N.J. MOVES TO END BAN ON OVER-THE-COUNTER SYRINGES

All Other States Make Needles Available Without Prescription; Health
Officials Say That Lowers Drug-Related HIV Cases

New Jersey, the last state with restrictions on access to syringes
without a prescription, may be ready to end its ban in the name of
AIDS prevention.

All other states allow over-the-counter sales of syringes in
pharmacies or let drug users exchange used needles for sterile ones.

Now New Jersey may go along. A bill authorizing six cities to launch
needle-exchange programs cleared the state Senate health committee
last month, the furthest such a proposal has gone since a needle
exchange bill was first introduced in 1993.

Political leaders, among them Gov. Jon Corzine, favor the
needle-exchange proposal, which passed the state's lower house in
previous years but never got anywhere in the Senate.

States began loosening restrictions on syringes after the AIDS
epidemic emerged two decades ago and one route of infection was found
to be needles shared by drug users. New Jersey was the last holdout
after two states relaxed laws on syringes this year:

. In Massachusetts, the sale of syringes without prescriptions became
legal last month under a law passed in July.

. Delaware legislators approved the state's first needle-exchange
program in June. The five-year pilot program in Wilmington is to
begin by early 2007. Over-the-counter sales of syringes are still prohibited.

Of all the states, only New Jersey, Pennsylvania, Georgia, Delaware,
Kansas, Vermont and the District of Columbia require a prescription
to buy syringes. All but New Jersey have needle-exchange programs run
by the state or cities.

In New Jersey, 44% of all AIDS cases resulted from drug users sharing
contaminated needles, according to the Kaiser Family Foundation,
which studies health policy. The national rate is 24%.

The percentage of new AIDS cases reported each year that are caused
by drug needles has declined since 2001, according to the Centers for
Disease Control and Prevention.

In 2004, the latest year for which national statistics are available,
22% of new AIDS cases were caused by injection drug use, down from a
high of 31% in 1993, according to the Kaiser Family Foundation.

In New Jersey, 14% of the 1,839 HIV/AIDS cases reported in 2005 were
attributed to injection drug use, according to the state Department
of Health. The low rate is the result of prevention efforts and a
decline in needle use by younger drug abusers, says Fred Jacobs, the
state health commissioner. Young users "are not so much shooting up
anymore. Nevertheless, it's still a significant percentage" of new
cases, he says.

A needle-exchange program would lower the rate further, he says.

The Senate committee approval "was a huge, huge step for New Jersey,"
says Roseanne Scotti, director of Drug Policy Alliance New Jersey,
which lobbies for needle exchange programs.

Then-governor Jim McGreevey signed an order permitting needle
exchanges in three cities in 2004, but a court challenge killed it.

The idea still faces opposition, especially from state Sen. Ronald
Rice, a Democrat from drug- and violence-plagued Newark.

"I'm not ever going to vote to give people a needle," Rice says.

He argues that exchanging needles supports the drug trade and the
violent crime that goes with it.

"If you give somebody a needle, you need the substance for the
needle, which means you have to go back to the same corners in Newark
and Camden." Then, he says, "They're out there doing all the things
they have to do to get the dollars to get the substance."

Proponents of needle-exchange programs argue that addicts show up to
get needles but eventually accept other services.

"It's a bridge to treatment," Scotti says.

"They come for the syringes, but they feel comfortable there. Needle
exchange programs do thousands and thousands of referrals" to
treatment programs, she says.

Studies of needle exchanges have found that they reduce HIV risk.
Since 1994, when Baltimore began a needle exchange, the number of HIV
cases attributed to injection drug use has dropped from about 60% of
all cases to 41% in 2003, according to the Baltimore Health Department.

"The policy debate is over," says Scott Burris, a Temple University
law professor who has tracked syringe-access laws for 10 years. "One
after another, the states that made it hardest to get syringes, and
therefore also tended to have the worst drug HIV problems, have all
made it easier. There's still huge problems of scale and funding,
because begrudging acceptance doesn't add up to an effective public
health program."

There is no federal funding for needle-exchange programs. The White
House Office of National Drug Control Policy opposes them. Its
position is that the focus for AIDS prevention should be on stopping
drug use through treatment.

Addiction "is a treatable disease," says David Murray, the agency's
lead scientist. "Treatment should be our first choice, not sustaining
people, not continuing to abet their ongoing drug use."