HEROES OR CRIMINALS?
THE LEGALITY OF NEEDLE EXCHANGE IN NEW JERSEY

In my book, Diana McCague and Thomas Scozzare are heroes.
Unfortunately, the state of New Jersey claims they are criminals.
Diana and Thomas were arrested in New Brunswick one cold night
last April because they were trying to stop the spread of HIV by
giving out clean needles to persons who injected drugs.

No knowledgeable person contests DianaÌs and ThomasÌ assertion
that New Jersey is at the epicenter of the American AIDS epidemic
caused by the use of dirty needles. According to the New Jersey
Health Department, over half of all AIDS cases in New Jersey are
injection-related. By the end of September 1996, 16,800 New
Jersey residents age 13 and over were living with
injection-related AIDS or had died from it. We can expect the
epidemic to continue on an alarming scale.

Some 1200 New Jersey residents will become infected with HIV
through the use of dirty needles in the next year, according to
estimates made by Dr. Scott Holmberg of the CDC and published in
the American Journal of Public Health.

Diana and Thomas are not medical doctors or sophisticated
researchers. But they are intelligent, concerned citizens. And
the technique they have chosen in their heartfelt effort to save
lives is one that has the support of every scientific body that
has examined the issue. In the five years between 1991 and 1995,
the federal government funded six studies on injecting drug use
and the spread of AIDS and all six studies concluded that clean
needle programs were an effective and necessary tool against the
spread of AIDS. The Medical Society of New Jersey, the New
Jersey Public Health Association and their national counterparts
are all in favor of clean needle programs. The New Jersey
GovernorÌs Advisory Council on AIDS and President ClintonÌs
Advisory Council on AIDS also recommend support for clean needle programs.

The same studies that have shown the effectiveness of clean
needle programs have also shown that these programs do not
increase drug use.

When Diana and Thomas gave out sterile needles they knew were saving lives.

They also believed that somewhere in New Jersey law there would
be a way for their humanitarian work to be accepted for what it
was. Their hope was not without basis. That had happened in at
least eleven other communities across the nation.

The arguments supporting Diana and Thomas are very persuasive.
New JerseyÌs law limiting access to sterile needles was written
before the AIDS epidemic was understood and was not intended to
apply to bona fide disease control measures such as needle exchanges.

There is no evidence that New JerseyÌs limitation on access to
sterile needles has ever been effective in achieving its original
purpose -- decreasing drug use. But the law has been very
effective in spreading the deadly AIDS epidemic. (Paradoxically,
persons who participate in clean needle programs have been found
to decrease their drug use. More research is needed to
understand why this is the case, but my own guess is that it is
due to the human interaction between needle exchange workers and
their clients. At last somebody cares if they live or die.)

Diana and Thomas were not running a criminal enterprise for
profit, intent on personal gain without concern for the health of
others. Rather it was the opposite. They were unpaid workers in
a public health enterprise, trying to save lives, taking
considerable personal risk.

The state of New Jersey had no compelling interest that was
disrupted when Diana and Thomas were giving out clean needles.
In fact, to the extent that the state of New Jersey has an
obligation to preserve the lives of its residents, Diana and
Thomas were doing the stateÌs business -- in a much more
effective way than the state itself.

The majority of DianaÌs and ThomasÌ clients were African American
and Latino. Thus eliminating DianaÌs and ThomasÌ work causes
disproportionate suffering in minority communities.

If the CDC research is correct, some 1200 New Jersey residents
will become infected with HIV in the next year as a result of
dirty needles, and their medical treatment will cost about $150 million.

To those of us who have studied the issue, the criminal
prosecution of public health workers like Diana and Thomas is
senseless from both humanitarian and fiscal perspectives.
Keeping clean needles from persons who inject drugs is causing
the spread of a deadly disease.

At the moment, New York has a higher rate of injection-related
AIDS than New Jersey. However New York now has a number of
needle exchanges. So, if New Jersey continues with current
policies, it is only a matter of time before our rate will rise
above New YorkÌs, a first that we should be very reluctant to claim.

What can two people in New Brunswick do to stem an epidemic that
is now claiming over a thousand lives in New Jersey every year?
They are our leaders. If they are allowed to go back to their
lifesaving work without fear of arrest, other volunteers will
follow in other cities. And from their collective work will
spring the reasonable hope that somehow we can stem the tide of
this horrible epidemic.

All DianaÌs and ThomasÌ lawyers ask at the moment is that their
clients be given a hearing so that the evidence on the extent of
this terrible epidemic in New Jersey and the research on how to
handle it can be brought forth for consideration. Is that too
much to ask?

Dawn Day, Ph.D., is the director of the Dogwood Center in
Princeton. Dr. Day is a sociologist and activist scholar who
writes on issues of social justice and AIDS.