: The Need For Needles

Cookie, a mother of six, lifts her denim skirt above her right knee, shows off her cratered track marks, and says she can score a $20 bag of cocaine almost anywhere in Queens in 15 minutes.

Getting a clean needle, she says, is the hard part.
In her heyday, Cookie said, “I would clean [needles] to the best of my ability with alcohol. [There would still be] blood in the tip.”

Cookie eventually contracted HIV, and she said, “I probably infected a lot of people in the past.”

For Cookie, the fight to open the first needle exchange program in Queens is an important one in the battle against the spread of HIV and AIDS. But it’s not just about herself and others like her.

It’s personal.

Her son Josh, 17, was born addicted to heroin and is set to be released from Riker’s Island shortly. Until he chooses to come clean, his mother Cookie at least wants his needles to be.

Opening In Queens
Clean for 17 years, Cookie is now a peer counselor at the AIDS Center of Queens County (ACQC), the non-profit organization that won community support this week to open the first syringe exchange program in the borough.

Once approved by the state – considered a formality at this point – the program could open by year’s end, ACQC officials said.

Since 1992, syringe exchange programs have operated in Manhattan, Brooklyn and the Bronx. Currently, Staten Island and Queens are without such programs.

The tentative agreement calls for the ACQC to operate the program from its Long Island City office at 42-57 Hunter Street. Hours will be on Tuesdays and Fridays, from 6 to 10 p.m. An advisory committee of local residents will be formed prior to the program’s commencement.

The Program
In a syringe exchange program, customers trade in used needles for new ones, along with injection kits that include everything a user needs except the drugs, such as water in sealed plastic vials, screens and cotton balls that act like filters, alcohol swabs to clean the skin, and bottle caps in which to mix the ingredients. Customers are not allowed to use the needles on the premises.

Clients over 18 years are given a unique customer number, and speak with counselors before grabbing their supplies. The program will be run by the ACQC, which is under contract with the City’s Department of Health (DOH).

ACQC Chairman Phil Glotzer said by giving drug users what they want – needles and supplies – they can be steered towards what they need – drug treatment and health programs.

All social workers have to be retrained before working at ACQC, said Glotzer. They are taught that drug users are unable to listen to medical advice, or simply not worth the effort, until they come clean. Glotzer said giving needles is a way to “meet customers where they are.”

Once inside a syringe program, clients can learn about food stamps, housing and employment benefits, and begin to stitch together a healthier social network, Glotzer said.

Just Do It, Safely
The goal of the syringe exchange program is not to stop drug use, according to Executive Director Jason Farrell of Positive Health Project, but to stop the spread of HIV and AIDS and Hepititus C. Farrell, who runs a program in Midtown Manhattan, said, “Whether they choose to stop is not the point…just do it safely.”

Supplies are laid out on a small table near the receptionist on the second floor of Farrell’s program, blocks away from Madison Square Garden. In addition to supplies, pamphlets entitled “Safer Injection Practice” are available, offering tips to users about how to properly “shoot.”

Tips include “avoid arteries,” “never share,” and “rotate your veins.”

In providing these tools, public health professionals like Farrell draw a clear distinction between themselves and drug prevention counselors. “We’re not social workers, we’re public health officials…HIV prevention is not drug treatment. It’s health prevention.”

Farrell, a Jamaica High School graduate who later organized needle swap programs when it was illegal in the mid-1980’s, said he’s confident the program will eventually spread throughout Queens. He points to NYC health figures that show an 80 percent reduction in HIV/AIDS cases among intravenous drug users where syringe exchange programs operate.

Cheaper Health
Dealing with drug users now could be cheaper than dealing with them later, according to the City’s Health Commissioner Thomas Frieden.

At a Community Board 2 meeting earlier this year, Freiden said, “If it [the program] prevented two infections, it would pay for itself.” Operating a syringe exchange program would cost $150,000 to $200,000 annually, he said, compared to “the cost of treating one person with AIDS, $150,000 in New York City.”

He added, “The largest number of AIDS cases are attributed to drug use: 22,500 people.” He identified three hotspots in the borough where infection rates have soared – the eastern part of the Rockways, Jamaica, and Western Queens, which includes Long Island City, Maspeth, Corona and Elmhurst. Of the drug users who the City’s DOH could identify “…we know there have to be four or five times that number using injection drugs.”

That population, regardless of the specific size, have an immeasurable impact on the City’s health, according to Farrel.

“New York City has 20 percent of the nation’s HIV cases and AIDS deaths,” he said. “Intravenous drug use has been the engine, the train of disease in the city and people don’t want to deal with it.”

Looking To The Future
The only certainty about the future of the syringe exchange program is the opposition it will face when attempts are made to bring the program to Corona, the Rockaways and Jamaica.

“We have a lot of health prevention programs, probably enough to service the borough of Queens…a lot of people feel we are the dumping grounds,” said District Manager Yvonne Reddick of Jamaica’s CB12. Glotzer has enlisted black clergy members for a May 13 meeting with CB12’s Health Committee, he said.