She pushes long hair over her shoulder, and her tattoos glow in the night spotlight of a coffeeshop patio.
If I was sitting in the room with one other person who I knew had an infectious disease, it didn't bother me. Because I was that sick.
In Cincinnati, I've used a needle between two people for a month.
Three anonymous former heroin junkies are talking into still summer air. Their stories tumble over each other.
It's not apathy. It's how little you care. It's how little hope you have. It's hopelessness and helplessness.
I've always shared needles. Because I was stupid.
It's not low on the list until you're strung out, until your addiction takes over.
If all you've got available is what you're sharing with your boyfriend, that's what you're going to use.
I've never shared a needle with anybody ever. I tried to use it only two or three times.
I've used one up to 20 or 30 times. Ideally you would use a fresh one every time.
Undisputed: The best reason to use a fresh needle every time you shoot dope is to prevent the spread of blood-borne illnesses such as AIDS and Hepatitis C.
The reason that, especially if you're addicted in Cincinnati, you won't use a fresh needle every time you shoot dope: Nearly all local pharmacies refuse to sell syringes without a prescription, and Cincinnati doesn't support needle exchange, also known as syringe exchange program (SEP).
If I hadn't had the fortune of having needle exchanges, I would probably not be so lucky. If I'd grown up here and used here for 7 years, I can pretty much guarantee I'd be screwed right now.
One woman has Hep C, though she lucked out and didn't pass it on to her child. One person is healthy. The third didn't say.
I shared when I first started when I was 16, and I just assumed that it just didn't exist in my circle.
Everyone that I know that is using, they all have Hepatitis. And I know between five and 10 people who have HIV.
I remember stashing rigs all over the place in cities.
Libby Lee says that someone who is going to get infected with a blood-borne virus usually gets tagged within the first 10 uses, before naive trust runs dry.
Lee worked in Portland, Ore., needle exchange programs from 1996 to 2003. One site was identified as "SE 82nd and Ash, one block off Burnside, in the white van."
Needle exchanges generally trade out used syringes for clean ones on a one-to-one ratio. This reduces the spread of diseases through shared rigs, while used needles pick up value and don't get carelessly tossed for some garbage collector or kid to find.
It's not a moral debate. It's a public health issue.
They don't want to encourage the activity.
Until some politician's daughter comes home with HIV from her drug use.
Lee tried to start a local SEP a few years ago. When she called the county health department, someone told her that Hamilton County Sheriff Simon Leis Jr. would prosecute for possession of paraphernalia.
When I call, Leis' spokesman, Steve Barnett, first asks what a needle exchange program is. Then he refers me to the prosecutor's office, which refers me to the city health department.
But Barnett does offer this off-the-cuff assessment: "I'd say if you're exchanging needles for needles and you have old needles with residue of heroin or methamphetamine or cocaine, you're in possession of drugs and drug paraphernalia at that point."
The positive thing about an exchange is that the people who end up using them and coming out of that will have that much longer to live.
A lot of the people who have HIV or Hep C pretty much feel like it's too late for them anyway. They act as if they're already dead.
There have been a lot of young people, 18- or 19-year-old college students that go to UC, that start experimenting with drugs and they decide to use a needle and they start hanging out with older junkies. They're not long-term users, they don't do it long, they're not using drugs anymore, but now they're taking Interferon for Hep C.
SEPs operate on the principle of harm reduction. And if keeping addicts healthy isn't worthwhile because their lives have inherent value, then preserve their health for the time they might clean up and go on to do good in the world and pay taxes.
Or forget them. Think of their kids or their ignorant sex partners.
The Centers for Disease Control and Prevention, the National Institutes of Health and nearly every major medical and scientific association endorse SEPs. Most major cities have SEPs. Study after study refutes the myth that they increase drug use. It costs far less to keep addicts in clean needles than to subsidize the health costs of their AIDS, Hep C, endocarditis, abscesses and other associated health problems. SEP workers, usually volunteers, can reach junkies with the offer of rehab and other resources in ways no one else can.
In spite of all this positive news, even the strongest needle exchange advocates don't hold out much hope for starting one in Cincinnati.
First, a ban in place since the late '80s prohibits the use of federal dollars for SEPs. But even if Congress' recent repeal of that ban for the District of Columbia extends nationwide, federal politics have nothing on local conservative mores.
Ohio State Rep. Tyrone Yates (D-Cincinnati) has spent the past decade promoting the worldwide need for needle exchanges. He'll soon present a resolution and bill revising Ohio law to decriminalize them.
"The reason we don't have one locally is that it's difficult to communicate that by giving people clean syringes the process works and further drug addiction is not promoted," Yates says.
So will he see a Cincinnati needle exchange program in his lifetime? Yates hesitates.
"No," he says. "I sadly say that I doubt it."
When I was like that, most people looked at me like I was a lost cause and they treated me like I was less than that. If it hadn't been for people caring enough and for the volunteers at the places, I probably wouldn't be here. I just try to always look at those kids the way a couple of people looked at me.
A pause. The muted sound of cars passing; crickets. I look at the three people sitting around me and our cigarette smoke mingling as it rises.
It seems that there must be a Them so there can be an Us, and in this case the Them are intravenous drug users. It's really no more complex than that.
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