NJ Needle exchange program struggling

February 22, 2008 10:32:04 AM PST
A heroin addict named Mickey has been walking 3½ miles each Tuesday to pick up a week's supply of syringes. Mickey, a tall man with several sweat shirts hanging from his thin frame on a blustery day, says it's a lot better than making the trip to Philadelphia to get needles - or getting them on the street - illegally - for $2 to $3 each.

"This is a good program. The only complaint I have is they should move it a little closer to town," said Mickey, a Camden resident who spoke on condition that his last name not be used because heroin possession is illegal. "I ain't a young boy."

An out-of-the-way location is one of many struggles New Jersey's fledgling needle exchange programs are having to gain clients. While the state is believed to have tens of thousands of intravenous drug users (a 2004 study estimated there were as many as 23,400 in the Newark area alone), only about 200 are enrolled so far in the three exchanges.

In December 2006, New Jersey became the last state to provide a way for addicts to get needles legally. It took almost a year, though, before the regulations were in place and programs could be started. Though the state approved the needle exchanges, it does not pay for them, leaving agencies that run the programs to look for grants from elsewhere.

The hope is that addicts who have easier access to needles won't be as likely to share them, and the spread of HIV and other blood-borne diseases will be slowed. According to a 2005 report by the Henry J. Kaiser Family Foundation, at least 43 percent of New Jersey's 48,000 reported HIV and AIDS cases were transmitted through needles; only Connecticut had a higher rate.

The New Jersey law passed over heavy opposition and only after years of wrangling. Critics balk at the idea of needle exchanges, arguing they enable or encourage illegal activity.

The Camden exchange is run by the Camden Area Health Education Center. Kim McCargo, who oversees the service, says that it would take $500,000 a year to run a program as expansive as she would like, with needles given out three days a week at locations around the city.

The health education center has managed to scrounge together about $85,000 in grants, enough for a once-a-week exchange, run by McCargo and some volunteers.

They distribute needles out of the back of a blue Ford van that sets up Tuesday afternoons on a gravel parking lot attached to an overgrown vacant lot where bottles of all types, trash, condoms and clothing are strewn.

It's in a desolate corner in the industrial Waterfront South section of city that is one of the nation's poorest. Officials would rather have addicts congregating there than in the more visible downtown area.

Traffic in the area consists largely of trucks headed to or from a nearby port. Most of the pedestrians are prostitutes, including some who are among about 15 clients at the needle exchange.

The health education center's motor home, where health workers draw blood for hepatitis tests, give instant HIV tests, and hand out snacks, blankets and condoms, is parked next to the van on Tuesday afternoons. Workers on both vehicles are trained to encourage clients to get regular HIV tests and tell them about treatment options. The state government did put $10 million toward drug treatment as part of the law that allowed needle exchanges.

When Mickey, 48, showed up last week, he had a grocery bag with him to carry 70 needles home. Mickey, originally from the Trenton area, says he shoots up - heroin mostly - about 10 times a day and has been hooked for more than a half-dozen years.

McCargo says state guidelines call for giving addicts one clean needle for every used one they turn in - plus 10 more. But in practice, she says, she gives them as many as they think they need for the week.

She wouldn't mind if her clients gave some of their clean needles to friends who aren't in the program. The idea is to help people - even if they're not enrolled.

And getting people to come has been a challenge.

McCargo says the weather is one reason. Though it's been a mild winter in southern New Jersey, Tuesday afternoons have been marked by flurries, sleet and frozen raid. That's a major factor because so many of the addicts don't drive. Over a couple hours this Tuesday, only one client arrived by car; the rest walked.

And some of those who show up can be easily scared away.

McCargo welcomes media attention, figuring it spreads the word about the program and may bolster grant applications.

But in January, on the first day the program was running, a television newscast reporting about the exchange aired one woman's face. She was so upset she hasn't returned, said McCargo, who was hoping to get a friend of the woman to take her some needles.

At the needle exchange at the Well of Hope Drop-in Center in Paterson, director Jerome King says people there have been scared off because they saw a police car parked - by coincidence - nearby.

"People are still getting over the stigmas and some of the fears, not knowing if it's going to be a police trap," King said. "Once people feel safe, it will pick up." Under state law, people in the program are given identification cards that explain it is legal for them to have the needles.

In its first few weeks, King said, his center registered 20 users.

The one center exchange where business is brisker is in Atlantic City, where about 175 people have enrolled since November at the Oasis Drop-in Center, the first legal exchange program in the state.

"They've had people come in, in Atlantic City, who have never been to the drop-in center before," said Roseanne Scotti, the director of the Drug Policy Alliance New Jersey. "You're reaching the hardest-to-reach people."

She says that the New Jersey needle exchanges are promising despite their modest starts. After 15 years of allowing exchanges, she pointed out, Pennsylvania has only two - one in Pittsburgh and one in Philadelphia.

New Jersey already has three. A fourth, in Newark, is expected to open soon, and there's some planning for additional exchanges in Elizabeth, Jersey City and Trenton.

Back at the Camden exchange, 41-year-old John Pruestel said he's been shooting drugs half his life. Mostly, the chatty Camden resident uses heroin and cocaine.

He appreciates the clean needles - and not just because they might keep him from contracting HIV. When he uses old ones repeatedly, he said, "sometimes, they're like nails," and tear up his arm.


On the Net:

Camden Area Health Education Center: www.camden-ahec.org/
Oasis Drop-in Center, Atlantic City: http://www.southjerseyaidsalliance.org/oasis.html
Drug Policy Alliance New Jersey: www.drugpolicy.org/statebystate/newjersey/