Home News, New Brunswick, NJ
Copyright: Home News

October 18, 1998

William F. Lamb 

By a four-to-three vote Sept. 17, the state Senate Health Committee recommended the passage of legislation that would bring the needle exchange experiment to New Jersey.

In the view of supporters, needle exchange programs reduce the incidence of HIV/AIDS infection in intravenous drug users, retarding the spread of this terrible disease.

The needle exchange bills, however, are not to be voted on by the full Legislature any time soon. Because the needle exchange movement lacks anything resembling broad legislative support and given the intractable opposition of Gov. Christie Whitman, the bills are being withheld from the floor indefinitely. This strategy is designed to afford the well-financed needle exchange lobbying corps the opportunity to work privately on individual legislators.

While we await the results of this backstair political courtship, those who agree with the governor need to make our voices heard. To restate the obvious, government endorsement of needle exchanges undermines efforts to reduce, if not eliminate, illegal drug use and sends a mixed and dangerous message to young people tempted by the drug culture. It is difficult to reconcile being against the use of heroin while simultaneously furnishing the needle to use that heroin.

However, much more than a government message is at risk here. Core societal values and important moral and philosophic principles are compromised by the sanctioning of needle exchange programs. And if principle is to be jettisoned to combat a dread disease, we should at least expect our lawmakers to come up with something that works. Regrettably, the Senate Health Committee majority has done the opposite, succumbing to the needle exchange craze, a medical fad that does not work and offering it up in a maladroit legislative package that promises to wreak unintended havoc all along the drug-war front.

The needle exchange bills recommended by the Committee are poor legislation - a muddle of misguided and self-defeating provisions that should disappoint even those who support needle exchange programs. The main bill (S-453) authorizes a needle exchange demonstration project to be conducted under the auspices of the state Department of Health and Senior Services. The preface to S-453 reflects uncritical acceptance of scientific studies that claim needle exchange programs reduce the level of HIV in heroin users. From the start, these studies have seemed odd and counterintuitive. There appears no reason to suspect that a person hooked on heroin is going to be scrupulous about the needle used to get it in his veins.

Dr. James L. Curtis, director of psychiatry at Harlem Hospital, in a New York Times Op-ed column, denounced needle exchange programs as "simplistic nonsense that stands common sense on its head."

The better and more recent scientific evidence supports Curtis. In rigorous clinical tests conducted in Canadian cities with long-established needle exchange programs, needle exchanges proved a failure. In Montreal and Vancouver, studies found addicts who took part in such exchanges were two to three times more likely to become infected with HIV than addicts who did not participate. And those who did participate in needle exchange programs frequently shared needles with other addicts anyway.

These findings have come as unwelcome news to the American medical establishment, which generally has been supportive of needle exchange initiatives. Efforts to suppress or distort the Canadian studies, however, succeeded only for a time, and the truth about needle exchange programs continues to emerge. In the meantime, the impact of needle- exchange programs on surrounding communities has been a constant and it does not present a pretty picture. 

It should be no surprise that needle exchange operations attract the drug dealers who supply the heroin that goes in the government-issued needles. Needle exchange area residents also can anticipate an increase in residential burglary, theft, convenience-store robberies, mugging, prostitution, disorderly public conduct and all the other social ills that come with the drawing of drug users to a particular location. The only thing that will go down are local property values. The inner-city neighborhoods where needle exchange programs would be situated already endure a disproportionate share of street crime and dysfunctional behavior. They hardly deserve the increase needle exchanges would bring. 

The best that can be said for needle exchange programs is that they constitute a chancy therapeutic experiment with nasty societal side effects. If S-463 represents no more than a risky legislative gambit, its companion bill, S-267, is something far worse.

This bill is a perfect example of legislative tunnel vision and inattention to collateral consequences. Current law prohibits possession of paraphernalia and devices intended for use with illegal drugs. S-267 would exempt from that law "10 or fewer hypodermic syringes, hypodermic needles or instruments adapted for the use of a controlled dangerous substance." Another part of the bill provides that "hypodermic syringes and needles in quantity of 10 or less may be provided or sold at retail without a prescription only by a registered pharmacist… "

The first unintended consequence of this unfortunate bill is the complete undermining of the needle exchange program it is intended to facilitate. By authorizing paraphernalia distribution outside the needle exchange demonstration project, the bill creates an attractive alternative to heroin users looking to restock their needle supplies. After all, what addict is likely to participate in a government-controlled program when the same needles can be obtained anonymously at a local pharmacy?

But the harm of S-267 is not confined to the crippling of the needle exchange demonstration project. The bill also effects a substantive change in the law and legalizes, presumably unintentionally, the possession of all types of drug paraphernalia. In this connection, note that the definition of drug paraphernalia in S-267 is not limited to the hypodermic syringes and needles used by heroin addicts frequenting government-sponsored needle exchange programs. It extends to syringes and needles. Worse yet, the bill's legalization of other "instruments adapted for the use of controlled dangerous substances" is indiscriminate. This effectively decriminalizes possession of crack pipes by cocaine users, water bowls by marijuana smokers and all other types of devices as long as the drug user only has 10 of each.

The S-267 restriction on retail sale of hypodermic syringes and needles "only by a registered pharmacist" does not apply to the other CDS "instruments" legalized by the bill. This would doubtless bring cheers from head shop owners whose open retail display of drug paraphernalia was stopped only after a long, expensive courtroom battle in 1983.

The most egregious aspect of S-267, however, is its failure to protect children. No age restrictions whatsoever on the procurement of CDS paraphernalia are contained in the bill. Nor is any form of parental notification required. If S-267 becomes law, a truly astonishing irony in public-health policy would have been achieved. It would be embodied in the first 14-year-old who walks into a pharmacy, unable to buy cigarettes, but leaves the counter with his own heroin-starter kit, no questions asked.

There are other shortcomings in the needle exchange bills but further dissection of such flawed legislation would be overkill. Suffice It to say that the crafting of a major change in an area as important as public-health policy requires more than good intentions. The work of the Senate Health Committee has fallen lamentably short of the mark and rejection of the needle exchange change bills in their present form should not require extended deliberations.

Obviously, defective legislation can be corrected. But before the repairmen are sent in to fix the needle exchange bills, we need to engage in a more fundamental debate.

The controversy has revolved largely around the efficacy of needle exchange programs in the battle against AIDS. How well do they really work? Largely neglected by the partisans on both sides of the matter has been the broader issue of right and wrong. Moral absolutes are not of fashion these days and to oppose something on moral grounds exposes one to censure as "judgmental." And in the AIDS area, the epithet "insensitive" Is likely to be uttered in the next breath. But It does not denigrate the threat posed by AIDS or the suffering of those afflicted with it to oppose needle exchange programs on moral grounds.

Some things simply are wrong, and government distribution of hypodermic needles to heroin addicts is one of them. First and foremost, needle exchanges are wrong because they undermine the force and moral authority of criminal laws.

On a more mundane level, needle exchanges are wrong because they offer drug abusers a false remedy. Left untreated is the addict's fundamental problem of his heroin addiction. Providing needles does nothing to dissuade the drug abuser from continuing to use drugs. It only makes it easier for him to do so.

To leave the addict untreated does more than ensure his own misery. There are enormous societal costs involved. Nothing is as pathetic as a sick, unemployed, long-time heroin user. But the addict is not the only one deserving of sympathy. Just remember how many homes the average junkie has to burglarize each year to finance his habit.

In addition to offering the heroin addict no help, needle exchange laws do not save the drug user from punishment and jail. Even if possession of drug paraphernalia is legalized, it still would be against the law to possess drugs such as heroin or to be under the influence of controlled dangerous substances in public. This smokes out the fundamental issue implicated by needle legislation: the legalization of drugs.

It is but a short jump in logic from needle exchange authorization to drug legalization. If government provision of needles for heroin use is to be sanctioned as a public health measure - a surreal concept - should not the government supply the heroin as well?

Unrestricted availability of drugs like heroin is the ultimate objective of George Soros, the wealthy currency trader bankrolling lobbying efforts in Trenton, and of those in the drug legalization camp who have infiltrated the needle-change movement.

The paradox here is that most needle exchange advocates, like most everyone else oppose, the legalization of drugs. Needle exchange change advocates often witness directly the human wreckage heroin leaves. But they are desperate for something with which to fight the spread of HIV/AIDS. This forces them to rationalize: I am against the legalization of heroin, but the addict's craving is so strong and irresistible he is going to get heroin whether it is illegal or not.

Consequently, the government ought to furnish the addict with the needle necessary to ingest that heroin so we can reduce the transmission of the HIV virus through heroin taking.

This kind of reasoning is more than just defeatist. It is intellectually dishonest, akin to being opposed to rape but because the sexual urge is so strong and irresistible in sex predators, being in favor of government distribution of condoms to serial rapists to reduce the incidence of sexually transmitted diseases in rape victims.

As a state, we cannot have it both ways on drugs. Either we legalize the possession and use of narcotics and call off the war on drugs or we stand firm and continue the fight to eradicate drug use. Needle exchange change legislation does not hinge on questions of medical efficacy. It is a matter of right and wrong. As long as the possession of drugs such as heroin is against the law, government provision of needles for heroin use is wrong. Needle exchange legislation should be rejected unapologetically on that basis.