Needle exchange starting in N.J.

ATLANTIC CITY - Bobby Jones, a self-described heroin addict, had never been to the Oasis Drop-In Center on Tennessee Avenue before.

But last month, when word on the street spread that the social service agency was offering drug users salvation in the form of the state's first legal needle-exchange program, Jones was among those lined up at the former union hall waiting for clean syringes.

Outside of an authorized needle-exchange program, possessing hypodermic syringes without a prescription is illegal.

With intravenous drug users and their sexual partners contracting AIDS at a growing rate, health advocates say that providing clean needles nationwide - no questions asked - could help save hundreds of millions of dollars in medical costs and prevent the spread of the disease to thousands of people in the drug-using community and beyond.

"Maybe this is a start to getting me on the right path again," said Jones, 43, who lives on the street and in Atlantic City homeless shelters.

"I know I've been going the wrong way in my life, but I need to stay as healthy as I can while I make my way to getting things right," he said.

Oasis, where Jones has obtained needles since Nov. 27, is run by the South Jersey AIDS Alliance, which offers free HIV testing and counseling, drug-treatment referrals, AIDS education and other services.

Needle-exchange programs remain controversial. Critics say they appear to condone, or even promote, illegal drug use. In public health circles, however, they are considered invaluable in preventing transmission of hepatitis and HIV, the virus that causes AIDS.

New Jersey became the nation's last state to institute a needle-exchange program when Gov. Corzine signed the measure into law last year, according to Roseanne Scotti, director of the Drug Policy Alliance of New Jersey.

Camden is scheduled to begin its program next month, with Newark and Paterson to follow this winter, Scotti said.

The need is great, she said. New Jersey ranks fifth in the nation in total number of reported adult HIV cases, third in pediatric HIV cases. And it has the highest proportion of women infected with HIV in the nation, according to the Centers for Disease Control and Prevention.

Proponents of New Jersey's exchange program say an estimated 45 percent of all new HIV cases reported in the state involve infection caused by drug users sharing contaminated syringes.

A 2003 article in the medical journal the Lancet estimated that of new HIV infections among intravenous drug users in the United States between 1997 and 2000, as many as 11,000 could have been prevented with a federal needle-exchange program, saving the government more than $600 million in health-care costs.

Underground programs have operated for years in urban centers such as Atlantic City, Newark and New Brunswick. Health workers have serviced addicts by going into "shooting galleries" and crack houses and handing out "works" bags that contain syringes along with other items utilized by drug users.

"Establishing a legal program like this is something that we've really been advocating for years," said Ronald Cash, director of Health and Human Services for Atlantic City.

Though his department administers the Atlantic City program, the South Jersey AIDS Alliance was chosen to run it at its Oasis center, within the shadow of the towering casinos, because the place had the respect of the community, Cash said.

"When people come in here, they need to feel they can trust us and that they aren't going to be arrested when they walk out the door," said Georgett Watson, program director of the alliance.

The exchange policy went into effect without protests. And Atlantic City police are behind it, said Gene Brunner, HIV program coordinator for the city, because it reduces the odds they will be exposed to HIV infection in their work.

In the first 31/2 weeks of the program, Watson said that 90 clients were given 11 clean needles for every used one they brought in.

"The law is written so that it's one clean needle for every needle brought in, plus 10 more clean needles" to discourage the need to share used syringes, Watson said.

Before the needles are distributed, Watson said, staff members briefly interview participants about their drug use and counsel them on the availability of treatment programs and other services.

Those in the program have their choice of different types of needles, plus small metal "cookers," sterile cotton swabs, and sanitizing wipes. They are also given sealable "sharps" containers for disposing of the needles safely.

Many seem to want help, Watson said.

"We've had two cases so far where someone who came in to exchange their needles have entered treatment programs," Watson said.

John Tan, who works in an Asian restaurant down the block from Oasis, said news of the needle-exchange location in his neighborhood didn't worry him. Besides Oasis, the neighborhood is home to a methadone clinic at St. Nicholas of Tolentine Roman Catholic Church.

"I don't necessarily think it will bring more drug addicts to the neighborhood," Tan said. "I think if it is one more tool that serves the community to keep people safe, then it's a good thing."