December 15, 2006
NJ LEGISLATURE APPROVES SYRINGE EXCHANGE
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On Monday, after over a decade of advocacy efforts, the New Jersey Assembly and Senate approved a measure that allows 6 cities to launch pilot needle and syringe exchange programs (S 494), joining a policy reform movement that has bettered access to clean needles in every other state.
Lifting the ban is a start, but NJ policymakers have not yet fully committed to this proven public health intervention. The limited number of pilot programs and lack of funding will hinder full scale access. Although the bill provides $10 million for drug treatment programs, the legislature did not fund syringe exchange.
NJ Governor John Corzine has pledged to sign, emphasizing the scientific evidence for syringe exchange as a way to prevent the spread of disease and increase the likelihood of getting people into treatment.
Everyone's life is worth protecting
The Drug Policy Alliance Network's Roseanne Scotti has been working toward syringe access for New Jersey for the last four years. "This is a huge victory in the fight against HIV/AIDS," she said. "Yesterday, New Jersey sent a message that everyone's life has value and that everyone's life is worth protecting. New Jersey sent a message that we are going to do everything we can to fight HIV/AIDS."
According to the New Jersey Department of Health and Senior Services, 14% of new HIV/AIDS cases in the state in 2005 were attributed to injection drug use. New Jersey has the highest new HIV infection rate among women in the U.S. and ranks fifth in HIV prevalence in the country. Despite these harrowing statistics, NJ is the only state that does not allow injection drug users access to clean needles through community-based needle-exchange programs or with a prescription.
"This is a great day, but it is just a first step," said Axel Torres-Marrero, commenting on December 11. Torres-Marrerro has been working for health and justice for injection drug users for 15 years and serves as the Director of Public Policy and Legal Affairs at the Hyacinth Foundation, NJ's first and largest AIDS service provider.
"We now have a law that will permit municipalities through city ordinances to enact syringe exchange with a limit of 6. This is better than nothing, but this is not a statewide syringe access program," he said. "We still need over-the-counter sale of syringes and to make sure implementation of community-based syringe exchange takes ground and expands."
Work now begins at the local level to be sure city councils pass legislation to approve and fund programming.
Atlantic City and Camden first in line<.em>
"New Jersey shouldn't really be cautious about syringe exchange because it is a proven effect strategy. Given all the time it has taken to create the situation to do exchange, there is now no excuse to not do it quickly and effectively," said Alan Clear, Executive Director of the Harm Reduction Coalition. He recommends local providers, advocates and officials "reach out to people who have been doing this for a long time so they can get this off the ground as quickly as possible and reach drug users effectively from the get go. They're already going on that, and Camden and Atlantic City are the most far along."
City council endorsements are lined-up in Atlantic City, Camden, Patterson and Jersey Cities, according to local advocates. Atlantic City, which recently passed an ordinance to allow a pilot needle-exchange program in the city, might have an operational program in three to six months, Ron Cash, Atlantic City health officer, said.
"In New Jersey, we are very thankful to the legislature and the Governor for making this happen. Syringe exchange is a tool we've needed for a long time, and it is finally here so hopefully we can make good use of it," said Gene Brunner, HIV Coordinator at the Atlantic City Health and Human Services Department. "I would encourage any municipalities who are eligible to apply. Eligible communities will have a high rate of HIV infection, and this opportunity to do something about it."
>The next challenge: the ban from the Hill
Despite consensus among the states to support access to clean needles, federal policymakers still refuse to allow federal funds to be spent on syringe exchange. 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."
Overwhelming evidence, however, shows that syringe exchange programs are a bridge to treatment. Internationally, the dialogue on this issue has progressed beyond whether or not communities should create syringe exchange programs to the challenges of effective implementation and the needs of overlooked populations such as women and prisoners. Human rights and public health advocates worldwide are pushing for more and better outreach, care and services for injection drug users.
The last major effort to lift the US federal ban was in the late 90s, but the fight for better HIV prevention has made solid progress since then. Clear said, "Although it is totally going to be a fight to get the federal ban lifted, we have momentum now. The situation has changed. We have more allies in Congress, who are better educated on the issues. The community is stronger, and major city and states are on board with syringe exchanges and more programs see the need. NIH and CDC agree that access to sterile syringes is necessary to prevent HIV among IDUs and their partners."
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