Southern States Outlaw Syringe Exchanges Used to Prevent Disease

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Tessie Castillo, AlterNet
December 6, 2012

In the pale light of early morning, a mobile unit sits curbside in Atlanta, Georgia’s most notorious crime zone. A woman in a tattered coat shuffles up to the vehicle. She’s diabetic and carries a bag of over 300 used syringes. The people in the mobile unit are happy to accept the needles, and they offer her clean insulin syringes in exchange. Mostly volunteers, they have braved the cold to bring public health services to the neighborhood’s residents. In doing so, they are breaking the law.

Syringe exchange, the act of exchanging a used syringe for a clean one, is an accepted practice for reducing bloodborne disease transmission in much of the northern United States. Not so in the South, which has steadfastly refused to endorse syringe exchange, and the practice is more or less prohibited in all Dixie states. But despite a legal situation that is ambiguous at best and often outright hostile, 13 syringe exchange programs exist in the South. Scattered across nine states, the programs and the people who run them are as colorful as they are unexpected. A program in New Orleans runs a clandestine exchange through volunteers on bicycles, advertising their services through a circus and the local music scene. In South Carolina, a doctor, two reverends and an atheist formed an unlikely alliance to create the first syringe exchange program in their state. In North Carolina, a former drug user living with HIV and hepatitis C distributes needles from the back of his van to help others avoid his fate.


The exchange programs are diverse in size, scope and methodology, but they share a common goal to reduce disease in their communities and to offer services to a population both stigmatized and ignored by traditional health providers.

“Just because you suffer from the disease of addiction does not exclude you from basic medical services and equipment,” says Jeff McDowell, executive director of the Atlanta Harm Reduction Coalition, which operates an exchange. “It costs $680,000 to treat a person with HIV and 9 cents to prevent it with a clean syringe.”

AHRC runs the largest and most comprehensive syringe exchange program in the South. Three times a week, outreach workers from AHRC visit fixed locations in a mobile unit. The unit is equipped with an examination room where clients are offered nonemergency medical care, HIV and hepatitis C testing, overdose prevention education, and referral to drug treatment if the client requests. Clients may also receive brown-bagged meals and access to a shower.

Unlike most syringe exchange programs in the South, and despite Georgia law prohibiting the distribution of hypodermic needles for nonemergency purposes, AHRC operates right under the nose of the Atlanta police department.

“We have an unspoken agreement with the police because a lot of officers recognize the benefits of syringe exchange,” explains Jeff McDowell. Benefits include lower rates of HIV and hepatitis C in the community, the collection of used syringes that might otherwise be discarded in public parks or bathrooms, and fewer accidental needle-sticks to law enforcement. AHRC distributed approximately 61,000 syringes last year and collected 60,000 dirty needles off the streets. Mutual respect between Atlanta law enforcement and AHRC has allowed the syringe exchange to operate effectively for nearly two decades.

Interestingly, local law enforcement policy toward syringe exchange seems to determine program operation more than state law. AHRC’s cooperative relationship with local police is unusual in the South. Miami offers a more characteristic example of how exchanges adapt to a murky legal environment. No official exchange program exists in Miami, just one man who believes in the public health benefits of syringe access. Fernando (an alias) collects extra syringes from local diabetics and disperses them to drug users who might otherwise share dirty needles. He operates as a volunteer and is discreet in his deliveries so as not to attract the attention of a police force tough on paraphernalia laws. Similar programs operate in Little Rock, Arkansas, Jackson, Mississippi, and Nashville, Tennessee, among others. In most cases, drug users are provided a phone number to call when they need supplies, and a volunteer performs a clandestine delivery.

North Carolina, home to five different syringe programs, illustrates how police practices can differ even within the same state. In western North Carolina, Michael Harney runs the Needle Exchange Program of Asheville with full knowledge of local law enforcement. “We’re honest with officers in Asheville about our program,” Harney says. “As long as we keep a low profile in the community and neighborhoods, they don’t interfere with this component of public health strategy.”

Further east, in Winston Salem, Steve, who gives only his first name, operates an exchange out of the back of his van. His operational mode is much like Michael Harney’s, only Steve doesn’t have a cozy relationship with the police. “I give the police their respect, but if I see them in the community, I keep walking,” he says. He believes some officers know about his exchange, but haven’t bothered him yet. That makes him luckier than the nearby Greensboro exchange, where police raided the site and jailed the organizer for possession of a used syringe in a biohazard container. A program in Charlotte, North Carolina, was similarly raided and closed.

For most people who run syringe exchange, the risk of arrest comes with the territory. Some, like George, whose alliance with Southern reverends is launching South Carolina’s first exchange, see humor in the situation. “If the police tried to arrest me, they wouldn’t arrest much,” says the retired physician with a laugh.

For others, fear of arrest is a serious impediment not only to people operating the exchange, but also to clients. “Some people are afraid to take syringes from us because they don’t want to get arrested,” explains Sharon Williams (an alias), organizer of an underground exchange for transgender people in Jackson, Mississippi. “They are afraid of police coming and searching their homes.”

Syringe exchange programs throughout the South share other challenges besides dealing with local police. Programs struggle with little to no funding, reliance on volunteers, limited supplies, and unfavorable public opinion.

“Public perception of syringe exchange is not always on your side in the Deep South,” says Laura Pegram, harm reduction coordinator for Women With a Vision of New Orleans. “Injection drug use and syringe exchange stir strong emotional, and often negative, reactions even in progressive groups. Combating this and trying to spread accurate and unbiased information is elemental to successful programming.”

Southerners who operate or support syringe exchange frequently confront accusations that they are enabling or endorsing drug use. “We need to get past the Bible Belt mentality and accusations about enabling drug use,” says Jeff McDowell of Atlanta. “Many of our former clients write us letters to say they are clean today and to thank us for keeping them safe and disease-free.”

Empirical evidence and numerous scientific studies demonstrate that syringe exchange programs reduce the incidence of needle sharing among drug users, who make up 19% of current HIV cases, and do not increase drug use. A 2006 investigation by the Institute of Medicine reported that syringe exchange programs actually reduce community drug use, as well as crime and the incidence of HIV and hepatitis infections. A Seattle study reported that syringe exchange participants were five times more likely to enter drug treatment programs than nonparticipants. Even the conservative American Medical Association endorses the practice, yet stigma and hostility towards drug users still abound. Despite this, most exchange operators remain cautiously optimistic.

“I feel as though you often run into situations where no good or practical solution to a problem exists and people feel disempowered,” explains Laura Pegram of New Orleans. “In light of this, it seems nearly impossible to ignore a situation [like HIV prevalence among injection drug users] that has such a clear, simple, proven, and readily available solution. I suppose part of my job is trying to get the community and law enforcement to see such solutions as productive as opposed to problematic.”

Given the numerous challenges, legal dangers, and lack of public support, one might wonder what motivates people to continue to operate underground exchanges. Joyce (alias) in Little Rock, Arkansas, captures the spirit of the movement with a simple answer, “We do it because somebody’s got to do it.”

Versions of this phrase are repeated over and over among groups that support syringe exchange. Proponents point out that nine out of 10 states with the highest rates of HIV/AIDS transmission and death are in the South and that syringe exchange can help reverse that trend.

“A lot of my friends have died [from HIV and hepatitis],” says Steve of Winston-Salem, North Carolina. “I do [syringe exchange] because I don’t want anybody else to go through the stuff that I went through. I do more than pass out syringes; I educate people about risks. I have taken people to drug treatment and some of them are still clean today.”

Southern syringe exchange programs will likely continue to face obstacles and difficult legal terrain in the coming years. Politicians won’t talk about them, public health departments won’t touch them, and the myths persist against an increasing body of facts. But that won’t stop the people who run syringe exchange in the South from doing what they believe is right.

Says Louise, who has served jail time for operating a syringe exchange in Greensboro, “Once you get involved in [the exchanges] and see the good you can do, you have to keep going, not matter what the cost. We have to kill this epidemic before it kills us.”

http://www.alternet.org/print/drugs/southern-states-outlaw-syringe-exchanges-used-prevent-disease
 
The goal is to spread disease not help people be safe and cautious
The goal of the drug war is not to help people But arrest them, fine them and feed the government legal system $
 
I
Unbreakable;11133304 said:
The goal of the drug war is to kill and silence, driving the creation and recreation of our era's particular foundational myths, instrumental to the logic of common sense and the legitimization of the status qua

literally key aspects to our literal arsenal of the great pun, aka the war one drugs

fixed :)
 
lol in Europe this would be UNIMAGINABLE.
South has ALWAYS been a backwards hillbilly hick heaven imho and will always stay tht way, even the big cities, i hate that flag and i hate everything about what it stands for. i dont care for racism, thats everyone's own business but come on i cant go buy clean needles or go to the needle exchange. what country are you in backwards south, Togo or Benin? no matter, youre lame and will always be so.
Canada is the best of all and has been always anyway, too bad the winters are so sucky. im 20 degrees more north and my winters are above zero during the day.
 
I'm so glad I live in Los Angeles, where there are needle exchanges operating legally. There are also local laws that dictate cops can't stake out a needle exchange to bust you!
 
Addicts are going to iv drugs regardless, so what's the problem with reducing the risk to others and allowing them the access to dispose their dirty needles and obtain sterile ones?
 
kushrolledup;11133513 said:
Addicts are going to iv drugs regardless, so what's the problem with reducing the risk to others and allowing them the access to dispose their dirty needles and obtain sterile ones?

Apparently they think that that would be saying it's a good idea to use drugs intravenously.
 
It's a real shame that there are still states that don't have open access to syringes. I got off lucky being a junkie in NY, where I can just go to any pharmacy and buy a pack or rigs for incredibly cheap. Like the article mentioned, studies have shown that syringe access programs do not increase the use of IV drugs.. but they do decrease diseases like HIV and hepatitis..

People aren't going to stop using.. so what would they rather? A bunch of junkies.. or a bunch of junkies with aids?
 
BlueHues;11133606 said:
It's this whole "get tough" attitude....bullshit reall1y

It's important to note that when you reduce IV drug users rates of HIV/Hep C, that does the entire community a lot of good. They won't need a bunch of medical treatment they won't be able for. As well, police and medical workers occasionally get needle stick injuries on accident; increasing the likelihood a subsect of people to have HIV/Hep C does a great disservice to our medical workers and policemen.

There was a video which addressed this issue as some cops lightened up on the idea of needle exchanges as they realized it protects them indirectly in this way.
 
^Also, how many people are really gonna think, "wow, syringes are legal now!? I'm gonna start injecting heroin immediately!" It just doesn't really work that way, IMO!
 
I don't think its a good idea to iv drugs but its been proven that this reduces the spread of diseases so why try to halt a program that is great for the environment and for the overall health of the entire south, especially since this directly affects me as I do reside in the south. Id rather have a group of people properly disposing of dirty needles than them being found in ditches or harmful places like playgrounds where young children play during the day while others use it as a spot to shoot up at night
 
kushrolledup;11133653 said:
I don't think its a good idea to iv drugs but its been proven that this reduces the spread of diseases so why try to halt a program that is great for the environment and for the overall health of the entire south, especially since this directly affects me as I do reside in the south. Id rather have a group of people properly disposing of dirty needles than them being found in ditches or harmful places like playgrounds where young children play during the day while others use it as a spot to shoot up at night

^ Excellent point. Even with needle exchanges, there can be lazy people who will just discard them on the ground/in the street sadly. However, giving a place for people to bring their used ones for new ones, will strongly deter people from recklessly discarding used insulin syringes.
 
funny thing is though, if you go to a state where the laws on syringe possession are lenient and go into a known "Heroin neighborhood", you find rigs everywhere! I think it prevents the spread of disease becausde addicts don't have to use dirty needles anymore! As far as people using sanitary disposal practices, I dunno! How many people realistically contract HIV or hepatitis from getting stuck with a needle thats just lying around? If you google it, you'll see that its pretty damned rare to contract anything even if you do get accidentally stuck with a needle...It's something like 1 in 200 hundred from a needle stick....Peoples extreme fear of needles overshadows the facts!
 
If you want to literally flip your lid (as in see the underside of your own skull as rage propels your cranial dome aloft with great force), then talk to a random person in Miami about the necessity for needle exchanges and OTC syringes. I am continually told, by otherwise temperate people, that we are subhuman, sub-mammalian and devoid of all rights. That we should all be publicly shot between the eyes and our families sent the bill for the bullet.

We here contend not only with the southern Bible-belt mentality (although I think Jesus would rebuke his self-styled followers), but also with the special brand of chauvinism that is characteristic of first and second generation Cuban Americans. Since there is practically no IV drug use on the island, my community has no context for a junkie. There are none I feel more distant to than my own people.
 
I've grown to hate right wing 'traditional' social conservatives with a passion. These people are absolute sub-human scum.

The only things these scum bags are good for is protecting the interests of the rich, the corporations and themselves.

I'm not talking Ron Paul type conservatives but Mitt Romney types. These people are evil.
 
yah theres virtually ZEERO in Oklahoma. Its pathetic. In Oklahoma City you cant even buy them at pharmacies there is a city ordinance against it. People I know cant find clean rigs all the time that share or re-use theirs for days/week.
 
Sincere respect to the guy living with HIV/Hep C in NC who goes out of his way to try to ensure (hopefully) no one in the area suffers his fate.

Re. Needle Exchange Programs in the South - Christianity and science have never mixed well. The first scientists - from what I understand - lived in constant fear as they were actually executed by the catholic church for... I forget, but it's ridiculous either way (I think they considered it blasphemy).

IMO, the Bible Belt unfortunately will be - by far - the toughest nut to crack in terms of any type of reform. They can be a stubborn bunch. I also believe that racism is presently still highest in that area of the US (my point is, old habits seem to die harder there when compared to other parts of mainland USA).

Sadly, this is what nearly a century of prohibition and propaganda has done to the mentality of the average American. There is still so much animosity towards those who choose to use illegal drugs.

I think if CNN was to do a survery (more specifically, an opinion poll) as to whether Americans think that drug users (not dealers) should either go to prison, or receive medical treatment; I'm willing to bet the vast majority will vote for a prison term.

Thankfully, we have made progress (especially over the past few years) in trying to break the taboo or stigma of drug use. That being said, after nearly a century of nutty-brown bullshit regarding drug (ab)use that's been crammed into our subconscious, I think it's gonna take years to get the general public to start accepting addiction as a medical condition rather than a crime.

BlueHues;11133683 said:
funny thing is though, if you go to a state where the laws on syringe possession are lenient and go into a known "Heroin neighborhood", you find rigs everywhere! I think it prevents the spread of disease becausde addicts don't have to use dirty needles anymore!

Let's try to focus on solving one issue at a time. I understand that seeing used needles anywhere in public may be disgusting. I've come across plenty of them and it's not something I'd want my child picking up out of curiosity while we're going for a walk. Be that as it may, littering is an enormous problem which is not limited to IV users, but rather everyone. Therefore, IMO, it would be more appropriate to leave that alone for now and focus on trying to stop the spread of HIV, Hepatitis C and so forth.
 
Texas I believe has one but it's a pilot program I believe could be wrong, it may just be a well known but overlooked by officials underground one, their facing funding issues and are selling T-shirts to help raise capital, it's good to know that even if officials refuse to acknowledge the reality of drug use there are still people who care enough to risk legal entanglement just for the sake of harm reduction :)
just restored some more faith in humanity :)
 
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