NJ expands harm reduction efforts by distributing clean needles, drug test kits

PATERSON — One by one, the unhoused drug users living in an encampment along freight railroad tracks in the city's 4th Ward trudged through a hole in the fence when they saw the harm reduction workers in a nearby parking lot.

A young woman with an infected cut on her neck from injecting heroin asked for her wound to be cleaned.

A man in his 30s with several large, infected abscesses on his legs came for his weekly supply of 10 new needles.

A woman who called herself “Blue Barbie” brought 33 used syringes to exchange for new ones.

“I love these guys,” said Ariel Smith, 34, of Paterson, nodding toward the outreach crew from the Tier1Recovery community program, after getting a safe sex kit, a safe smoking kit, a package of needles, and a peanut-butter-and-jelly sandwich.

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“They’re a blessing,” continued Smith, who is blind in her right eye. “Now I don’t have to share anything. There’s nothing better than being safe.”

Allan Higgins, the man with the abscesses, agreed: “They give me whatever I need to be safe when I’m getting high.”

That scene on a recent Monday morning in Paterson reflected the dramatic changes in the harm reduction movement sweeping through New Jersey. State government this year boosted its annual funding for such programs from $4.5 million to $16.5 million, and also gave approvals increasing the number of harm reduction centers allowed to operate in New Jersey from seven to 45.

The changes extend far beyond amounts of money and numbers of programs.

For example, some of the items that the Tier1Recovery workers were distributing — such as glass stems for smoking crack and hammer pipes for heroin — were considered by police as illegal drug paraphernalia until Gov. Phil Murphy signed harm reduction supplies legislation last January.

Distributing pipes, needles, kits to test drugs for xylazine or tranq

Under the new law, pipes, needles and other drug-using supplies distributed by harm reduction programs essentially were decriminalized. The recipients are given registration cards from the programs telling police that the items came from harm reduction efforts and that the person holding them should not be charged with possession of paraphernalia.

“We want to meet people where they’re at,” said Greta Anschuetz, the New Jersey Health Department’s assistant commissioner for HIV, STD and TB services. “We want everyone to be safe and protected.”

Other supplies distributed by harm reduction programs in New Jersey include kits that people can use to test their drugs to see whether they contain potentially deadly fentanyl or xylazine, known on the streets as “tranq,” a sedative that can have a severe impact on someone’s breathing and heart rate.

Murphy set the stage for the current growth in harm reduction centers by signing legislation in January 2022 that changed the process for approving the operation of such programs.

Before then, local municipal officials had to enact an ordinance allowing the programs to come into their towns, a requirement that advocates say stymied efforts to open new harm reduction centers. The 2022 law shifted the authority for approving harm reduction programs to state government.

Sandy Gibson, a professor at The College of New Jersey who has worked as a substance abuse counselor and is among the champions of harm reduction programs, said the recent changes in the state’s laws come at a critical time.

“The drug supply is becoming so toxic, people are dying all over the place,” Gibson said.

Harm reduction outreach workers are trained not to urge drug users to stop using. The goal is to keep them safe, not to convince them to abstain, said harm reduction workers.

Gibson said that’s because not every user needs to stop taking drugs. She said that in her experience as a counselor, many of her clients’ only drug-related problems stemmed from the criminal justice system. Providing clean syringes and new pipes can save drug users from fatal consequences, she said.

“Dead people don’t recover,” Gibson said.

$24M from opioid pharma suit

Anschuetz, the state health official, said her biggest challenge right now is finding a way to sustain the recent increase in funding and programs. New Jersey is using $24 million in money the state received from opioid pharmaceutical company litigation for the $12 million-per-year harm reduction funding increase for the current fiscal year and next.

It’s not clear where the state will get the money to continue the current level of harm reduction spending in 2027.

Anschuetz and Gibson both said they believe the proliferation of harm reduction programs in New Jersey will reduce the numbers of fatal overdoses and HIV infections in the state.

Tier1Recovery in Paterson is getting $100,000 from the state’s harm reduction funding, said the program’s chief executive director, Willie Moody.

Tier1Recovey also sends out opioid response teams to conduct a different type of outreach among Paterson’s drug users. The opioid teams encourage addicts to seek treatment and provide referrals to drug programs.

The somewhat divergent efforts reflect the fact that one approach doesn’t work for everybody, Moody said.

“Some people are not ready to go to treatment,” Moody said, explaining why harm reduction teams don’t push that option.

The opioid response team members are accompanied by a plainclothes police officer, while the harm reduction workers don't have any officers with them. Moody acknowledged that in years past there have been tensions involving syringe exchange programs and the police. But that hasn’t been a problem recently, he said.

“They’ve been very cooperative with us,” Moody said of local law enforcement officials.

The Paterson Police Department declined to comment about the growth of harm reduction programs that distribute needles and pipes in the city.

Paterson Black Lives Matter — known primarily for its activism against what it describes as police misconduct — also runs a harm reduction program in the city.

“We’re fighting to protect the marginalized people in society,” said BLM leader Zellie Thomas. “It’s about moving people away from the more dangerous forms of drug use, such as sharing needles. We do everything we can to help them stay alive.”

Shampoo, bug spray, a tent

During Tier1Recovery harm reduction work near the railroad tracks encampment, people approached the outreach workers for things other than drug-use supplies. One woman was happy to get some shampoo. Another got bug spray to fight off August mosquitoes. A 30-year-old man asked for a tent.

“I don’t want to have to keep sleeping out in the open,” he said.

Samantha Boseski, the harm reduction program manager, said she didn’t have any tents that day but told the man she would try to find one. The woman who called herself Blue Barbie said she feels like a “functional addict” who is not yet ready to seek treatment.

“Maybe one day I will get there,” she said.

Boseski didn’t seem bothered by the woman’s plans to keep using drugs.

“It’s really up to the individual person to say when they are ready to stop,” the outreach worker said.

This article originally appeared on NorthJersey.com: NJ expands harm reduction efforts by distributing clean needles, drug test kits