THE NEEDLE EXCHANGE DEBATE

For those working to achieve sensible public-health policies in New
Jersey, two important questions await answers in the waning days of
2011.

Question 1: The Legislature completed action last week on a bill to
allow pharmacies to sell up to 10 hypodermic needles to adults without
a prescription. By enabling intravenous drug addicts to obtain clean
syringes, the measure would reduce the spread of HIV, hepatitis C and
other blood-borne diseases. Will Gov. Chris Christie sign it into law?
As of this writing, his administration says only that the bill "will
get careful review and consideration."

Question 2: The state Department of Health has promised to deliver a
final report this month on the results of demonstration programs in
Newark, Jersey City, Paterson, Atlantic City and Camden through which
addicts can bring their dirty needles to supervised clinics and
receive clean ones in exchange, along with a strong pitch for drug
treatment. Will the report be positive, which would allow
authorization for the program to continue?

These issues truly matter. New Jersey's rate of adult HIV infection is
the fifth-highest in the nation. Forty-one percent of the victims
contracted the virus from injections, compared to a national average
of 17 percent. And it's not only the addicts whom the malady punishes.
Drug users with HIV transmit it to their sexual partners and to the
infants they conceive, which is why New Jersey also has the highest
rate of HIV among women and the third-highest rate among children.

These unwanted distinctions have come to New Jersey and made a mockery
of its progressive reputation, because of the opposition to
intelligent drug laws over two decades by hard-liners in both parties,
mostly Republicans. New Jersey and Delaware are the only two states
that still ban the over-the-counter sale of clean needles, and, until
2006, ours was the only state that forbade government-supervised
needle-exchange programs. While conservative strongholds such as
Mississippi, Alabama, Oklahoma and Texas reaped the benefits of
drug-law reform, we stood alone on the outside.

But facts and logic have begun to win out. The Assembly passed the
over-the-counter needle sales bill last week by a 54-24 margin, with
10 Republicans casting "yes" votes. Last February, when the Senate
approved the measure 28-12, six Republicans voted with the majority.
There was little or no debate by opponents on either occasion.

Roseanne Scotti, director of Drug Policy Alliance New Jersey, is
encouraged by those displays of bipartisanship. She's encouraged also
by the long list of public health and advocacy organizations,
representing diabetes activists, hospitals, doctors, nurses,
pharmacists and others, that have backed the legislation. These groups
have written individual letters to Gov. Christie asking him to sign
it, Scotti said.

It's all up to Christie. He could sign the bill, veto it outright or
conditionally veto it with amendments that would reduce its
effectiveness. Whatever he decides will be the final verdict, even
though the measure passed both houses of the Legislature by more than
the two-thirds majority that would be needed to override a veto. The
Republicans in both houses march to the governor's orders, and in a
veto showdown those majorities would be certain to crumble.

There's reason for optimism, though. Christie has taken some
enlightened positions on drug addiction. Last month, he announced a
comprehensive plan to help offenders break their drug and alcohol
habits by expanding the state's Drug Court Program, which offers
nonviolent addicts treatment and counseling instead of prison
sentences. "Putting people in prison for nonviolent drug offenses
makes no sense," he said. Surely he knows that condemning them to the
risk of contracting life-threatening diseases is equally senseless.

There's also reason to hope that the forthcoming Health Department
report on the five local needle-exchange pilot programs will be
favorable. The same department, in an interim report in 2010, found
that the overall project "is off to an excellent start and serves a
hard-to-reach population with tremendous promise in preventing the
transmission of blood-borne pathogens." The department's study found
no increase in crime or improperly discarded syringes, as
needle-exchange foes had warned. "Based on the evaluation's findings,
it is recommended that the program continue," the department said.

Since then, the results have continued to be heartening. Between
November 2007 and October 2011, more than 9,500 people in the five
participating cities have received sterile syringes; more than 2,000
of them have signed up for drug treatment; hundreds have been tested
for hepatitis C and hepatitis B and given access to medical care. Not
bad for a handful of programs that receive no state funding and are
scraping by with donations from foundations and other private sources.

Assuming the Health Department does call for the needle-exchange
programs to be continued, the Legislature should respond
appropriately. It should make the authorization permanent, allow
communities throughout the state to establish similar programs and
provide public money to supplement the private support. New Jersey's
full enlistment in this humanitarian effort is long overdue.