Before coronavirus, drug users coming to the Harm Reduction Center in Asbury Park to exchange dirty needles for clean ones would be warmly greeted by staff, who would ask how they were doing and whether they wanted counseling or other support. It was personal, on purpose.

Now, site coordinator Robert Lowry is handing kits of clean syringes and test strips through a window, separated from the population he’s trying to help by a wall, gloves and a mask.

“At first I was feeling badly” about the barriers, Lowry said. “But honestly, the clients we’ve had have been grateful we’re still open. One guy earlier this week said, ‘I used the same syringe for two weeks, so I’m glad you’re open.’”

The Prevention Resource Network Harm Reduction Center, run by the Visiting Nurse Association of Central New Jersey, is one of only three syringe access programs currently open in the state during the coronavirus pandemic. Though they count as an essential service, four others in the state shut down because they didn’t have a safe way to give out needles without risking their staff’s health.

This pandemic is going to be especially dangerous for many intravenous drug users, harm reduction advocates say, and not just because of fewer needle exchanges where they could get clean needles and naloxone, an opioid overdose reversal drug.

Already at risk for serious health issues and homelessness, now they are even greater risk of relapsing and fatally overdosing, advocates say. And state officials have warned that opioids, methamphetamine, and alcohol can suppress respiratory function, restrict blood vessels, and aggravate respiratory distress caused by the virus.

“For drug users, social distancing is almost a death sentence... As drug users, community and social gatherings are kind of what keep us alive,” said Caitlin O’Neill, a founding member of the Harm Reduction Coalition of New Jersey, who is in recovery.

“It is people using drugs who are quite often the first responders (if) our friends or loved ones overdose. So removing that element of hanging out together, or a passerby who might notice somebody who has overdosed on the street, that just makes for an extremely heightened risk for not just overdoses but fatal overdoses,” O’Neill said.

Jenna Mellor, another founding member, said they are also concerned the pandemic might lead to slower response times for EMTs or even changes in the heroin supply, which means users wouldn’t know what they’re injecting.

So far, state data do not show a rise in fatal overdoses between February and March. Just over 250 suspected overdose deaths occurred each month. Data for April and death numbers broken down weekly were not available from the Office of the Attorney General.

Lowry worries that the closing of the four needle exchanges — two of which are working to reopen on a limited basis — could lead to an outbreak of HIV or Hepatitis C. He also expects more people to relapse, and people who relapse are more likely to overdose than regular users.

“People in recovery who are stuck at home, not able to go to their meetings,” he said. “This can definitely trigger a relapse.”

Life-saving measures

Mellor said now is the time for the state’s clinics and doctors to step up their efforts to provide medication that prevents opiate withdrawal symptoms for those in recovery.

New federal guidelines meant to keep those individuals well-supplied during social distancing measures now allow methadone clinics to give clients weeks worth of methadone so they don’t have to come in daily. Doctors who previously could only prescribe buprenorphine in person are now able to do so over the phone, she said.

The Harm Reduction Coalition of New Jersey is also trying to meet the need for naloxone since it is less available through needle exchanges and other support programs.

Through a partnership with NEXT Naloxone, people who are likely to overdose or witness an overdose can get naloxone confidentially mailed to them by signing up online or calling or texting the hotline 1-877-4NARCAN. O’Neill said they’ve gotten over 500 requests from New Jersey residents.

Naloxone Hydrochloride, also known by the brand name Narcan, temporarily reverses the effects of an opioid overdose. (J. Scott Park | Mlive.com)MLive Media Group

Kathy Ahearn-O’Brien, executive director of the Hyacinth AIDS Foundation that runs syringe access programs in Jersey City, Trenton and Paterson, said her staff gives out naloxone on request, usually at a rate of about once a week per site.

But the three sites have been shut down since March 18.

“The bulk of the clients who come to our sites tend to be homeless or very low income and can’t afford to buy [syringes] over the counter, so we’re absolutely worried about it,” she said of the limited access. “We don’t have the personal protective equipment for staff and until we get that we can’t risk our staff getting exposed.”

However, she said she was able to get enough masks to reopen two sites this week on a very limited basis: Wednesday from noon to 3 p.m. in Trenton and Thursday from noon to 3 p.m. in Jersey City.

Staff at those sites can pass the supplies out a window, she said. Since the Paterson syringe access program is run out of a van, she said she wouldn’t reopen it until she could get full PPE, including gloves, masks, gowns and goggles.

Lowry said the Asbury Park needle exchange, run out of an old train station on Sunset Avenue, had two N95 masks that he and his coworker can each use. But the site was closed for a few days before they began the window service, he said, and now many program participants haven’t returned. Before a busy day meant 15 or 20 clients, but now it would be five. Their hours were reduced to 10 a.m. to 2 p.m. Monday through Friday.

And while he hopes more will come as word spreads that they’re open, Lowry remains very concerned about the community he serves.

“People who use drugs are people, too,” he said. “In my mind, they’re going to be a huge victim of this pandemic.”

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Rebecca Everett may be reached at reverett@njadvancemedia.com. Follow her on Twitter @rebeccajeverett. Find NJ.com on Facebook.