It Happened to Me: I Work in a Syringe Exchange Program

If our program wasn’t here, those needles would be in trash cans, landfills, parks, sidewalks, public bathrooms. This is where Harm Reduction really shines!
Publish date:
October 17, 2011
healthy, drugs, needles, M

I am an Administrative Assistant at an office that provides case management services for clients with HIV/AIDS. We also provide free condoms, educational materials, support groups for LGBT youth, HIV Testing, and a food pantry. Our seediest service, though, is our Syringe Exchange Program.

My desk is in our waiting room, so I exchange a lot of our participants. We open at 8 am, but we don’t see any IDU’s (IV drug users) much before 11am. There are your working-class, functioning IDU’s, but it’s pretty stereotypical junkies that roll in and out of here.

What’s not stereotypical is how they behave. 98 percent of them are friendly and funny and thankful that we’re around, without acting as if they’re owed this service. More often than not, I’m told that our staff makes them feel like human beings and they don’t get treated that way a lot. I’m also told that they wouldn’t wish their lifestyle on their worst enemy. I’m not sure if they tell me this last part because I look fairly innocent (truth be told, I couldn’t show you how to smoke a cigarette, so they’ve pegged me) or because it’s good for them to just say out loud that what they go through sucks.

When we intake a new (to us) user, they are assigned a number to use every time they exchange. The only identifying information we ask of them is a first name and date of birth. If they ever lose or forget their card with their number on it, we can look them up. Nothing in our database is tied to the police (it’s a common user question) so it remains confidential. We have almost 1,000 registered users, and since January of this year, we’ve exchanged about 67,000 needles.

If our program wasn’t here, those needles would be in trash cans, landfills, parks, sidewalks, public bathrooms. This is where Harm Reduction really shines! Preventing those needles from being out and about where your animals, babies or nana might accidentally contact them protects our community.

Using dirty needles increases risk for contracting HIV and Hep C. Hep C can live outside the body in a moist environment (like a needle) longer than HIV. It’s a nasty thing, and it’s prevalent in the IDU population. Providing clean needles helps to stop that.

So, back to the intake. They get a “starter pack” when they sign up: a pack of 10 clean needles (in their preferred size and gauge), along with clean “works”: alcohol and benzo wipes (before & afters), single tubes of distilled water, bags of tiny cotton balls, vitamin E capsules, antibiotic ointment, band aids, tourniquets, tiny bottles of bleach, and cookers. We also have travel size biohazard containers, and “home size” containers.

I’ve seen needles brought back in Pringles containers, bleach bottles, and a high heeled shoe. By a dude.

Our program is a one-for-one, so they will get the same number of clean needles back that they bring in dirty. They can leave needles “on credit” on their exchange number, so should they be arrested, robbed, etc (we’ve heard it all), they can still get clean needles if they don’t have any on them when they come in.

Opiate use is highest among our users, but Bath Salts is a new epidemic here (it’s way hallucinogenic, in the most frightening way. Not like Strawberry Fields Forever, but like pulling your fingernails out with a pair of pliers because you think they are ticks. True story.) I have a panic button that goes right to the cops, and my own personal stash of pepper spray. Mostly I just taser them with kindness.

We don’t get much more escalated than loud voices when they don’t get needles because they didn’t bring any in. Typical conversation:

IDU: You mean you want me to use a dirty needle?

Staff: No. Bring that dirty needle in and get a clean one. See how it works?


IDU: I have 300 at home, I just didn’t have time to bring them in.

Staff: I can’t give you any without you having your dirty needles here.

IDU: You’re making me use a dull needle!

Staff: I’m not making you do anything.

IDU: Don’t you give out starter packs?

Staff: Yes. When you start here. You already have a number.

IDU: That’s dumb.

Staff (in her head…cause this was my conversation with an IDU this very week): You’re dumb. Doing drugs is dumb. I could point out three or four more dumb things. Me following the rules is actually pretty smart.)

Since I’ve started, I’ve seen one user get into a treatment regimen. I’ve read about many in the paper who are being arrested and serving time. I’ve done intakes on 18-year old girls just starting to shoot up and an intake on a nice guy doing steroids.

Husbands and wives, moms and daughters…the combinations are frighteningly familial. I’ve seen participants half-clothed. Or wearing very large knives on their belts. Or dumping out their dirty needles from a container decorated by their young daughter that says “Daddy’s Box.”

They convert digital camera cases into works cases. They accidentally drop 10 tiny bags of heroin on the floor, but don’t notice, and then we get to call the cops and have it taken away.

I have seen things I can’t unsee (don’t ever say yes when a user asks you if you want to see something gross. Cause it will be damn gross.) I’ve learned things that I never thought I’d know. But most importantly, I’ve pushed aside my personal judgments toward a population of people and helped keep them, and us, and your nana, safe.

There’s so much more I could tell you. But a lot of it you’d have to see to believe.