| Needle Exchange |
IMAGE: TOM HUMPHREY
Last year, drug users in the Rose City swapped more than 600,000 dirty needles for clean ones. It's part of an effort to curb the spread of AIDS and hepatitis C among intravenous drug users, something that not only saves lives but also reduces the need for tax-supported medical services. Roughly one-third of all AIDS cases nationwide are linked to use of IV drugs.
But junkies and public health workers say their efforts are increasingly hindered by local police, who target needle-exchange sites and hassle the people who use them.
"Other counties haven't been seeing the level of harassment like we see in Portland," says Anna Vail, coordinator of the state Department of Human Services' anti-AIDS and -intravenous drug program. "It has definitely been a Portland problem rather than in other counties."
Although needle exchange is supported by the American Medical Association and the federal Centers for Disease Control and Prevention, critics, including President George W. Bush, have long argued that public funds shouldn't support drug use.
More than a decade ago, Outside In opened one of the first needle-exchange programs in the country and today receives $93,000 a year in city and county funds. In 1996, Multnomah County began its own $135,000 program. Some exchanges take place at fixed locations, such as at Northeast Martin Luther King Jr. Boulevard and Killingsworth Street. Others are done from mobile vans. In addition to new needles, clients can get clinic referrals and bleach kits to clean used needles, as well as receive educational materials about disease prevention.
Health-care workers say clients frequently complain that shortly after exchanging their syringes they get stopped by cops, who search them, question them, and sometimes confiscate or break the needles.
"It's hard to quantify, but I believe it's escalated within the last year," says Vail.
It is not illegal to be carrying a clean syringe, but police can arrest you for carrying a needle that contains, or has contained, illegal drugs.
"Some conflict is not surprising," said Central Precinct Commander Rosie Sizer when the issue was brought to her attention. "Certainly, there's a great public-health purpose to needle-exchange programs." But, she adds, "we have a law-enforcement purpose, to deal with people selling or possessing drugs."
Amy Gredler, who manages the county's HIV/hepatitis C prevention program, views the problem as more about education than malice. "We think the cops are not able to distinguish between clean and dirty needles," she says. As a result, she says, "some of the clients feel uncomfortable carrying needles."
Jarvis Allen, who heads homeless outreach efforts for the nonprofit Yellow Brick Road, says the increased attention from police deters drug users from coming to the exchange sites but doesn't keep them from shooting up. "The police think that by taking away their needles they aren't going to use," Allen says, "but these people are going to try and get it anywhere."
Fellow outreach worker Ed Muckenthaler says the fear of coming to exchange sites hampers education efforts. "Basically all the [clients] scatter; they don't get the health information and are afraid to come back," he says.
Prompted by such concerns, then-Chief Mark Kroeker issued a statement last November confirming the Police Bureau's support of local programs. "In part due to early introduction of syringe-exchange programs, Portland has not had the increase in HIV infections experienced by many other cities in the U.S.," Kroeker wrote.
But it appears that news of this stance has not been widely disseminated within the Portland Police Bureau. Sizer, for instance, says she was not aware that needle-exchange workers had such complaints. Health officials have not briefed the police in years, meaning new officers are unfamiliar with the program.
"Now that this issue has surfaced in this way, we're going to have the outreach workers meet with officers," says Sizer. "We don't want to defeat the needle-exchange program."
Gary Oxman, Multnomah County's public-health officer, downplayed the conflict between officers and needle-exchange clients as an "occasional" problem, a position that frustrates Vail, the state AIDS-prevention director. "I wish the county would take a more active stance on harassment of public health services," she says. "From my perspective, the cops are interfering with the county's public-health job in getting clean needles out."