TRENTON SLOW TO ACT ON EASING HIV TOLL

In New York State, heroin addicts can buy hypodermic needles for 50 cents
at drugstores. No prescription needed. No questions asked.

The same goes for New Hampshire, Rhode Island, Maine, and Connecticut. In
fact, all around the Northeast, states are loosening their regulations on
needle distribution in an effort to slow the spread of AIDS among drug
users, their sex partners, and children.

But not New Jersey, even though two-thirds of the state's 40,000 AIDS cases
have been traced to contaminated needles.

Indeed, the state Legislature has not even discussed the issues of
over-the-counter needle sales or needle exchanges in three years, given the
unwavering opposition to such programs from former Gov. Christie Whitman.
During her seven years in office, Whitman argued that giving addicts access
to needles would send a dangerous message -- especially to children -- that
the government condones illegal drug use.

"New Jersey has done nothing to stop the HIV epidemic" among drug users,
said Glenn Backes of the Lindesmith Center-Drug Policy Foundation, a
national advocacy group for reforming drug laws. "It has done nothing
except watch an incredible number of people get sick and die for no good
reason."

Now, however, with Whitman in Washington and a new governor to be chosen in
November, needle-exchange advocates say they intend to remain quiet only
until after the election -- when a new administration will begin setting
its agenda. They are waiting until then, they say, because the issue is so
controversial it could be counterproductive to bring it up during the campaign.

"We've probably got a decent shot" at getting legislation passed after the
election, said Diana McCague, who shut down the only openly public
needle-exchange program in the state after her second arrest.

There are currently no pending bills that would ease needle regulations.

Of the two leading candidates, Democrat Jim McGreevey says he supports
needle exchanges if they are run in a hospital setting, spokesman Richard
McGrath said. Acting Gov. Donald T. DiFrancesco, a Republican, is against
needle exchange because the research hasn't convinced him it would prevent
AIDS, spokeswoman Jayne O'Connor said.

But, she said, "He is open to having discussions with proponents of needle
exchange and to look at any research or statistics."

Even conservative lawmakers who have opposed needle programs in the past
say they are willing to take another look.

"I am not going to close my mind to looking at good data," said state Sen.
Gerald Cardinale, a Republican from Demarest.

Still, Cardinale said he sees a problem with the government arresting
people for using drugs while giving them the equipment to do so.
"Government can't talk out of both sides of its mouth," he said.

It's a divisive issue, acknowledged state Sen. Joseph F. Vitale, a past
sponsor of needle-exchange bills and a member of the governor's Advisory
Council on AIDS, which supported needle exchanges even though Whitman
didn't. But the Woodbridge Democrat said he hasn't given up hope that he
can get a bill passed.

"Those who oppose it are hung up on some sort of message," he said. "I
don't know what that means when at the end of the day hundreds of people,
mostly women and unborn children, are infected with HIV."

Non-Addicts' Lives Are Placed In Danger

On average, every day in New Jersey six new cases of AIDS or HIV are
reported. Every day, three people die.

Contaminated needles are a major reason the state ranks third nationally in
the rate of children with AIDS, fourth in the rate of women, and fifth in
the overall number of AIDS cases -- even though it's the ninth largest in
population, according to New Jersey health officials and state statistics.

The proportion of AIDS cases here caused by dirty needles is twice the
national average, according to state and national health officials. When
intravenous drug users, who are primarily male heroin addicts, get HIV from
used needles, they pass it to their sex partners. When their sex partners
are women, the women then pass the virus to the children they bear after
becoming infected.

The American Medical Association, the National Institutes of Health, the
Centers for Disease Control and Prevention, and the Institute for Medicine
all endorse needle programs, saying providing access to clean needles slows
the spread of AIDS and hepatitis without increasing drug use.

More than 150 needle-exchange programs now operate in more than 30 states.
Half are legal, a third blatantly illegal, and the rest run in violation of
local laws but with formal support from elected officials, according to a
1997 survey.

But needle exchanges operate only in certain locations -- typically inner
cities -- and are open limited hours.

That's why AIDS activists also support pharmacy sales of needles.
Conveniently located and open long hours, drugstores can offer sterile
needles and syringes for a fraction of the price they sell for illegally on
the street.

"There's no taxpayer money involved in allowing people to purchase
something for their own protection," Backes said.

Most states have never explicitly barred over-the-counter needle sales, but
some, primarily in the Northeast, have had decades-old laws requiring a
prescription. New York passed the nation's first such law in 1914 during an
epidemic of opiate addiction, while New Jersey's law in 1955 grew out of
concern over injection of cocaine and narcotics.

On Jan. 1, New York and New Hampshire began allowing the sale of up to 10
needles at a time over the counter. In New York, participating pharmacies
-- including the CVS, Rite-Aid, and Eckerd chains -- give needle buyers
information on disease prevention and drug treatment.

Rhode Island lifted restrictions on needle sales last fall, Maine in 1993.
The trend began in Connecticut. Two years after launching needle exchanges
in 1990, Connecticut made it legal to buy and possess needles without a
prescription.

"It makes sense," said Dr. Richard Melchreit of the AIDS Division of the
Connecticut Department of Public Health. "By giving people more access to
clean needles, you reduce the chances of sharing."

Melchreit said the share of AIDS cases caused directly by injection drug
use in Connecticut has fallen from 55 percent to 40 percent in the last six
years, although he said it's unclear how much of the drop is from increased
access to sterile needles.

In one study led by a Yale University professor, a New Haven needle
exchange was shown to reduce the incidence of HIV infections among its
participants by 33 percent. The researchers collected dirty needles that
addicts had swapped for clean ones at the exchange, and counted those
contaminated with HIV.

But there have been bumps along the way. Police in some parts of the
country have complained that laws making it legal to carry drug
paraphernalia hurt their efforts to stop the illegal drug trade. And
community uproar in one Connecticut town forced a needle exchange to close
after a toddler was pricked by a needle discarded outside.

Melchreit said that program was poorly run. Just as a recycling center
reduces litter, a well-run needle exchange motivates addicts to gather used
syringes to swap for new ones, he said.

"It actually sucks needles out of the community," Melchreit said, adding
that needle-exchange programs also help link addicts to drug treatment.

Blaming Addicts For Their Illnesses

New Jersey Deputy Health Commissioner George DiFerdinando said helping
addicts get off drugs is a centerpiece of the state's AIDS prevention effort.

One state program that operates in four cities reports some progress. Of
the 902 intravenous drug users who enrolled last year, a follow-up survey
showed that 22 percent were not using drugs, 74 percent reported they were
not sharing needles, and 61 percent said they were practicing safer sex,
state health officials said.

Another program in 16 cities finds and counsels various groups at risk of
AIDS, including injection drug users.

"The idea is to get them into treatment," DiFerdinando said.

AIDS activists say New Jersey must do more.

Karen Walker, a nurse who sees the ravages of AIDS firsthand at a health
clinic in Paterson, is exasperated by critics who say addicts bring HIV
upon themselves.

"If someone gets coronary artery disease from overeating, do we say 'Tough
luck, we're not going to do bypass surgery?' " she asked.

Over the years, frustrated New Jersey AIDS activists have opened illegal
needle exchanges. A New Brunswick group passed out tens of thousands of
needles between 1994 and 1998 until its director, Diana McCague, was
arrested for a second time for flouting drug paraphernalia laws.

McCague's group now hands out bleach kits to sterilize injection equipment.
Bleach doesn't always kill the AIDS or hepatitis viruses, but it's the only
legal alternative at this point.

"I got sick of beating my head against a brick wall," McCague said.