Needle Exchange Programs Blocked in New Jersey
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New Jersey has the highest rate of HIV infections among women in the nation and the third-highest for children. Half of those infections are transmitted by the sharing of dirty needles among drug users, yet a pilot project to begin distributing clean needles was blocked by a lawsuit just days before it was about to start on July 1st. Nancy Solomon reports.
NANCY SOLOMON reporting:
On a blistering hot day, Camden's mobile health van rumbles down Broadway passed an unending string of dilapidated houses and empty lots. This is one of the poorest neighborhoods in one of the poorest cities in America, and the 30-foot RV, run by the Camden Area Health Education Center, is treated like the Good Humor truck around here.
Ms. MARY KAY DOLLARD(ph) (Nurse): I've always thought that we should have one of those, you know, ice cream truck jingles. People come running out of their houses and, you know, wave us down, flag us down. And, like, those women just flagged us down. This isn't a scheduled or intended stop where we are now.
SOLOMON: Mary Kay Dollard is the van's nurse.
Ms. DOLLARD: How is your pain today?
SOLOMON: She and outreach worker Johnny Brown travel Camden's most desperate patches, handing out free condoms through a sliding window.
(Soundbite of window sliding)
Mr. JOHNNY BROWN (Outreach Worker): What's up? What's your age and initials?
Unidentified Man: Forty; D.J.
SOLOMON: Dollard provides basic health care while Brown coaxes people into the RV for an HIV test.
Mr. BROWN: Come here for a minute.
SOLOMON: Camden and Atlantic City were about to become the first two cities in New Jersey to offer needle exchange, a program that allows drug users to trade in used syringes for new sterile ones. Because HIV can be spread by sharing syringes, most states allow either an exchange program or allow pharmacies to sell them without a prescription. Rosanne Scotti, director of the Drug Policy Alliance of New Jersey, says the state is way behind on this issue. Her group, which advocates for compassionate drug policies, has collected evidence and studies on needle exchange since the first program started in 1988.
Ms. ROSANNE SCOTTI (Director, Drug Policy Alliance of New Jersey): Every major medical, scientific and professional body to study the issue has concluded that syringe exchange reduces the rate of HIV, hepatitis C and other blood-borne diseases, and it does not increase drug use or other social harms. As a matter of fact, needle exchange programs have been shown to be a bridge to treatment for drug users.
SOLOMON: Scotti has lobbied for several New Jersey legislative bills that would have allowed needle exchange. But when those failed, her coalition was able to convince outgoing Governor James McGreevey to pass an executive order that allows up to three cities to establish pilot programs. A group of legislators sued and received an injunction just days before the first needles were to be exchanged. The opposition consists of conservative Republicans and one powerful Democrat, Senator Ronald L. Rice, from Newark, the state's largest and most troubled city.
State Senator RONALD L. RICE (Democrat, Newark): When you go to Mrs. Smith, or my seniors, or the merchant out there, or the churches where people crowd the steps, they're saying to us, `Please remove these drug dealers and drug users from out in front of our places. We feel like prisoners. We're afraid to go out.'
SOLOMON: Instead of needle exchange, Rice wants more funding for drug treatment.
State Sen. RICE: Don't tell me--we have $28 billion budget--we don't have the money. The question is how are you using the $28 billion. And as things go on the health-care level, when it come to women and minorities, we're the ones that folk want to find all kinds of ways to do end runs rather than spend money.
SOLOMON: Rice isn't just bitter about the lack of funding for drug treatment. Like his conservative allies in the state, he believes injection drug use is so dangerous that anything less than zero tolerance is wrong. But New Jersey's resistance to needle exchange is a bit surprising, given its high rate of infection and its close proximity to New York and Philadelphia, early adopters of exchange programs.
(Soundbite of voices)
Ms. CASEY COOK (Prevention Point Philadelphia): Hi. How you doing today?
Unidentified Woman #1: OK.
Ms. COOK: ...(Unintelligible) number?
(Soundbite of rustling paper)
SOLOMON: Casey Cook of Prevention Point Philadelphia is sitting in front of an RV next to an abandoned lot on the north side of town. A steady stream of people come by with dirty used syringes and leave with the same number of clean ones in a brown paper bag.
Ms. COOK: Do you want to see the doctor?
SOLOMON: Cook says HIV infections among the city's drug users have dropped by half since needle exchange was legalized here in 1991.
Ms. COOK: People are going to use drugs, and we've been unsuccessful at keeping drugs out of the country and keeping them off of our streets. And you know, given that people are going to use drugs, they need to use drugs safely and in ways that are not going to create additional harm in their lives.
SOLOMON: It's just a 10-minute drive from this Philadelphia neighborhood over the Ben Franklin Bridge to Camden. Yet drug users on the Jersey side of the river say the trip can be insurmountable, especially if they're broke and need a fix.
Unidentified Woman #2: An addict with an addiction, they're not going to take the time to go all the way to Philadelphia to get a needle when you could just give somebody a dollar or $2 that's trying to get drugs, and use their needles.
SOLOMON: This woman wouldn't give her name because she's afraid of the police. She stopped by the mobile health van to have an open wound checked by the nurse. She says she never shares needles, but she's still disappointed the exchange program was stopped.
Unidentified Woman #2: Personally, I've been fortunate enough to know someone that's a diabetic or whatever, and then still, you're taking from that person that's a diabetic. They need their syringes for--to administer their medication. But there's a lot of girls out here on the street. I have seen people pick needles up off the ground and use them.
SOLOMON: One man approached the mobile health van looking for bleach kits, because it's easier in Camden to find a dirty needle and clean it than to get a new sterile one. He says he went to college, served in the Navy and has struggled with his addiction for several years. He would only give his first name, Dave, because he's afraid of arrest. He scoffed at the critics who think providing clean syringes encourages drug use.
DAVE (Drug Addict): Putting a needle in your arm, usually there's a long path that leads up to that. I mean, people--I can't see anybody going out and doing it just because they can get one free. I mean, it's usually a long road, and I think that's just an ignorant point of view.
SOLOMON: Dave left the van empty-handed. The bleach kits hadn't been ordered because the health center had expected to be handing out sterile syringes instead. There's no telling when, or if, needle exchange will be legalized here. Instead, the staff continue trawling the streets of Camden, passing out condoms and cookies.
For NPR News, I'm Nancy Solomon.
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