The needle and the damage undone
One of the best programs in the city for fighting the spread of AIDS and hepatitis is still illegal
Susan Ziony backs the Plymouth into the rutted Vine City driveway and the clutch of hungry-eyed onlookers pulls a little closer. A black dog barks incessantly, and the animal strains against its tether in the dirt yard.
Ziony, Nick Hess and Teresa Dulce open the van's rear doors and grab a box of books and clothing, some satchels with medical supplies, two plastic bags of pastries and two milk crates, filled with brown lunchbags. They form a small assembly line with the goods and wait on a cracked sidewalk in a place called "the Bluff," in the shadow of the Georgia Dome.
It is the woman with the needles, though, who is the center of attention. Mona Bennett slides open the van's side door, grabs a clipboard and plops down. Her first customer approaches and flashes his identification card.
In one hour, Bennett will pass out 1,800 syringes.
For Atlanta Harm Reduction Center, it's a hum-drum afternoon's work. It's also illegal.
In fact, what Atlanta Harm Reduction does is against the law everywhere in Georgia. Technically speaking, Bennett, Atlanta Harm Reduction's sole paid staffer, and her crew of volunteers are distributing drug paraphernalia.
Despite such laws, though, the government's own statistics show that programs such as Atlanta Harm Reduction's needle exchange save lives. Maybe that's why the cops leave these lawbreakers alone.
On this unusually slow morning, the line to reach Bennett stretches maybe 20 feet up the street. Anyone who wants one receives a bleach kit — paper bags that contain distilled water, tourniquets, alcohol patches and various other accoutrements for shooting heroin cleanly — as well as Band-Aids and anti-bacterial ointment, condoms and rubber stems that can be used for crack pipes.
Between 11 a.m. and noon, men and women keep materializing around corners. A few drive to the spot. Many carry a week's worth of used needles with them in old bleach bottles. Bennett matches them syringe for syringe plus an extra 10 — up to 120.
For the most part, her customers are polite and quiet. Some even trade jokes with Ziony and Hess, who wears the rubber crack pipe holders around his neck like tribal jewelry. Most of the men and women grab day-old pastries from the Starbucks bag, and when they reach in, it's easy to see the tell-tale black-and-blue mastication of a heroin user's arm.
A few times the line inches too close to the van, and Hess has to ask the customers to back off, but that's all the excitement he gets today.
At the end of the hour, the group packs up the few remaining bleach kits, piles into the van and drives back to Epworth United Methodist Church in Candler Park, where the offices of the Atlanta Harm Reduction Center are located.
Atlanta Harm Reduction was formed in 1994 as a subcommittee of ACT-UP Atlanta. The group has five board members and Bennett, its program director. It's a cause that struggles to find money to purchase the 8-cent syringes and the 6-cent condoms it distributes. Money for AIDS outreach is drying up, and funds it receives from entities such as the Atlanta AIDS Partnership Fund won't cover the purchase of syringes.
The mere fact that what Atlanta Harm Reduction does is illegal may sound anachronistic. To many, needle exchange is downright passé. It is widely recognized as a way to prevent the transmission of AIDS and hepatitis among injection drug users.
According to an August 1999 report by the Centers for Disease Control and Prevention, using sterile needles only once "remains the safest, most effective approach for limiting HIV transmission."
And the spread of AIDS hasn't abated, especially among African-Americans. In June, the CDC announced that blacks account for 50 percent of new AIDS cases and 57 percent of new HIV diagnoses, while making up just 12 percent of the U.S. population.
Thirty percent of black American men ages 23 to 29 are HIV positive, according to the CDC's most recent data, more than four times the rate for white men of the same age.
Meanwhile, agencies such as the General Accounting Office, the National Commission on AIDS and U.S. Surgeon General David Satcher have all authored studies that indicate needle exchange programs do not increase drug use.
And when compared to the public costs of caring for someone with AIDS — as much as $25,000 per year — needle exchange is cheap.
So why isn't it legal in Georgia? Lack of political courage is one reason.
"We're hoping county or state officials will develop the backbone to follow science," Bennett says, instead of relying on the politically safe duo of counseling and incarceration. "As we see way too often, dead people don't 12-step."
When it comes to drug abuse, Mayor Bill Campbell hasn't been a vocal proponent of harm reduction, but there are signs his stance has softened. At a recent conference where the rise of HIV infection among blacks was addressed, Campbell said it was time to applaud grassroots groups that operate needle exchange programs and distribute condoms.
But asked in June whether the mayor had changed his mind about needle exchange and would be willing to advocate to change state law, Campbell spokeswoman Glenda Blum Minkin did not directly address the question but instead referred Creative Loafing to the city's community affairs office.
No matter. Campbell will be out of office come the first of the year, and then the question of advocating for needle exchange will fall in the lap of a new mayor.
So what do the frontrunners for that office have to say? Last week, CL placed calls to the campaigns of Robb Pitts and Shirley Clarke Franklin, seeking their stance on needle exchange programs. Mum's the word, apparently. Whether Pitts and Franklin don't want to address a touchy subject, or they are just not getting messages, one thing's for sure: Atlanta Harm Reduction will have to continue its program of quiet civil disobedience.
"Sometimes you have to say, 'Fuck the law, we're going to save lives,'" Bennett says.
Logan Spector, the vice president of Atlanta Harm Reduction's board of directors, says there are about 22,000 injection drug users in the metro Atlanta area. But, he says, those numbers are dated, and heroin use has been increasing around the country.
Most of Atlanta Harm Reduction's clients are black males. Most are in their 40s and have been using for at least 10 years. Half of them shoot heroin. The rest inject heroin and cocaine or cocaine alone, and there are a few who inject crystal meth. Most of the men and women are unemployed.
Harm Reduction volunteers admit that they are sometimes hassled by police, but no one has ever been arrested. Still, the Atlanta Police Department officially can't sanction such action.
"Generally speaking, if it's been passed by the legislature or the city, we are obligated to uphold it," says Officer John Quigley, APD spokesman.
But while volunteers may be violating the letter of the law, they're certainly adhering to a higher one.
Besides, says Bennett, referring to the early days of the program when organizers were primarily white women from Emory's University's Rollins School of Public Health, "Who wants to arrest white women from Emory?"