problems worse. The best approach, says Engelsman, is nuanced, pragmatic, businesslike -- zakelyk is the Dutch word for all three rolled into one. Holland's drug laws carry stiff penalties for users and sellers, but police and judges are given wide latitude in how they are enforced; the official goal is that the punishment should never outweigh the harm that drug taking itself causes. The Netherlands inverts the U.S. drug budget ratio, funnelling the bulk of its funds into prevention, treatment and research, funding a wide range of rehabilitation programs, and a curriculum that teaches kids the risks of all intoxicants. For fear of glamorizing illegal drug taking's outlaw appeal, "We keep a low profile," says Engelsman. "No mass media campaigns. No policemen into the school. No fingers pointing, saying you shouldn't do this and that. Reduce the problem, control the problem and don't make a moral issue of it." * Prescribed drugs for addicts. From his bland offices in the town of Widness just outside Liverpool, psychiatrist John Marks carries out the most controversial of all harm reduction approaches. He writes out dozens of prescriptions for heroin, crack-style cocaine and amphetamines for local addicts who declare no intention of quitting. It has been British policy since 1924 that the best way to treat addicts is to wean them off drugs, but if that can't be done, to prescribe whatever the doctor thinks they need. Marks is one of the few doctors with the stomach to prescribe hard stuff, though. He reminds that heroin addicts finance their habits by buying more than they need, cutting it with "something nice and heavy, like brick dust," pushing that to new recruits, thus expanding the industry. Marks asserts that his prescriptions have undermined that criminal pyramid scheme. "Nobody's going to pay a fortune to gangsters to get rubbish and perhaps be threatened, when they can get pure, excellent stuff from me for free." Given a way out of the black market hustle, Marks argues, his clients might now be able to imagine a future beyond the next fix, and if that leads them to decide they do want to kick, Marks is there to guide them into one of many free rehab programs. His willingness to cooperate with police -- he turns in patients he knows are committing drug crimes -- plus the fact that heroin street sales and drug-related crime has dropped in the Widness area, has the powers-that-be on his side, says Marks. While harm reduction methods can set an American's ethical compass tumbling, so can the increasingly skewed casualty figures from this country's own war on drugs. Although 80 percent of U.S. drug users are white, the majority arrested are black. (Drug prosecutions of white juveniles actually dropped 15 percent between 1985 and 1988, while jumping 88 percent for minority youth.) The U.S. now incarcerates its citizens at a higher rate than any other nation, and three quarters of the new $10 billion drug war budget continues to go to policing and prisons instead of education and treatment. Middle-class cocaine use is down, but inner-city crack and heroin use is on the rise and the HIV virus spread via dirty needles is today the number one source of AIDS in the United States, hitting minority groups especially hard. Dr. Arnold Trebach, who teaches criminology at American University in Washington D.C. and heads the nearby private Drug Policy Foundation, argues that it is time this country began experimenting with harm reduction techniques, for the simple reason that they save more lives. "What the English and Dutch have taught me," he says, "is that you can disapprove of drug use, but you don't have to hate users."