The New York Times - September 25, 2006
Richard G. Jones

"Works for sale! Works for sale!"

But the shouting stopped at one corner recently after one of those dealers died of a drug overdose. For his loyal customers, it was a disaster, however briefly.

"It was a drought of works," said Maria Lugo, 26, who said that she injects heroin eight times a day. "People were picking up old needles off the street. They didn't care. They just wanted to get off."

That mix of apathy and addiction has led to what health officials say is a public health crisis in New Jersey, where state figures show that more than 4 in 10 cases of H.I.V. infection result from injecting illegal drugs with contaminated needles. Even so, New Jersey remains the one state that prohibits the distribution of hypodermic needles in government-sanctioned programs.

That may soon change. In a reversal that even supporters acknowledge would have been unexpected as recently as six months ago, lawmakers may well pass a bill soon to allow needle exchanges in New Jersey.

The legislation, to be considered this week, appears finally to have enough support to win passage, 14 years after it was first introduced, and Gov. Jon S. Corzine has said he would sign it.

To supporters, the bill is long overdue, and the Legislature's refusal to approve it has contributed to the deaths of an untold number of drug users.

To opponents, including State Senator Thomas H. Kean Jr., the Republican nominee for the United States Senate, the measure would mean nothing less than a government endorsement of illegal drug use.

One of the bill's most vocal critics, State Senator Ronald L. Rice, a former Newark police officer who represents a district in Essex County, has compared legal needle exchanges to the notorious Tuskegee Syphilis Study, an experiment in Alabama from 1932 until 1972 in which proper treatment was withheld from African-Americans infected with venereal disease.

Mr. Rice has argued that exchange programs contribute to a cycle of social and economic inertia for minorities and the poor.

A better use of state money, he says, would be to create more programs providing drug education and treatment.

"Those who want a syringe access program are saying that it's O.K. for drug users to continue using drugs and kill themselves because it's cheaper for the government," he said.

It was Mr. Rice, a Democrat, who negotiated an alliance with the Republican minority in the Senate to prevent the needle exchange bill from getting out of committee as recently as last spring.

But last Monday, committee members reached a compromise that would allow pilot needle exchange programs in six cities. The program would be re-evaluated in five years under the bill, which would also provide $10 million for drug treatment programs.

State Senator Nia H. Gill, a Democrat from Essex County who sponsored the original legislation, cited statistics that show New Jersey is the state with the third-highest rate of H.I.V. infection among children, and the highest rate among women.

Nearly 33,000 residents of New Jersey have AIDS, according to state health officials, and, in a statement, Ms. Gill noted that almost as many - about 30,000 - have died of the disease.

"If there were any other cause of hundreds of deaths of children, thousands of deaths of women and the orphaning of tens of thousands of children - our Legislature would act on an emergency basis to reduce that cause," she said.

To those who see the consequences of the drug trade in neighborhoods like South Camden, an exchange program cannot come too soon.

Several times a week, Jose Quann and Johnny Brown, workers with the Camden Area Health Education Center, drive a modified recreational vehicle through some of the bleakest parts of the city to do street-level prevention and education concerning H.I.V. and AIDS.

They hand out free condoms to prostitutes. They give intravenous-drug users bleach kits to sterilize syringes. And they offer health services like free blood pressure screenings and new oral H.I.V. tests that yield results in 20 minutes.

Bouncing over the uneven asphalt along Broadway in South Camden the other day, Mr. Brown, a burly 51-year-old, said that he did not believe free needles would encourage drug abuse.

"When they take part in needle exchange, it means they're starting to take an interest in their health," Mr. Brown said. "That's the first step."

Mr. Quann, 46, agreed. "It's a win-win for everybody," he said. "Right now, they're disposing of these things in our back alleys, in our playground where our kids are getting pricked."

Although the six cities in the proposed pilot program have not been chosen, both men hope that Camden, whose 75,000 residents, according to city figures, include an estimated 800 people with H.I.V. or AIDS, will be one of them.

So did a half-dozen visitors to their bus.

One of them, a 30-year-old prostitute who said her first name was Summer, sneered at the idea that providing free needles would promote drug use.

"Users are going to use anyway," she said. "But you'd have less people infected with H.I.V., hepatitis."

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