Pubdate: Mon, 11 Aug 1997 Source: Trenton Times (NJ) Author: Dawn Day Today in New Brunswick Municipal Court, Judge Terrill M. Brenner has an opportunity to save many lives. He will be deciding whether Diana McCague and Thomas Scozzare were acting outside the law when they were arrested one cold evening in April over a year ago. Their ìcrimeî was that they were trying to slow the spread of HIV in New Jersey by giving out clean syringes to persons who injected drugs. Half of all AIDS cases in New Jersey are injection-related. Thus the New Jersey AIDS epidemic is not an epidemic that will be controlled through the use of condoms and safe sex. An epidemic spread through dirty needles can only be brought under control by giving people who inject drugs access to drug treatment and to sterile syringes. Clean syringe programs help with both. Over the past six years, six different national scientific commissions have reviewed the growing body of research, and concluded that clean syringe programs slow the spread of HIV and do not increase drug use. In the testimony phase of the trial two weeks ago, Dr. Ernest Drucker of Albert Einstein College of Medicine and Dr. Don Des Jarlais of the National Research Council/Institute of Medicine panel on HIV summarized these important conclusions. Dr. Frederick Rotgers, director of the drug treatment program of St. Peterís Medical Center in New Brunswick spoke about how the Chai project has been an important source of referrals to his program. The Chai project is the clean syringe and harm reduction organization founded by Diana McCague and the organization for which both she and Thomas Scozzare were volunteering at the time they were arrested. The case against Diana and Thomas turns on the question of which laws apply: the antiquated New Jersey laws limiting access to sterile needles or the broad powers present in New Jersey law which permit persons concerned with the public health to do whatever is necessary to save lives. In California and a number of other states across the nation, judges have concluded that the AIDS epidemic constitutes a public health emergency and that therefore people working in clean syringe programs are acting within the law. It is the business of government to preserve the lives of its citizens, not to create circumstances that cause their deaths. It is time to recognize that we have a health emergency here in New Jersey and suspend the deadly laws limiting access to sterile needles before these laws cause even more deaths. The people at risk number in the thousands. Dr. Scott Holmberg of the Centers for Disease Control recently estimated that there are 46,200 persons in New Jersey who inject drugs and are as yet uninfected with HIV. If they are found guilty, Diana and Thomas can be sentenced up to six months in jail and fined up to $1000 each. Not all states are as backward as New Jersey. If, instead of volunteering their time in New Brunswick, Diana and Thomas had chosen to work in clean syringe programs in Philadelphia or New York, they could have been paid employees in city- and state-financed clean needle programs. The effectiveness of the new combination drugs in treating AIDS in some patients is not a reason for ignoring the importance of prevention. The drugs do not work with all patients. The drugs, even when they are effective, are painful to take and can cause serious side effects. And they are expensive. From the point of view of human pain, suffering and death, there is no question that an ounce of prevention (or in this case a clean syringe) is worth a pound of cure. From a fiscal point of view, the conclusion is the same. AIDS treatment with the new combination drugs can cost $15,000 a year. The annual per person cost of a clean syringe program is a fraction of that amount. Since the laws limiting access to sterile needles are so wrong, why hasnít the Legislature changed them? That is a very good question. Bills have been submitted to the Legislature to do just that. There has been no action. In terms of the lives that are being lost, that inaction is inexcusable. Although her own Advisory Council on AIDS has stated that clean syringe programs are necessary to deal with New Jerseyís deadly injection-related AIDS epidemic, Gov. Whitman remains opposed. Gov. Whitman is confused. In the face of a deadly, infectious epidemic, we need to follow the best advice of our independent medical experts. The New Jersey Public Health Association, the Medical Society of New Jersey and their national counterparts all say that clean needle programs are necessary to begin to control the drug-related AIDS epidemic. Right now New Jersey has the third highest injection-related AIDS rate in the nation. Without active prevention efforts the situation will only get worse. It may not be the usual role of a municipal judge to tell the governor and Legislature that application of one set of its laws is causing the deaths of its citizens and that a health emergency must be declared. But it is the role in which Judge Brenner finds himself today. With all my heart, I hope he will have the courage to stand up and say what must be said. 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.