Needing to be oblivious isn't the same as wanting to be dead. This, it always struck me, is a fundamental misperception about heroin abuse. I say abuse because use--in the rational-sounding and p.c. sense of "IV-drug user"--doesn't begin to scratch the surface of addiction. The desire to leave your head is a worthwhile ambition. But--as Important Studies Have Shown--it can get out of hand. And as it does, it tends to carry away all sorts of reasonable behavior. Abusers may find themselves, oh, grifting, begging, kiting checks, shoplifting, burgling, whoring, or boosting portable electronic equipment from relatives and friends. They mayalso find themselves using someone else's syringe.
Addicts are often shrewd but they are rarely calculating. To do that requires steady contemplation of such abstractions as the future. Both the Zen beauty and the downfall of addiction is that it exists in the bliss of a prolonged but unsustainable present. No one knows better than a junkie the meaning of Be Here Now. The dilemma of addiction is a logistical one of making now last. This is impossible, of course, once you die.
I would have thought that the argument in favor of providing clean syringes to addicted people makes itself. Most of us--certainly most elected officials--are by now aware of the numerous studies establishing that needle exchange is an effective barrier to infection with blood-borne diseases. Two months back, the Secretary of Health and Human Services and the Surgeon General shared with Bill Clinton their finding that needle exchange definitively inhibits the spread of HIV infection and hepatitis. It does so, they added, without leading to increased use of drugs. According to activists, laws banning access to sterile syringes result in 33 new HIV infections a day. As reductive as the formulation may be, it's also, in important ways, probably accurate.
Jennifer Gulizio certainly thinks so. Last February, Gulizio's daughter Mary died of AIDS. She was 27 and left behind a six-year-old son. "Heroin became her lover, her best friend, her mother and father," explains Gulizio, adding that "the way it works is, it stops all pain from happening, but then you're at a point where now you're an addict on top of whatever other problems you had."
Gulizio is one of roughly 2000 protesters, from ACT UP, Housing Works, ADAPT, and a dozen other groups, who've gathered in Bryant Park to march on the United Nations, where Bill Clinton is addressing the conference on World Drug Problems. The rush hour action is vintage street theater, with protesters carrying targets, cardboard coffins, a bloodstained effigy of the president, and posters characterizing the needle exchange issue as "Clinton's Tuskegee."
The comparison is far-fetched, yet throughout his term Clinton has stonewalled federal funding for needle exchange programs, and remains silent about a proposed Senate bill permanently banning use of government funds for any program that, "directly or indirectly," carries out the distribution of sterile syringes for hypodermic injection of illegal drugs. This, to Gulizio's way of thinking, is a form of murder. "What about my daughter?" she asks. "She made a mistake. That mistake cost her her life. What good does it do to judge? The fact is people are using. If they're going to do it, at least let them have the opportunity to live to be rehabilitated."
Earl Driscoll is one who did. A drug user for two decades, he surprised himself eight years ago by testing negative for HIV. "It was amazing," says the 41-year-old recovering addict, who continued to inject drugs until last year, although "after that first test, I never used a syringe behind anyone again."
Driscoll was able to maintain his HIV status, he insists, "because of Philadelphia's needle exchange. There are five sites [in the city] where you can turn in used syringes. One good side effect is the streets got cleaner. Junkies used to discard their syringes. Now they pick them up. It's not to be civic-minded. You want to find more to get more when you exchange."
Critics of needle exchange programs tend to characterize them as a form of drug recruitment. They talk about the presence of Lower East Side Needle Exchange vans as if they were insidious Mister Softee trucks set up at curbside to dispense sinister treats for junkies. What they neglect to note is the fact that, as Gulizio says, addiction exists. As people in the government and in harm-reduction circles are well aware, HIV is by no means the only epidemic currently transmitted along hypodermic vectors. Check with the Centers for Disease Control for some horrifying statistics on the spread of hepatitis C.
And it's not just heroin addicts using needles "behind" one another anymore.It's transsexuals shooting hormones. It's athletes and bodybuilders injecting illegal steroids in gyms and high school locker rooms. "We don't need to recruit, believe me," says Jason Farrell, executive director of the Positive Health Project, and a former addict who contracted HIV during 17 years of IV drug use. "There are thousands currently available.
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