Pubdate: Tue, 14 Jan 1997 Source: Trenton Times (NJ) Author: Dawn Day HEROES OR CRIMINALS? THE LEGALITY OF NEEDLE EXCHANGE IN NEW JERSEY In my book, Diana McCague and Thomas Scozzare are heroes. Unfortunately, the state of New Jersey claims they are criminals. Diana and Thomas were arrested in New Brunswick one cold night last April because they were trying to stop the spread of HIV by giving out clean needles to persons who injected drugs. No knowledgeable person contests Diana╠s and Thomas╠ assertion that New Jersey is at the epicenter of the American AIDS epidemic caused by the use of dirty needles. According to the New Jersey Health Department, over half of all AIDS cases in New Jersey are injection-related. By the end of September 1996, 16,800 New Jersey residents age 13 and over were living with injection-related AIDS or had died from it. We can expect the epidemic to continue on an alarming scale. Some 1200 New Jersey residents will become infected with HIV through the use of dirty needles in the next year, according to estimates made by Dr. Scott Holmberg of the CDC and published in the American Journal of Public Health. Diana and Thomas are not medical doctors or sophisticated researchers. But they are intelligent, concerned citizens. And the technique they have chosen in their heartfelt effort to save lives is one that has the support of every scientific body that has examined the issue. In the five years between 1991 and 1995, the federal government funded six studies on injecting drug use and the spread of AIDS and all six studies concluded that clean needle programs were an effective and necessary tool against the spread of AIDS. The Medical Society of New Jersey, the New Jersey Public Health Association and their national counterparts are all in favor of clean needle programs. The New Jersey Governor╠s Advisory Council on AIDS and President Clinton╠s Advisory Council on AIDS also recommend support for clean needle programs. The same studies that have shown the effectiveness of clean needle programs have also shown that these programs do not increase drug use. When Diana and Thomas gave out sterile needles they knew were saving lives. They also believed that somewhere in New Jersey law there would be a way for their humanitarian work to be accepted for what it was. Their hope was not without basis. That had happened in at least eleven other communities across the nation. The arguments supporting Diana and Thomas are very persuasive. New Jersey╠s law limiting access to sterile needles was written before the AIDS epidemic was understood and was not intended to apply to bona fide disease control measures such as needle exchanges. There is no evidence that New Jersey╠s limitation on access to sterile needles has ever been effective in achieving its original purpose -- decreasing drug use. But the law has been very effective in spreading the deadly AIDS epidemic. (Paradoxically, persons who participate in clean needle programs have been found to decrease their drug use. More research is needed to understand why this is the case, but my own guess is that it is due to the human interaction between needle exchange workers and their clients. At last somebody cares if they live or die.) Diana and Thomas were not running a criminal enterprise for profit, intent on personal gain without concern for the health of others. Rather it was the opposite. They were unpaid workers in a public health enterprise, trying to save lives, taking considerable personal risk. The state of New Jersey had no compelling interest that was disrupted when Diana and Thomas were giving out clean needles. In fact, to the extent that the state of New Jersey has an obligation to preserve the lives of its residents, Diana and Thomas were doing the state╠s business -- in a much more effective way than the state itself. The majority of Diana╠s and Thomas╠ clients were African American and Latino. Thus eliminating Diana╠s and Thomas╠ work causes disproportionate suffering in minority communities. If the CDC research is correct, some 1200 New Jersey residents will become infected with HIV in the next year as a result of dirty needles, and their medical treatment will cost about $150 million. To those of us who have studied the issue, the criminal prosecution of public health workers like Diana and Thomas is senseless from both humanitarian and fiscal perspectives. Keeping clean needles from persons who inject drugs is causing the spread of a deadly disease. At the moment, New York has a higher rate of injection-related AIDS than New Jersey. However New York now has a number of needle exchanges. So, if New Jersey continues with current policies, it is only a matter of time before our rate will rise above New York╠s, a first that we should be very reluctant to claim. What can two people in New Brunswick do to stem an epidemic that is now claiming over a thousand lives in New Jersey every year? They are our leaders. If they are allowed to go back to their lifesaving work without fear of arrest, other volunteers will follow in other cities. And from their collective work will spring the reasonable hope that somehow we can stem the tide of this horrible epidemic. All Diana╠s and Thomas╠ lawyers ask at the moment is that their clients be given a hearing so that the evidence on the extent of this terrible epidemic in New Jersey and the research on how to handle it can be brought forth for consideration. Is that too much to ask? Dawn Day, Ph.D., is the director of the Dogwood Center in Princeton. Dr. Day is a sociologist and activist scholar who writes on issues of social justice and AIDS.