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Opposition to harm reduction centers does not hold up | Editorial

November 22, 2021
By Star-Ledger Editorial Board

For the first time in U.S. history, 100,000 Americans have died from drug overdoses in a single year. This 29% surge since last year was both overshadowed and fueled by the pandemic, and the trajectory is staggering: The number of OD deaths has more than doubled since 2015.

New Jersey is not immune: We lost 2,918 lives last year, down 1% from the year before, and we have the 21st highest overdose mortality rate in the nation. Like other states, we can either ignore the alarm bells or choose to fight addiction with every weapon we can bring to bear.

The Assembly Health Committee did its part Monday, advancing a bill by 9-4 party-line vote that would allow expansion of Harm Reduction Centers, a.k.a. needle exchanges, throughout the state. There are only seven HRCs in New Jersey, and one of them — the Oasis Drop-In Center in Atlantic City — is barely hanging on, because a judge’s order kept the city council from shutting it down, at least for now.

Without Oasis, there will be 1,200 clients with no refuge and no hope, which is a common and tragic story for IV drug users in our state. These facilities have saved countless lives. They provide clean syringes, Naloxone, offer wound care and fentanyl testing strips, and they build relationships, which gives users a portal to recovery.

Fact: Addicts with access to harm reduction services are five times more likely to enter treatment. Eliminate these facilities, and they will share dirty needles, leading to outbreaks of HIV and Hep-C and other deadly infections that can overwhelm the health care system.

So seven centers statewide – for 535 municipalities – is an absurd shortcoming. Massachusetts has only three-quarters of our population, but it has 44 HRCs; Kentucky has half our population, but it has 74.

The barriers toward expansion were clear during the Assembly hearing masterfully chaired by Dr. Herb Conaway (D-Burlington). Opponents on the panel dug in: Some fear the loss of home rule, because the bill gives the Department of Health the authority to place an HRC where demand exists – “in consultation” with local officials — so that impulsive locals cannot repeat the mistake Atlantic City just made.

“While I have long supported needle exchange programs, I’m going to say no because the towns cannot say no,” said Assemblywoman Nancy Munoz (R-Union), a nurse by profession.

That is largely irrelevant in this case, the bill’s sponsors say. The towns would demonstrate a need for such a facility, and they would be placed strategically. Sen. Joe Vitale (D-Middlesex), who created the original HRC laws in 2006, put it this way: “These aren’t sited near schools or ice cream parlors,” he said.

Consider this: Only nine states require local authorization to create an HRC. But HRCs can be launched in 19 other states without municipal approval — including citadels of liberalism such as North Dakota, Tennessee and Georgia. That’s right, New Jersey is more NIMBY than Tennessee, which is why its expansion has stalled so badly.

Another objection raised in committee was from Asm. Erik Peterson (R-Hunterdon), who has never visited a harm reduction center but says he has yet to see proof that they work. In his experience, “free syringes are no solution,” and they will inevitably lead to safe-injection zones. He believes addicts must “hit rock bottom,” perhaps in the criminal justice system, because only desperate circumstances make them see the light.

Actually, that’s dead wrong. Addiction is defined by the NIH as a “chronic, relapsing disorder characterized by compulsive drug seeking and use despite adverse consequences.” In other words, if punishment and prison actually cured addiction, we have fixed the problem by now.

Advocates have a saying: If it’s tough love you prescribe, you better be prepared for tough funerals.

Gov. Murphy and Speaker Craig Coughlin support HRCs; they agree with Jenna Mellor of the NJ Harm Reduction Coalition that “your zip code should not determine whether you have a pathway to recovery.” But this bill still faces an uncertain fate as it works its way through the budget committees on the way to a floor vote, and many lives will depend on what happens in this lame duck session.

As Vitale said, “Limiting access to HRCs – and the array of services they provide – is a death sentence, and it crushes families forever.” With another 3,000 dead in New Jersey this year, this is no choice at all: Expand the network, or reap the whirlwind.