ATLANTIC CITY NEEDLE EXCHANGE PRODUCES MIXED RESULTS

Numbers Are in for First Year of A.C. Needle-Exchange Program

ATLANTIC CITY - The state's first needle-exchange program was born
here a little more than a year ago under heavy scrutiny and
controversy. State officials launched a three-year pilot effort in
November 2007 to see if they could slow the spread of HIV and
hepatitis. But to do so, they would spend public money passing out
free hypodermic needles to intravenous drug users.

First-year statistics are in and show the city's program has been
highly successful in distributing clean needles but subpar in getting
addicts into rehabilitation. That means the debate is likely to continue.

State records show the city dispensed far more clean needles than did
similar programs in Camden, Paterson and Newark. Atlantic City gave
out 60,001 needles between the start of the program and Jan. 5. The
resort's closest competitor is the Camden operation, which has
distributed 21,000 fewer needles, although Atlantic City's program
started two-and-a-half months before the second program in the state.

Other state Department of Health and Senior Services' statistics
indicate 52.9 percent of Atlantic City's needles have been returned
to the city's Tennessee Avenue facility - an indication that used
needles are not being passed on. That exchange rate is the
second-highest in the state, below only Paterson's program, which
dispensed far fewer needles overall. Atlantic City registered more
clients than any other program - the needles are not just going to
the same addicts.

"Word of mouth is obviously working," said Ronald Cash, the city's
director of Health and Human Services.

But the program's first year of operation has not been all good news.
While it has made considerable progress with needle exchange, its
primary focus, workers have struggled with referring their addicted
clients to get drug treatment.

According to state numbers, Atlantic City ranked last among the four
programs in drug referrals, with just 74 as of Dec. 21.

Larry Greene is one of the few participants in Atlantic City who will
enter a drug treatment program, but not by his own choice.

Greene was arrested by Atlantic City police for buying a small amount
of heroin in August and faced a decision: three years in prison or
six months at a Philadelphia treatment center. It wasn't a tough choice.

But in his three months participating in the program, the 54-year-old
never opted for referral to the John Brooks Recovery Center, located
across the street from the Atlantic City program.

"I should have," Greene said, sitting on a couch inside the city's
small facility. "I'm getting too old for this."

Greene said he's been enrolled at similar facilities six or seven
times, but personal setbacks always bring him back to drugs. He said
he's grateful for the opportunity to get clean again, even if he
didn't take it voluntarily.

Therese Wilkerson, a co-coordinator of the city's program, said
guiding their clients into treatment is a difficult balancing act,
weighing the importance of getting proper help for addicts with fears
of scaring them away.

"I wish we could do better, but we can't push it on them," Wilkerson said.

When clients such as Greene arrive at the exchange, after disposing
of their used needles, they enter a small cubical and are offered a
number of services, including drug treatment and testing for HIV and hepatitis.

One client, who called himself Tom, sat in the cubical and selected
dental care but said nothing about treating his addiction. Asked
later why he overlooked the option, Tom insisted he plans to get into
a program soon - but not today.

If a client chooses drug treatment, a representative from the John
Brooks Recovery Center meets the client at the drop-in center and
walks the client over.

Alan Oberman, the center's CEO, said he has noticed that fewer of his
workers have had to make the short trip across the street. He recalls
the program referring as many as eight clients per week when it first
began. Now, he said, it's closer to one or two a week.

And it could become more difficult to coax addicts from the program
to the center. Officials say the state recently imposed more
requirements on the program regarding when counselors can make a
referral. Participants must have valid identification, a history of
drug use and must have been out of treatment for six months.

However, drug treatment is not the only option the program offers
that can help clients, beyond avoiding HIV.

The pilot program recently added a new state housing initiative,
which strives to place addicts in low-income housing. Some
participants are responsible for paying partial rent. If they are
employed, they must contribute 30 percent of their income.

The housing project is a response to studies that show drug users
with stable housing are more likely to get off drugs and become more
stable citizens. The program received 31 vouchers from the state,
which house 15 people who are currently in drug treatment and 16
people who are not in treatment.

The housing plan is the newest addition to the ever-evolving
needle-exchange program. Officials hope the program's critics will
see their results and opinions will evolve.

"I think they've done a terrific job," Oberman said. "It also hasn't
been a disturbance to the area. That's important regarding perception
in the community and all the fear attached to the program. Maybe
people can see there's nothing to be afraid of."