A KINDER, SMARTER WAR ON DRUGS

The state of New Jersey has begun to recognize that drug addiction
should be treated primarily as a medical problem, not a crime. Its
change in attitude is having some positive effects.

Four cities are taking advantage of hard-won permission from the state
to try to stem the spread of HIV and other blood-borne diseases by
making clean syringes available to drug users. Trenton isn't one of
the cities, unfortunately, although it has kept open the option to
join them later.

The capital is set to benefit, however, from a related shift in state
policy that has made more dollars available to help users overcome
their addiction. Trenton will be one of four locations for state-
funded mobile units that will dispense methadone and suboxone for
maintenance treatment and detoxification.

The mobile units have been purchased by the New Jersey Division of
Addiction Services at a cost of $250,000 each and will be operated
with state grants of $1.2 million a year to each host municipality.
They will set up shop in sites that are convenient to substance
abusers who have no money or insurance but who want help in breaking
the grip of drugs.

The Trenton unit will be run by NHS Human Services, a Pennsylvania-
based nonprofit group, and will open its doors later this year, after
the City Council has enacted some necessary ordinances. Like the other
units, it will contain doctors' offices, computers and lab facilities,
a confidential counseling office, a client waiting area and lavatory,
and safes for storing medication.

As for the state's four clean-needle pilot programs, they "are
operating on a shoestring, but they're operating," said Roseanne
Scotti, director of the Drug Policy Alliance and a leader in the 13-
year battle to win legislative approval for a government-supervised
needle exchange.

Until 19 months ago, New Jersey -- despite its reputation as one of
the nation's most progressive states -- was the only state that denied
addicts any legal way to obtain clean needles. Its laws banned both
needle-exchange programs and over-the-counter sale of syringes. Not
surprisingly, New Jersey also has been among the states hardest hit by
HIV/AIDS, particularly among women and infants.

In December 2006, the Legislature enacted and Gov. Jon Corzine signed
a law authorizing up to six cities to conduct carefully monitored
pilot programs by which drug users could exchange dirty syringes for
clean ones. So far, Newark, Atlantic City, Camden and Paterson have
implemented such programs. They serve a total of some 800 clients,
with Atlantic City leading the way with 361, and have distributed tens
of thousands of clean needles. Jersey City has enacted the necessary
enabling ordinance but doesn't have a program yet. A slot remains open
for the sixth municipality.

"The programs are going very well," said Scotti. "I visit these four
cities, and it's amazing to me to see them in operation after all this
time. It's wonderful."

Because winning legislative approval of even a modest pilot needle-
exchange program was so difficult, there was no hope that state
funding for it also would be authorized. For that reason, the four
pilot programs are serving only a fraction of their potential clientele.

But the law did provide $10 million a year for inpatient and
outpatient drug-abuse treatment and outreach. The money will be used
in several ways, including vouchers that will enable addicts to select
treatment providers that best accommodate their needs. It's also the
source of the funds for the mobile medication units in Trenton,
Atlantic City, Camden and Paterson.

In the last-named three cities, the units will be parked close to the
cities' local clean-needle facilities, in keeping with findings cited
by the Division of Addiction Services that "individuals in areas with
needle-exchange programs have an increased likelihood of entering
drug-treatment programs."

"Should Trenton implement a needle-exchange program, the contract
awardee for the mobile medication unit will situate in close
proximity," the division said in a news release.

Paterson actually has had its mobile unit up and running for nearly
two months. Housed in a big white bus, the unit operates Monday
through Saturday in two locations, parking at one spot in the morning
and the other in the afternoon.

In addition to providing the methadone and suboxone that relieve
addicts' craving for heroin without delivering the "high," Paterson's
mobile unit also provides medical screenings, including HIV testing,
and counsels clients on finding housing and jobs and resolving family
problems.

"After an almost overwhelming response, organizers had to cap the
number of new clients and start a waiting list," reported The Herald
News of Passaic County. "Today, the [mobile center] has about 30
people on that waiting list until a new drug counselor is hired. ...
The bus staff must refer those interested to other drug treatment
centers or -- in the worst case -- to the free needle-exchange program."

When the Legislature finally authorized needle exchange in the last
session, it left an important piece of business unfinished.

A companion bill would have allowed pharmacies to sell small
quantities of syringes to adults without a prescription. The bill
would have been an important additional weapon against AIDS, as well
as a convenience for diabetics and others with diseases that require
self-administered injections. It passed the Assembly twice, but died
in the Senate Health Committee.

The same measure has been re-introduced by Sens. Joseph Vitale, D-
Woodbridge, the Health Committee chairman; Nia Gill, D-Newark, and
Loretta Weinberg, D-Teaneck. "That's strong sponsorship," said the
Drug Policy Alliance's Scotti. Speaking for the bill's many advocates
in the public-health community, she added: "We hope to go back to the
Legislature in the fall and finish the job."