Nearly every week for the last two years, Christina Brown and her friends have begged for change until they have enough to cross the bridge from Camden to Philadelphia for clean hypodermic needles that might save their lives.
From there, Brown — who has been homeless and addicted to heroin for years — will walk, or, if she can afford it, take the Broad Street Line another mile to meet the van from Prevention Point. The Philadelphia needle exchange will accept the week’s worth of used needles she brings back so they can be properly disposed of and replace them with clean ones.
It has been nearly two years since Camden distributed free, clean hypodermic needles that people in addiction need to avoid getting — and spreading — blood-borne illnesses like HIV and hepatitis.
Commuting for needles takes so much time that Brown and her friends worry they will slip into the pain and nausea of withdrawal before they can use again. The next week, some may decide just to take their chances on a shared needle, or one of unknown origin purchased on the street.
Camden’s needle exchange closed in 2016, after the energy company Holtec International opened a corporate campus on the lot where the exchange used to sit. Martha Chavis, who ran the needle program, said she’d been assured it would be back up and running again in a few weeks.
But there is still no site, even as the opioid epidemic has spiraled into the worst public health crisis in a century. Ninety people died of fatal overdoses in the city last year, more than double the year before.
Hepatitis C cases among people under 30 — the group most at risk because of addiction — spiked in 2015, the year before the exchange closed, and kept rising through 2017, the most recent data available. And though Camden County has just over 5 percent of the state’s population, it represents 10 percent of the state’s cases of the liver-destroying disease.
Without a needle exchange, Chavis said, the city is missing a crucial opportunity to reach people in addiction and offer them treatment — or at least help them avoid infections and overdoses.
A city spokesman blamed the delay on efforts to find a location that is convenient, yet won’t affect a residential neighborhood, or downtown businesses and schools.
“The biggest concern is, like anything, the perception that comes with a needle exchange,” said city spokesman Vincent Basara.
Chavis’ perception, however, is that saving lives is more important. “I’m baffled. I am absolutely baffled,” at the city’s hesitancy, Chavis said. “And considering the opioid epidemic as it’s existing now — so many more lives are in danger.”
The exchange was never a large operation. After the state legalized needle exchanges in 2006, Chavis ran her program out of two trailers in an isolated parking lot near the Delaware River. Small as it was, though, it’s too big to run from the cramped rowhouse that houses her organization, the Camden Area Health Education Center.
Camden residents have long protested that their city, after years of disinvestment, has become a dumping ground for programs other, wealthier communities would refuse on principle. It’s a familiar argument — Philadelphia’s hopes of hosting a safe injection site have also run into a buzzsaw of concerned citizens.
So the proposed relocation of a downtown Camden methadone clinic that sits across from City Hall into a more residential area has drawn intense opposition. But the needle exchange has drawn less attention.
“Some people think that a clean needle exchange program makes Camden a more welcoming place” for people who are addicted, said Sean Brown, an activist and former member of the Camden school board.
Brown’s in favor of the needle exchange reopening — as long as it’s part of a comprehensive plan to address the city’s addiction crisis. But he doesn’t begrudge his neighbors their qualms: “The sewage plant, prison, social services — we get all the stuff that everyone doesn’t want,” he said.
New Jersey allows needle exchanges to operate throughout the state, unlike Pennsylvania, where they operate only in Pittsburgh, Philadelphia and Reading. But Camden isn’t the only New Jersey city with qualms; Atlantic City officials are considering moving their needle exchange out of the city’s tourism district.
Chavis is reluctant to hand out needles at her downtown office in part because its size means clients would have to line up outside. “I don’t want people to be stared at,” she said. “Nobody knows your business when you come into our agency — you want confidentiality and respect.”
But she says she’s tired of waiting, and tired of telling people to leave the county for free needles.
Outside the Walter Rand Transportation Center in Camden last week, Christina Brown waved to an ex-boyfriend, Peter LaRosa, who shook out an iced tea bottle full of dirty needles. He planned to exchange them for clean ones across the bridge later that week.
Down the block, Angel Spir, 23, made her way toward the train. Originally from Atlantic County, she’d been homeless in Camden for a week. A few nights before, she said, she woke up in withdrawal, and without a clean needle. For people deep in addiction, the next hit doesn’t necessarily produce a high; it may just ward off pain.
The man sleeping next to her had a needle, she said. She knew he had used it. She knew he had hepatitis C. But she took the needle anyway.
“What could I do?” she said, and shook her head. “I was desperate.”