Governor Signs Executive Order Allowing Needle Exchange in Certain New Jersey Communities

TRENTON, N.J. Gov. James E. McGreevey on Tuesday signed an executive order declaring a public health emergency in cities with high rates of HIV infection due to injection drug use. The declaration would allow these communitieswith municipal support--to start needle exchange programs to reduce the spread of HIV infection.


 Of those living with AIDS in the U.S., New Jersey has the highest proportion of cases who are women. It also has the third highest pediatric HIV rate, the fifth highest adult HIV rate and a rate of infection among injection drug users that is significantly above the national average.


 Today, there are New Jersey communities facing a public health crisis that cannot wait, said McGreevey.  With New Jersey ranking fifth highest in the nation in AIDS cases, HIV/AIDS has ravaged too many in our state.  While communities with a high incidence of injection drug use are being devastated by this disease, it is not just the user who is affected. Children in these communities are quite simply, dying for our help. Research demonstrates that needle exchange programs are a powerful weapon against the spread of HIV/AIDS.  Yet in the face of that research, New Jersey is one of only two states that provide no access to sterile syringes to prevent the spread of the disease. That changes today.


 Under McGreeveys executive order, cities with the highest prevalence of HIV due to injection drug use would be eligible to start a needle exchange program if they meet two additional criteria: Municipal commitment and an ability to demonstrate to the state Department of Health and Senior Services that participants in the program would have sufficient access to health care facilities, social services and drug treatment.


 It has been convincingly demonstrated that expanding access to clean syringes decreases the sharing of needles and thereby decreases the transmission of bloodborne diseases, said Clifton R. Lacy, MD, commissioner of the Department of Health and Senior Services.


 Syringe exchange programs also provide an important gateway to engage drug users into health and social services and into drug treatment. Regular visits to exchange sites allow increased opportunity for harm reduction, education, counseling and referral, said Lacy.


 Baltimore, Md. instituted one of the first needle exchange programs in the nation in 1994.  Results there showed incidence of HIV among injecting drug users declined 12 percent per year in the first four years of the program.  And a 2003 study in the International Journal of Drug Policy evaluated 99 cities and their results showed HIV prevalence decreased 29 percent in cities with syringe exchange programs and actually increased 5 percent in cities without programs.


 In New Jersey, infection by the human immunodeficiency virus (HIV) has resulted in 64,219 cumulative cases of HIV/AIDS as of June 30, 2004.  Approximately 51 percent of those cases can be attributed to injection drug users, their partners or their children.


 The following is a copy of McGreeveys executive order:






          WHEREAS, in New Jersey, infection by the human immunodeficiency virus (HIV) has resulted in 64,219 cumulative cases of HIV/AIDS as of June 30, 2004, and nearly 32,000 people have died of this disease in New Jersey alone since the beginning of this pandemic; and


          WHEREAS, approximately 51 percent of those cases can be attributed to injecting drug users, their partners or their children; and


          WHEREAS, in comparison with other states in the nation, New Jersey has the highest rate of HIV infection among women, the third-highest pediatric HIV rate, the fifth-highest adult HIV rate and a rate of injection-related HIV infection that significantly exceeds the national average; and


          WHEREAS, HIV has had an especially devastating impact on New Jerseys minority communities, in that (1) minorities account for 75 percent of the cumulative HIV/AIDS cases and the disparity is growing; (2) 86 percent of the children living with HIV/AIDS are minorities; and (3) women account for 35 percent of those persons living with the disease, and four of every five of those women are women of color; and


          WHEREAS, over 1 million people in the United States are frequent intravenous drug users at a cost to society in health care, lost productivity, accidents and crime that exceeds $50 billion annually; and


          WHEREAS, 61 percent of the States pediatric HIV/AIDS cases can be attributed to needle sharing on the part of the childs mother or her partner; and


          WHEREAS, sterile syringe access programs are designed to prevent the spread of HIV, Hepatitis C and other blood-borne pathogens, and to provide a bridge to drug abuse treatment and other social services for drug users; and


          WHEREAS, sterile syringe access programs have been proven effective in reducing the spread of HIV, Hepatitis C and other blood-borne pathogens without increasing drug abuse or other adverse social impacts; and


          WHEREAS, scientific, medical and professional agencies and organizations that have studied the issue, including the federal Centers for Disease Control and Prevention, the American Medical Association, the American Public Health Association, the National Academy of Sciences, the National Institutes of Health, the American Academy of Pediatrics, and the United States Conference of Mayors, have found sterile syringe access programs to be effective in reducing the transmission of HIV; and


          WHEREAS, New Jersey remains one of only two states nationwide that do not provide access to sterile syringes in order to prevent the spread of disease; and


          WHEREAS, the lack of sterile syringe access programs in certain New Jersey municipalities creates a threat to the health, safety and welfare of New Jersey residents, one that is too large in scope and unusual in type to be handled by regular municipal operating services, and one that poses a compelling need to act to protect the public interest;


          NOW, THEREFORE, I, JAMES E. McGREEVEY, Governor of the State of New Jersey, by virtue of the authority vested in me by the Constitution and by the Statutes of this State, do hereby DECLARE a State of Emergency and ORDER and DIRECT as follows:


          1.          A State of Emergency exists with regard to the transmission of HIV/AIDS through intravenous drug use. 


2.                I invoke such emergency powers as are conferred upon me by the Laws of 1942, c. 251 (N.J.S.A. App. A:9-30 et seq.) and all amendments and supplements thereto. 


3.                To combat this Emergency, the Commissioner of Health and Senior Services is authorized to adopt guidelines for the establishment of a sterile syringe access program to provide for the exchange of hypodermic syringes and needles in up to three municipalities in New Jersey that have a high prevalence of HIV/AIDS cases attributable to intravenous drug use.  In order to establish a sterile syringe access program, the eligible municipality shall enact an ordinance of its governing body establishing or authorizing establishment of a sterile syringe access program at a fixed location or through a mobile access component.  The municipality may operate the program directly or contract with a hospital, a health care facility, a federally qualified health center, a public health agency, a substance abuse treatment program, an AIDS service organization or another non-profit entity designated by the municipality. 


4.                The Commissioner of Health and Senior Services shall have the authority to review and approve the request of the eligible municipality to establish the sterile syringe access program, based on the proposals compliance with existing health-related guidelines.  The Commissioner shall ensure that the sterile syringe access program proposed by the municipality is linked, to the maximum extent practicable, to such health care facilities and programs capable of providing appropriate health care services, including mental health, dental care, substance abuse treatment, housing assistance, employment counseling and education counseling to participants in any such program. 


5.                The Commissioner of the Department of Health and Senior Services shall have full authority to adopt such rules, regulations, guidelines, orders and directives as he shall deem necessary to implement such programs. 


6.                It shall be the duty of every person in this State or doing business in this State, and the members of each and every governing body, and of each and every official, agent or employee of every political subdivision in this State and of each member of all other governmental bodies, agencies and authorities in this State, to cooperate fully in all matters concerning this Emergency. 


7.                Any person who shall violate any of the provisions of this Order or shall impede or interfere with any action ordered or taken pursuant to this Order, shall be subject to the penalties provided by law under N.J.S.A. App. A:9-49. 


8.                This Order shall take effect immediately and shall remain in effect until December 31, 2005. 


GIVEN, under my hand and seal this  26th day of October in the Year of Our Lord, Two Thousand and Four, and of the Independence of the United States, the Two Hundred and Twenty-Ninth.



James E. McGreevey