NEEDLE EXCHANGE GAINS OLD FRIEND

WHEN Governor McGreevey was elected three years ago, one group in
particular saw his victory as a coup of its own. After all, Mr.
McGreevey had promised to start a pilot program that would allow
intravenous drug users to trade dirty needles for clean ones in an
effort to slow H.I.V. and hepatitis C transmission.

But the governor's resolve seemed to wane, and advocates of what has
become known as needle exchange found themselves joining the growing
clamor of those looking to collect on campaign promises. They were
still waiting for their pilot program on Aug. 12, when political life
as they knew it was reshaped.

As it turns out, Mr. Greevey's political demise could be the best
thing that has happened to them. Far from reversing needle exchange
advocates' political fortunes, the seismic shift that day has been
cause for renewed optimism, as the governor makes up for lost time
during his days as a lame duck. Needle exchange is near the top of his
agenda; his aim is to legalize it, and this time there is a firm
deadline: Nov. 15, the day he leaves office.

"I think there's a recognition now, because of the limited time left
and because of political considerations not being important, that
there's an ability to overcome obstacles and look for common ground,"
said Micah Rasmussen, a spokesman for the governor. "All of a sudden
there is a clarity that the issue of protecting people's health and
protecting people's lives is bigger than any one of us."

At the end of last month, Mr. McGreevey took action, urging
Commissioner Clifton R. Lacy of the Health Department to work with
state lawmakers in coming up with legislation that would allow needle
exchange in the state, which now forbids possession of syringes
without a prescription and prohibits distribution as well. This week
the plan will take a leap forward: legislators are ready to introduce
a pair of bills in the Assembly on Monday that would promote syringe
access. Mr. Lacy will testify in support of the bills. And while Mr.
McGreevey has not gone so far as to say he will sign the legislation,
it is safe to say that the bills would not have made it this far
without his prodding.

Mr. McGreevey's stance is a departure from just a few months ago, when
he wrote in a June 1 letter to The New York Times that said: "I have
supported and would sign legislation providing for a hospital-based
needle-exchange program under the jurisdiction of New Jersey's
Department of Health. Regretfully, it is bad public policy to authorize
cities that have their own challenges to operate an initiative for
which they are woefully equipped."

The position expressed in the letter, which came after Atlantic City's
and Camden's separate efforts in June to authorize needle exchange
programs of their own, was a carefully calculated one, according to
two top-ranking state officials who spoke on the condition of
anonymity last week. They said the governor had avoided needle
exchange, a tactic suggested by his aides to avoid controversy. With
contentious issues all around him, amidst a gathering fog of
corruption, the governor's advisers feared that he could not afford to
tackle another issue that could polarize the Legislature, the
officials said.

As a result, Mr. McGreevey insisted that he would support only
programs based in hospitals. This drew criticism from needle exchange
experts, who charged that because addicts often shy away from
hospitals, attempts across the country to create hospital-based needle
exchange had failed.

Before the governor refocused on the issue, lawmakers were working on
needle exchange even as it seemed to lose support.

The Assembly Majority leader, Joseph Roberts, spent the summer
researching options for needle exchange legislation. To explore
different models, he visited a pair of programs, hosted by the
Positive Health Project in New York City and Prevention Point in
Philadelphia. And when he bumped into Senator Nia Gill at the
Democratic National Convention in July, the two of them took the
opportunity to visit a Boston needle exchange site together.

Momentum built as August drew to a close. On Sept. 1, Superior Court
Judge Valerie Armstrong struck down Atlantic City's new needle
exchange ordinance. The move strengthened the resolve of legislators
to see the matter addressed in Trenton.

This week, Assemblyman Roberts and Senator Gill, along with a
coalition of other lawmakers including Senator Joe Vitale,
Assemblywoman Loretta Weinberg, and Assemblyman Reed Gusciora, put the
final touches on the pair of bills that will be introduced in the
Assembly on Monday. According to Assemblyman Roberts, the first bill,
called the Blood Borne Disease Harm Reduction Act, will give
individual cities the option to sponsor local needle exchange programs
affiliated with hospitals, clinics, or local health departments. Along
with clean needles, the programs would be required to offer a range of
health and social services for their participants.

"If Newark doesn't want it, then Newark doesn't have to have it," said
Senator Gill, explaining that the bill would be permissive, not
prescriptive. "But we cannot sit back and not provide the legal
framework for Atlantic City to have it, when one in every 40 residents
has AIDS there."

The second bill would deregulate pharmacy sales of syringes, allowing
customers over the age of 18 to buy up to 10 needles at a time without
a prescription. Currently, New Jersey is one of only five states that
require a doctor's prescription for needle purchases.

Both bills are expected to find strong support in the Assembly, but a
more daunting challenge is anticipated in the divided Senate, where
versions of the bills may be introduced as soon as next week. Senate
President Codey, who supported needle exchange legislation in 1998,
has not yet decided whether he will stand behind its latest
incarnation. And Senator Ron Rice, the state's most vocal opponent of
needle exchange, is already preparing to challenge the bills.

"I can't get jobs, I can't get housing, but I can get a free needle.
That is the dumbest thing in the world to me," said Senator Rice. In
the past, he has equated the distribution of needles with passing
around cups of Kool-Aid in Jonestown. "They're saying, 'Here, this
clean needle is going to set you free.' Oh, it's going to set you
free, all right," he added. "It's going to set you up when you OD.
It's going to kill you."

Public health advocates have expressed renewed optimism for a
situation that they say is growing more desperate. As of Dec. 31,
2003, more than half of the state's 62,752 reported HIV and AIDS cases
were attributed to sharing needles, according to the Health
Department. Yet New Jersey remains one of only two states in America
where the laws build a formidable double barrier: they criminalize the
purchase or possession of syringes without a doctor's prescription,
and they also prohibit needle exchange programs.

Some proponents, though, are still wary. Scott Burris, the associate
director of the Center for Law and the Public's Health at Johns
Hopkins University, said that the bills would bifurcate a single
issue: syringe access.

"The fact that there are two makes me think that someone thinks there
might be some political tradeoff to be made," Mr. Burris said. He is
concerned that, with all the attention paid to needle exchange over
the past year, it might seem an easy compromise to drop the pharmacy
deregulation bill. Mr. Burris still marvels that New Jersey has
managed to lag so far behind.

"What I think is that it's scandalous that it's taken this long," Mr.
Burris said. "The terms 'scandalous' and 'McGreevey' have a certain
redundancy at this point."