West German heroin policy is strictly prohibitive. This policy has resulted in the neglect of pain relief for cancer patients, the enhancement of police powers, the creation of an underground economy, and discrimination against drug users. In addition, inadequate attention is being focused on the role of intravenous needle sharing in the spread of AIDS. Increased availability of syringes as well as medical information about prevention possibilities would contribute to risk reduction and might slow the spread of AIDS among intravenous drug users. The use of methadone maintenance programs would also help slow the spread of AIDS. However, establishing these programs would require a major shift in current medical and governmental policies. Such a shift is unlikely to occur, because the public and policymakers prefer to let this segment of the population die. 15 references.