Atlantic City’s Flagship Syringe Program in Battle for Survival

    In the past few months, the South Jersey AIDS Alliance (SJAA) has been planning to relocate outside of the tourism district in Atlantic City. The organization’s syringe service program (SSP)—the first to have opened in New Jersey—stands near the boardwalk, just blocks away from the Hard Rock Hotel and Casino. But political pressure against it was mounting, amid competing concerns over gentrification and economic development.

    Carol Harney, the head of SJAA, thought she had found a solution to appease the detractors: Soon, SJAA would move next to the Atlantic City Rescue Mission—farther away from the beach but still close enough to be walkable from there. The Casino Reinvestment Development Authority, a state governmental agency, had agreed to pay for renovations to the new building, which the AC Rescue Mission operated. Everything was to be under one roof: a homeless shelter, a drug treatment center and a harm reduction agency. It’d be a social services hub, and SJAA would pay rent to the AC Rescue Mission. It seemed like a win for everybody.

    But on June 4, Harney sent an email to her board members, warning that the organization’s syringe service program in AC could imminently be shuttered.

    “Like any city, Atlantic City has needs,” Harney told Filter. “We cannot wish them away by increasing barriers for lifesaving services. If we close our eyes to the needs of our residents, we will reverse the progress that our community has fought so hard to achieve.” Data from SJAA show that more than 1,200 people have accessed syringes there.

    SJAA’s hard-fought success—addressing needle retrieval, previous City Councils’ opposition, lawsuits—has swiftly transformed into potential tragedy. Now, two City Council members in Atlantic City are set to introduce an ordinance closing down the SJAA program on June 16. It will likely come to a vote a week later, on June 23, and harm reductionists around AC fear that it will pass. 

    Advocates and service providers in AC and throughout the state say that even New Jersey’s Democratic lieutenant governor, Sheila Oliver, has signaled her support to the City Council. They were blindsided by this information. Many of them only learned about the reversal from a local news story with scant details and an ominous quote from Atlantic City Council President George Tibbitt. “The residents of Atlantic City have had enough … seeing dirty needles just dropped on the ground all over the city,” Tibbitt told WPGG talk radio. “This must come to an end. That end is now.”

    Neither Tibbitt, one of the council members who will introduce the ordinance repealing the SSP, nor the New Jersey Department of Health responded to Filter’s request for comment by publication time.

    “Atlantic City’s harm reduction program is the flagship program in our state,” Jenna Mellor, the co-director of the New Jersey Harm Reduction Coalition, told Filter.

    I think a lot of times advocates for these programs fall into these sorts of traps of trying to produce the evidence that the other side says that it wants to see,” Leo Beletsky, a professor of law and health sciences at Northeastern University, told Filter. “But [the other side] doesn’t really want to see evidence. Its just a smoke screen for something they find politically objectionable or inconvenient.

    “I fear for the state of harm reduction in New Jersey. I fear for people who use drugs.”

    Most harm reductionists on the ground in AC say they have not had significant contact with the City Council since that article was published. They believe, however, that much of the narrative around the SSP has to do with the entrenched belief that the program is attracting drug users to a city that has been attempting to rebuild financially. Only 200 people—or 7 percent—of the city’s homeless population live outdoors, with the other 93 percent residing in the mission’s building, according to the AC Rescue Mission.

    As the Centers of Disease Control and Prevention (CDC) states, nearly 30 years of research has shown that comprehensive SSPs are safe, effective, and cost-saving, do not increase illegal drug use or crime, and play an important role in reducing the transmission of viral hepatitis, HIV and other infections.” It is indisputable. And Lieutenant Governor Oliver had not been previously against the SSP in Atlantic City. She had been, in many ways, the program’s saving grace. Her opinion is crucial.

    After the city struggled economically for decades, reaching the verge of bankruptcy, then-Republican Governor Chris Christie and the Democratic state Congress made an agreement with AC in early 2016 to take over much of the city’s finances. That deal included “the power to restructure municipal debt, alter or terminate municipal contracts and collective bargaining agreements, strike shared service agreements with the county, or sell or lease city-owned services,” according to NJ.com.

    The takeover, which will soon expire but seems likely to be extended for another four years, means that Lieutenant Governor Oliver would need to approve the shutdown of the SSP. For whatever reason, activists in Atlantic City believe the council has her blessing. They do not know why she has apparently changed her mind. (The lieutenant governor’s office declined to comment.)

    “The syringe access program has always been under threat,” Axel Torres Marrero, the senior director of public policy and prevention at Hyacinth, New Jersey’s first and largest HIV service provider, told Filter. Because the genesis of the program was originally through a city ordinance, Marrero explained, it could be revoked whenever, at the whims of a new council.

    This could easily be understood as a tale of the economic rebirth of AC and the inevitable conflict between the city’s unhoused residents and the looming likelihood of gentrification. But given that Lieutenant Governor Oliver essentially controls the City Council—she has the power to veto the mooted ordinance, for example—the outcome has implications not only for Atlantic City but for New Jersey as a whole. A shutdown would run counter to the harm reduction message that the Democratic governor, Phil Murphy, has invoked for years.

    Many SSP in the US still struggle to simply exist. In June, commissioners in Indiana’s rural Scott County, where there had previously been a cluster of HIV cases in 2015, voted to end the county’s program as cases decreased; earlier in the spring, West Virginia Governor Jim Justice signed more stringent SSP regulations into law, which critics argue will make it more difficult to obtain sterile syringes in a state experiencing a spike in HIV cases.

    And this all comes as US overdose deaths have reached a record high amid the coronavirus pandemic. In June 2020, NJ.com reported that overdose deaths in the state had climbed so much that during May, almost 10 people per day had died. SJAA has given out almost 1,380 naloxone kits, with 48 reported lives saved from the medicine that rapidly reverses an opioid overdose.

    Governor Murphy has repeatedly pledged to increase state funding for harm reduction centers. But his state does not have the best history with harm reduction approaches to drug use. To this day, there are only seven harm reduction centers in New Jersey.

    A shred of optimism, however, might remain. When asked for comment, Alyana Alfaro Post, Governor Murphy’s press secretary, told Filter that “Governor Murphy believes that harm reduction centers are critical to battling the opioid crisis.”

    The Murphy administration is committed to ensuring that Atlantic City and area residents continue to have access to these evidence-based and lifesaving services,” she said.

    Still, harm reductionists in AC remain on high alert as the June 16 City Council meeting approaches.

    “I fear for the state of harm reduction in New Jersey,” Mellor said. “I fear for people who use drugs in Atlantic City. I fear for people who use drugs across the state.”

     


     

    Photograph of Atlantic City by drpavloff via Flickr/Creative Commons 2.0

    • Alex was formerly Filter’s news editor. He previously worked as a reporter and copy editor at VICE, and has been published in the New York Times Magazine, the Columbia Journalism Review, the Los Angeles Times and the New Republic, among other outlets. He was also previously a freelance editorial consultant for the Foundation for a Smoke-Free World; The Influence Foundation, which operates Filter, has received grants from the Foundation for a Smoke-Free World. He is currently based in Los Angeles.

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