The Atlantic City council will hold a vote Wednesday that is expected to shut down the city’s needle exchange -- the first created in New Jersey and still the state’s largest, an oasis that keeps 1,200 clients alive by supplying IV drug users with clean syringes, helping them avoid blood-borne infections, and offering them a doorway to recovery.
The council admits that this facility – literally called Oasis – is essential. But it lies within the tourism district, it attracts out-of-towners who can’t get help in their communities, and neighboring towns don’t share the burden of helping a desperate population. So the vote will not be close.
What the council members don’t say, however, is where 1,200 addicts can go after the city padlocks the modest brick building on Tennessee Ave, because they have yet to propose an alternative site that Oasis visitors can reach by foot, as 60 percent of them do now.
That’s the kind of myopia that will get people killed, so it’s up to the adults in government to avert an avoidable tragedy, starting with Gov. Murphy.
He needs to not just maintain this service for Atlantic City, but use this moment to build a state-wide network of needle exchanges, in cities and suburbs, so that every addict can get this help.
The governor already agrees with the CDC that these syringe access programs (SAPs) help prevent IV users from sharing needles and contracting HIV and Hep-C.
He knows that people who use needle exchanges are five times more likely to enter drug treatment than those who don’t, according to the CDC.
The governor knows economics: A clean needle costs 10 cents, and a lifetime of treatment for HIV could cost the taxpayer $500,000 for the rest of that user’s life.
And Murphy knows that Oasis is more than a place for an addict to get a half-dozen syringes per day. They have on-site nurses who do free HIV and Hepatitis screening, and it’s the city’s only public source of free naloxone.
So it is reassuring to hear a spokeswoman say that Murphy is “committed to ensuring that Atlantic City and area residents continue to have access to these evidence-based and life-saving services.” The governor’s point man in this negotiation, Atlantic City health director Dr. Wilson Washington, adds that Murphy is “leaning towards trying to keep the program here, the challenge is finding an appropriate place.”
This is one issue in which Murphy must draw a red line, though his office won’t say whether he is willing or able to veto the council vote, even as Atlantic City remains under state control.
Sen. Joseph Vitale (D-Middlesex), whose legislation created needle exchanges in our state in 2007, wants the governor to send a message: “He should veto the ordinance and let the legal chips fall,” Vitale said. “And failing that, the state should just buy a building, because we’re flush with cash right now.”
But any decision going forward, Vitale asserts, should be based on one premise: “If there is less access to clean needles starting next week, more people are going to die, period.”
There were roughly 3,200 overdose deaths in our state last year, up from 1,400 in 2014, and we’re starting to employ more vigorous harm-reduction strategies. Naloxone will be available over the counter by September, and medication-assisted treatment (MAT) has become more accessible.
But fifteen years after Oasis opened its doors, we have failed to evolve on needle exchanges.
Chris Christie refused to fund our then-five SAPs until 2016, four years after his health commissioner declared them an unqualified success, notably in their ability to draw users into treatment.
Murphy has increased state funding for SAPs in each budget, but some funds are never spent because no town is opening its doors to them.
In response, Vitale recently introduced a bill that gives the health commissioner more authority to place SAPs in towns with urgent need and resistant governments.
For now, New Jersey still has only 7 syringe access programs to cover 21 counties and 535 municipalities. Compare that with another Northeast state with an opioid crisis: Massachusetts has 34 SAPs, plus another 10 mobile units, and it has only three-quarters of our population.
Or consider Kentucky, which has half our population, but 74 needle exchanges: If New Jersey had the same number per-capita harm reduction programs as the Bluegrass State, we would have 150 SAPs.
“When it comes to public health, we are positively primeval sometimes,” Vitale said. “Addiction is a health crisis we can fight. The data say it is the right thing to do. Yet we are still in the dark ages on this issue.”
This is a wakeup call, for Atlantic City and for New Jersey.
In a city built on the big broad shoulders of stupid math, 7 minus 1 is a deadly equation, and shuttering an SAP without an adequate replacement will cost lives.
The AC council must do the right thing – with state help, since it may not be long before the health commissioner is given the statutory power to drop a facility in any town she chooses.
The council isn’t wrong when it says that Atlantic City can be the regional hub for employment, shopping, dining and entertainment. That doesn’t mean it can’t also be the regional hub for public health.
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