With Heroin and HIV on the Rise, Activists Run a Covert Needle Exchange

Every few months, a 38-year-old woman drives to Miami from Broward. She meets with Carlos Franco, a 66-year-old retired drug-rehabilitation specialist turned harm-reduction advocate. He hands her a box with hundreds of new, wrapped syringes, and she then in turn covertly hands them out to low-income intravenous drug users in Fort Lauderdale to prevent addicts from reusing dirty needles and spreading diseases. Franco does the same in downtown Miami. The woman declined to comment and preferred not to give her name because if intercepted by police, she could be arrested for a third-degree felony — delivering drug paraphernalia.

“She is a real fireball and go-getter,” Franco says of his Broward counterpart. “She’s busy and goes to school, but she is so determined to help these people that everyone has given up on.”

Behind Miami-Dade County, Broward has the second-highest rate of new HIV cases in the country — a trend that is not being helped by an epidemic of heroin users who share dirty needles. The Centers for Disease Control reported last month that heroin use has increased across the country and across all demographic areas. Medical professionals like Dr. Hansel Tookes, a medical resident at Jackson Memorial Hospital in Miami, have been fighting to change Florida legislation and start a needle-exchange program that may not address the root addiction but would at least provide addicts with clean needles. (Ideally, they would turn in a dirty needle to get a clean one, so the needles do not litter the streets.) He’s been working closely with Florida legislators to pass the Infectious Disease Elimination Act (IDEA). If passed, the law would provide funding for a pilot needle exchange program at Jackson Hospital, where Tookes works, and remove criminal penalties for people who pass out needles.

“IDEA will allow us to practice preventative medicine,” Tookes says. “This is a measure that will save countless lives directly attributable to our lack of a needle-exchange program.” Though the Florida Legislature doesn’t meet again until next spring, two weeks ago, Broward Rep. Katie Edwards filed the bill. “I’m excited about the enthusiastic early filing of HB 81, and I look forward to working with Rep. Edwards and Sen. Braynon to pass this vital legislation,” Tookes says. This is the fourth time the 34-year-old representative has filed this bill. In the past three legislative sessions, it died in committee. But Edwards is not giving up.

“It’s very frustrating. I see in Broward the ramification of intravenous drug use on law enforcement, families, state, and local resources,” Edwards says. “It seems like a no-brainer to pass a needle-exchange program to stop the spread of HIV and other diseases.”

In medicine, the idea of “harm reduction” can be controversial. Proponents of harm reduction argue that certain users are addicts, so they try to reduce the associated problem — by providing electronic cigarettes to smokers or clean needles to people who shoot up. Critics of harm reduction, however, say that such measures increase the drug use. Edwards blames young conservative legislators — who believe that an exchange program would encourage heroin use — for blocking the bill. She says they’re in denial about the scope of intravenous drug use in Florida. She remembers tears filling her eyes when two 30-something Republicans dismissed her presentation on the subject.

“Unfortunately, some lawmakers need to see more people infected with HIV and to have AIDS rise to a level where it’ll be impossible to ignore,” she says. “They need to see more heroin use in counties outside of South Florida and have it become a state-level issue. I’m trying to be proactive and get ahead of the game.”

Edwards is not alone. Recently, the United Way of Broward has started researching the issue, meeting with stakeholders, and holding policy briefs. This month, it is launching a public awareness campaign to dispel some of the myths associated with a needle-exchange program — the main myth being that needle-exchange programs encourage drug use.

“All studies — the CDC, the National Institute of Health — show people who go to a syringe exchange are five times more likely to enter drug treatment programs,” says Dave Wallace, director of public policy advocacy of the United Way of Broward. “There’s so many myths about it. It’s hard to change legislation until we start changing the understanding of the issue.”