NEEDLE EXCHANGE...

"New Jersey is to drug policy," says Ethan Nadelmann, head of the Drug
Policy Alliance, "what Mississippi was to civil rights during the 1960s."

The facts bear this out:

New Jersey leads all other states in transmission of AIDS through injection
drug use. New Jersey leads all other states in the number of women with
AIDS. New Jersey ranks third in the nation in number of fetal AIDS cases.

It's time to relinquish our claim to these dubious distinctions. It's time
that New Jersey acknowledge AIDS for the public health issue it is. It's
time for New Jersey to adopt a needle exchange program.

New Jersey is one of only 16 states without authorized needle exchange -
that is, a service that allows intravenous drug users to exchange used
syringes for clean ones. Ours is the only state in the Northeast without
needle exchange, despite the fact that the Governor's AIDS Advisory Council
has been advocating such a program since Jim Florio was chief executive.

Fortunately, the state now has a governor and a health commissioner who
have expressed their willingness to launch a trial needle exchange program
in New Jersey.

What is it that James McGreevey and Clifton Lacy understand that their
predecessors did not?

A great deal.

- -- They understand that dispensing clean syringes saves lives.

The Centers for Disease Control (CDC) estimates that 90 percent of new AIDS
cases in women, and 93 percent of new cases in children, are due to, or
linked to, injecting drugs. The National Institutes of Health (NIH) reports
that needle exchange programs throughout the country have reduced HIV
transmission rates by one-third to two-fifths. When Connecticut repealed
the law prohibiting the sale of syringes without a prescription, needle
sharing dropped by 50 percent and HIV infections by over 30 percent. These
statistics are not surprising when you consider that HIV-1 can survive for
over four weeks in a contaminated syringe and that in a pilot program in
New Haven, 40 percent of needles collected tested positive for HIV.

- -- They understand that needle exchange programs do NOT increase the
incidence of drug use, as opponents charge.

The CDC, the National Academy of Sciences and the General Accounting
Office, having assessed a number of exchange programs, concur that making
clean syringes available to intravenous drug users does not encourage drug
use - in current users, in non-users, or in children in communities with
such programs. The NIH arrived at the same conclusion and further observed
that the incidence of drug use among program participants often decreased.

- -- They understand that needle exchange programs are cost-effective.

The average city will pay about $160,000 per year to run an exchange
program (about $20 per user), a sum significantly lower than the current
$195,188 lifetime cost of treating one person infected with HIV.

- -- They understand that needle exchange programs can be an effective bridge
to treatment.

While addicts' primary purpose in visiting an exchange center is to procure
clean needles, while they are there they have the opportunity to discuss
treatment options with a drug counselor. One organization, Prevention Point
Philadelphia, refers roughly 25 percent of the 5,000 users it sees annually
for treatment. Some programs, particularly those associated with hospitals,
require addicts to register, be tested for HIV and receive AIDS prevention
and drug counseling.

Gov. McGreevey's proposed program would be hospital-based, a provision that
should allay opponents' fears that crime will increase in the neighborhoods
in which needle exchange will operate - fears that studies show are unfounded.

- -- They understand that implementing and funding needle exchange programs
in no way condones drug use.

Some New Jersey politicians - including former Gov. Christie Whitman, who
consistently opposed needle exchange during her two terms - believe that by
distributing the device that delivers an illegal substance we would be, in
the words of Assemblyman Samuel Thompson, R-Old Bridge, "convey[ing] a
mixed message to our children."

It's certainly true that we can't have one group of state-sanctioned
workers handing out needles and another group arresting those who use them.
That's why it's imperative that we cease to perceive the crisis of drugs
and AIDS as a problem for law enforcement to solve and recognize it for the
public health issue it is. With an exchange program in place, what children
will see are positive interventions in the lives of addicts - addicts who
may be their parents or brothers or sisters. The message now being conveyed
to children is that their lives are less important than blind adherence to
an absolute: "Drugs are bad." New Jersey's first obligation is to protect
its children. Even those who might feel that AIDS is the drug addict's just
deserts - and the just deserts of the sex partner he infects - cannot find
culpability in a fetus.

- -- They understand that championing needle exchange is not a political
liability.

Many legislators seem to fear a voter backlash if they support such
programs. In fact, what happened in Connecticut 10 years ago when that
state revoked its ban on the sale of over-the-counter needles is
instructive: Not one of the lawmakers who supported the plan was defeated
for re-election. Success spoke for itself.

For these reasons, we welcome the governor's willingness to create a pilot
needle exchange program. We urge the Legislature to approve Assembly Bill
1620, sponsored by Assembly members Reed Gusciora, D-Princeton, and Loretta
Weinberg, D-Teaneck, that would provide statutory support for this overdue
initiative.