Texas Attorney General Greg Abbott’s May 5 ruling that 2007 state legislation authorizing a pilot needle-exchange program in Bexar County doesn’t protect participants from being arrested for distributing drug paraphernalia kicked the DA’s case against local activists Bill Day, Mary Casey, and Melissa Lujan into gear. The trio, volunteers with the non-profit Bexar Area Harm Reduction Coalition, face Class A Misdemeanor charges that threaten up to a year in jail and $4,000 in fines for handing out packets containing sterile syringes, whips, condoms, bottle caps, and public-health referral pamphlets on the streets of SA. `See “The damage done,” January 30, 2008`
Day was inspired to start the Coalition’s needle-exchange program after attending the National Episcopal AIDS Coalition conference in Austin in 2003. Texas is the only state without some form of legalized needle exchange, although there are a handful of active programs, including the 17-year-old Dallas Area Needle Syringe Exchange.
“Episcopaleans are very much involved in the social gospel,” says Day, and he felt the call. Back in San Antonio, he approached his church, St. Mark’s Episcopal, which responded positively. Another congregation member introduced Day to Curt Harrell, a former military man and biologist who had been working for a decade with the HIV/AIDS Prevention Coalition Community Planning Group.
Says Harrell, when Day pitched his group, “of course we said absolutely, because that’s the best way to block transmission ... is to simply use sterile equipment.”
Day and Harrell came by the Current’s office last Friday.
One of the things that Cliff Herberg at the DA’s office likes to say is that if a needle-exchange program isn’t done right, it can do more harm than good.
Bill Day: May I say that needle exchange is not rocket science? The idea is to get `sterile needles` into the hands of individuals who share needles with other individuals, and keep them from killing themselves by repeatedly using dirty syringes.
Curt Harrell: There’s no wrong way to provide sterile equipment. There are some philosophical differences in whether you make it a direct one-for-one exchange or whether you preferably put out as much sterile equipment as you can to help as many people as possible, with the idea of educating them to bring back the contaminated equipment for appropriate proper disposal. And we are singularly encouraged and blessed in that situation because the Metropolitan Health District has given us free help in disposing of contaminated equipment that we bring in. So that’s the approach we’ve taken, to place as much sterile equipment as we can in the hands of the users and educate them to bring the contaminated equipment back. And we’ve seen in areas that we have been able to operate that the dirty needles are disappearing out of the gutters and off the streets and out of the vacant lots, and the people themselves are cleaning up the areas in which we have been able to operate so far. So there’s not a wrong way; there are many different ideas on what’s the right way.
And you’re saying that this idea that there’s a one-for-one exchange doesn’t necessarily accomplish what needs to be accomplished?
CH: No, because we know from past experience and from other operations around the nation that `an IV drug user`, he will share `additional sterile equipment` with his friends in what we call secondary exchange. And secondary exchange actually reaches more people than we’re capable of in the primary exchange. So if we require someone to bring us a dirty needle to give them one needle, that only takes care of that individual, and the object is to break the transmission as widely as possible, not just with the people we’re capable of dealing with one-to-one on the street. And this has been shown over and over again across the nation. I just came back from the national convention in Tacoma, Washington, and there was a lot of activity and discussion along these lines, and one-for-one exchange is very much frowned upon as being ineffective.
BD: That also comes from `North American Syringe Exchange Network` Chairman Dave Purchase, who came down here and advised us. I said, you know, what should we do about this thing? He says, get these needles out in the hands. He says, where do you think these needles are gonna end up? They’re gonna end up in the hands of a user. They’re not gonna be thrown away; somebody is eventually gonna get those needles.
CH: I spoke with Dave in Tacoma last week and the message he continually emphasizes to everybody is, the point is the point. Get the supplies out and educate these people to bring the contaminated needles back. And believe it or not, there’s some pretty smart people out there on the street. They know the difference and their education curve is pretty sharp.
You’ve mentioned that both the AG ruling and this case with the Bexar Area Harm Reduction Coalition could affect underground needle-exchange programs in the state. What have you heard from folks in other cities?
BD: Well, they’re concerned, and I think Curt found that out when he went to the national convention. He was suddenly surrounded by people asking what is going on down here. Because if a district attorney can triumph down here, it might inspire district attorneys in other states, or all through — there are four other needle exchanges in Texas — it might possibly inspire those — I don’t think so, because these other people have been around for 15, 20 years and I think they’re pretty well thought of and pretty safe.
I don’t think we’re the main target. The main target of the DA is the test program itself. She says she’s not, but she is philosophically — along with her cohorts — opposed to needle exchange. One of the things they like to say is needle exchange only encourages drug addiction. According to the Centers for Disease Control, that has been studied and and re-studied, it’s been proved to be false. Our good friend William Martin of the James A. Baker Institute of Public Policy at Rice University — a Republican, by the way — he has said emphatically it does not encourage drug addiction. You’re not gonna have somebody who says, oh, we’ve got clean needles, let’s go out and find some heroin. That doesn’t happen.