ATLANTIC CITY'S NEEDLE-EXCHANGE PROGRAM BUCKS STATE TREND

ATLANTIC CITY - It's hard to imagine things could be any worse for
Tommy Fagan.

The 25-year-old has been shooting heroin since he was 14, starting
by secretly pinching the dope from his addict mother. His 11-year
relationship with heroin has left him homeless, and in 2004 he
tested positive for Hepatitis C, a disease he says he acquired
because of his tendency to share syringes.

"I could be worse off right now," Fagan says with his face in this
hands, trying to quell a headache resulting from his head being cut
open by a box-cutter during a recent altercation. "I could be dying
from AIDS."

Instead, Fagan learned last week he tested negative for HIV during a
routine visit to the city's needle-exchange program. He says the
clean needles he gets have prevented him from contracting the deadly
disease or sickening others.

Fagan is one of more than 200 heroin users enrolled in the city's
pilot program since its inception in November. The program, located
on the second floor of the Oasis Drop-In Center, was the state's
first legal exchange and appears to be its only successful program.

In just three months, the city's program has registered 204 users
and sees about eight clients per day, according to recent statistics
provided by the city Health Department.

New visitors to the program must register by answering basic
demographic questions and questions about their history of HIV
testing and drug treatment. They also are assigned an identification
number, and after six months will be asked other questions, such as
whether they are still sharing needles with others and whether they
have sought drug-addiction treatment.

New participants are initially given 10 needles and one needle for
every used needle they return. The amounts they are given when they
return depend on how many times they shoot-up in a week.

"Our goal is one shot, one syringe," Program Director Georgette Watson says.

But addicts are offered more than just needles. A long line of clean
paraphernalia is displayed in the back of the room, including small
containers called cookers that clients can take with them to heat
the heroin rock, as well as cotton bags, solution,
alcohol preparation wipes, hand wipes and bleach.

"The disease isn't just in the needle. We tell the people that come
here, the disease lives in the cotton, the disease lives in the
spoon," says Marcy Pinsky, a volunteer and former heroin addict.

The city's needle exchange is a far cry from the state's other pilot
programs operated in Camden and Paterson. While the program at the
Well of Hope Drop-in Center in Paterson fights to attract users,
Camden's exchange is done out of the back of a van.

While both are the victims of low funding, Gene Brunner, the
Atlantic City Health Department's HIV services coordinator, thinks
the city's program is benefitting from its location.

The program sits near busy Pacific Avenue, a popular stretch for
area prostitutes and just a block away from The Boardwalk. It is
also just four blocks from the bus center, a half-block from the
jitneys and across the street from the John Brooks Recovery Center,
a methadone clinic that works with the program.

But its biggest asset is the popularity of the Oasis center below,
operated by the South Jersey Aids Alliance. The center had already
provided free HIV counseling and testing, drug-treatment referrals
and other social services. Watson says the transition was
surprisingly seamless.

"We picked up right away," she says.

Along with the program's convenient location, it has the funding to
keep thriving. The resort pays staff salaries and also provides
$50,000 yearly for purchases and supplies.

"We're number one over here," says Joe Marino, a project supervisor
at the Brooks center across the street who works to recruit clients.
"I don't know if that's a positive or negative, but we are helping
people. The one in Camden makes it look like the program is doing
something illegal."

For some, the state's authorization of exchanges in 2006 is nothing
short of illegal. Opponents contend the programs do not work and,
instead, aid addictions and send the wrong message.

But Atlantic City officials have been advocating the legalization of
needle exchange for years, viewing the program as an important
health tool in a city where one in 31 black males lives with HIV or
AIDS. In June 2004, City Council became the first governing body in
the state to pass an ordinance approving needle-exchange programs,
but the ordinance was struck down in court three months later.

"This is a proven method," city Health Director Ronald Cash says.
"It's a tool being used throughout the world. We believe it's going
to work. We believe it is working. We're the model for the state."

Shortly after noon Thursday, a new client named Tony walks into the
exchange program with apprehension. After participating in the
initial surveys, he is given new syringes and begins filling his
brown paper bag with other accessories when he's approached by Marino.

He's met with questions about getting clean and quickly relents,
telling Marino he'll be entering a halfway house soon.

"You have to be clean to get into a halfway house," Marino says.

The conversation ends shortly thereafter. Tony is gone with his
needles and no commitment to treatment or tests.

For Marino, it's a difficult balancing act.

"It's tough because you don't want to scare people off but you want
them to know they can get help," he says. "It's tough, but we'll keep at it."