New Jersey has become the last state where intravenous drug users can legally get clean needles, but two of the state's three needle exchanges are struggling to get clients. A lack of funding, winter weather, remote locations, and a mistrust by drug users are all making it tough for the exchanges to reach clients.
One exchange, located in Camden, distributes needles out of the back of a blue van that sets up Tuesday afternoons near an overgrown vacant lot in an industrial waterfront section of the city, where bottles of all types, trash, condoms, and clothing are strewn.
Officials say they would rather have addicts congregating there than in the more visible downtown area. Most of the pedestrians are prostitutes, including some who are among about 15 clients at the needle exchange.
A 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. The state government put $10 million toward drug treatment as part of the law that allowed needle exchanges but didn't fund the needle-exchange programs.
''All the programs in New Jersey are operating on a shoestring,'' said Roseanne Scotti, director of Drug Policy Alliance New Jersey. But she said the exchanges are nonetheless promising, despite their modest starts. The state legislature approved the pilot needle-exchange program in 2006 over heavy opposition and only after years of wrangling.
New Jersey is believed to have tens of thousands of IV drug users, but only about 200 are enrolled so far in the three existing exchanges. Advocates of the exchanges hope addicts who have easier access to needles won't be as likely to share them and that 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% of New Jersey's 48,000 reported HIV and AIDS cases were transmitted through needles; only Connecticut had a higher rate.
The Camden exchange is run by the Camden Area Health Education Center. Kim McCargo, who oversees the service, says 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 volunteers.
Last week, one of the clients was a 48-year-old man named Mickey. The Camden resident said the exchange is a lot better than making the trip to Philadelphia to get needles, or getting them on the street illegally.
''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.''
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 rain. That's a major factor because so many of the addicts don't drive. Over a few hours on a recent Tuesday, only one client arrived by car; the rest walked.
The first legal exchange program in the state, the Oasis Drop-in Center at Atlantic City, has had more success reaching intravenous drug users. About 175 people have enrolled since November.
The needle exchange at the Well of Hope Drop-in Center in Paterson has registered 20 users in its first few weeks. 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.'' (AP)
