In Connecticut, getting needles was “a whole lot fucking easier,” reminisces Ben. As a teenager who grew up—and started using heroin—near Hartford, he became accustomed to buying a 10-pack of syringes for $3.50 in his local pharmacy. Since coming to New York four years ago, the gangly hipster, now 20, has had to rely on the Lower Eastside Needle Exchange for Clean Needles. But even while acknowledging that the little storefront has helped protect him from HIV, Ben still finds himself longing for a more convenient way to avoid sharing his works. “This place is only open three hours a day,” he says, emerging onto Avenue C with some clean needles and his buddy Mike. “It’s not enough.”
Soon Ben and IV drug users all over the state will have the same access to syringes he enjoyed in his suburban youth. Thanks to a law passed two weeks ago, drugstores throughout New York will be able to sell up to 10 needles at a time without a prescription. Certain hospitals and clinics will also be authorized to give drug users syringes. The change can be expected to significantly lower new HIV infections among drug users; soon after Connecticut passed a similar law in 1992, the number of people who shared needles decreased by about 25 percent, according to Robert Heimer, an associate professor in the department of epidemiology and public health at the Yale School of Medicine. It also brings New York in step with the vast majority of states, which already allow pharmacies and clinics to dispense needles without prescriptions.
Having tried to push one version or another of the legal needle law through the system for more than a decade, AIDS activists are welcoming the change with relief. “It’s about time,” says Joyce Rivera, executive director of the St. Ann’s Corner of Harm Reduction, a community group that runs a needle exchange in the South Bronx.
For Drew Kramer, executive director of the Lower East Side exchange, the first response was a simple “Hallelujah.”
The true impact of this new law, scheduled to take effect on January 1, is bound to be anything but simple, though. Based on studies in Connecticut and other states where needles recently became legal, exchange programs can expect their participation to shrink by more than 30 percent as those who can afford to start buying their needles in nearby stores. But ask New York drug users about the coming shift, and many will tell you that, even with the promise of cooperative pharmacies and doctors, they plan to keep frequenting the exchanges that provide social services as well as needles.
Juan R., a 51-year-old who used to run a shooting gallery on the Lower East Side, was worried when he first heard that pharmacies would begin selling needles. “I thought, ‘Wow, will they be closing the needle exchanges now?’ ” says Juan, who gets needles—and takes occasional classes—at the Housing Works needle exchange on Crosby Street. “Then I thought, ‘I’m going to have to hit the corners again, buying them at $2 a pop.’ ”
Even if the law were to mean the end of needle exhange (an eventuality no one anticipates), Juan figures he wouldn’t buy needles at pharmacies. Living on a mere $700 a month, he would rather pay the higher street price, anywhere from one to as much as five dollars per needle, than face the disapproving eyes of other shoppers in a drugstore. “I would go into a pharmacy with the working Joes and the middle-class ladies standing in line, and here I am asking for syringes?” he says, shaking his head. “No. I’d pick up a complex right away.”
Stopping by St. Ann’s outdoor needle exchange on 148th Street in the Bronx, one grandmother agrees. “Nobody’s embarrassed to come here,” she says, gesturing toward the old card table set up near a vacant lot. “At the drugstore, they’d see what you’re asking for and be like, ‘Oh, shit, there’s a drug addict.’ ”
There’s also the not-inconsequential matter of price. Ben’s buddy, Mike, for instance, says that he’ll never pay for needles. Ben confirms: “The sad fact is, Mike would rather share than spend the money. That’s how junkies think. Whatever you pay is money that could go toward your next bag.”
Money weighs heavily for Marie, too. A small, blond 22-year-old who works as an escort, Marie is at first excited by the idea of buying needles near her apartment in Far Rockaway, an option that would spare her frequent hour-long train rides to the Lower Eastside exchange. But, pausing to calculate what the 70 or so needles she uses a week might cost, she reconsiders. “Why would I pay if I can get them for free?”
There are other limits to what the new law can do. Under it, pharmacies are explicitly forbidden from advertising the fact that they sell needles, which will no doubt leave some users unaware of this new option. Since drugstores won’t have to participate, some will likely decide not to, if only to avoid attracting addicts to their shops. In New Haven and Hartford, about one-third of pharmacies have chosen not to sell needles without prescriptions. And though New York’s law will require that needles be sold with an insert explaining proper disposal, the law doesn’t require drugstores to collect dirty syringes in containers, as needle exchanges now do.
Perhaps the biggest question mark is how—or whether—the new law will improve drug users’ tenuous relationships with police. Needle exchange participants already live by a seemingly contradictory set of rules, some of which are routinely broken. It’s still illegal to carry dirty syringes, or at least the miniscule amounts of drug residue on them, for instance, despite the fact that getting dirty needles off the street was part of the reason needle exchange programs were decriminalized in 1992. And, though registered needle exchange members should be allowed to carry clean needles, as many as one quarter of those in a recent, informal survey spent time in jail for this technically legal “offense.”
“Many police, lawyers, and judges just aren’t aware of the law” that protects needle exchange members, says Corinne Carey, the lawyer who conducted the survey. The ignorance of—or disregard for—the law that causes these situations will likely be unchanged by the fact that drugstores will be allowed to sell needles, notes Carey. “The police who don’t care what your [needle exchange] card says will say the same thing about pharmacies,” she predicts.
Nevertheless, even Carey and other vigilant advocates for drug users acknowledge that allowing pharmacies to sell needles without a prescription is a step in the right direction. “It normalizes the issue,” she says. The law may also allow needle exchange programs to focus their efforts on those in the most dire situations, as users who are a little better off pay for their needles elsewhere.
Just which side of the fence anyone will end up on is not always apparent. Though he says he plans to buy at the pharmacy come January, it’s easy to imagine that Ben may not be able to swing that. He might be on the street, where he’s been before, or just so broke he’ll have no choice but to rely on the free needles from the exchange. If, on the other hand, Ben keeps his job as a makeup artist and hangs on to his apartment (he’s now two months behind in rent), you might find him buying needles from the local Rite Aid when January rolls around. Almost everyone, not least of all Ben, is glad he’ll have that choice.