Boxes of supplies onboard the PreventionWorks mobile unit. In addition to clean needles, volunteers hand out wound care kits and clean drug cooking equipment.
Boxes of supplies onboard the PreventionWorks mobile unit. In addition to clean needles, volunteers hand out wound care kits and clean drug cooking equipment. Petra Mayer/NPR
On a gray and drizzly September day, a beat-up old RV pulls up across the street from Washington, D.C.'s Marvin Gaye Park — formerly known as Needle Park. The RV is a familiar sight to the people there.
Soon, a small line forms as intravenous drug users arrive to exchange their dirty needles for clean. PreventionWorks is the largest and oldest needle exchange program in the city.
Taking needle exchange to public places has long been controversial. Now, advocates worry that legislation on Capitol Hill will stop it altogether.
In the park, volunteers — many of them former PreventionWorks clients — stash the old needles in red biohazard boxes and hand out fresh ones, wound care kits and packed lunches. The day's special offering of strawberry cake is proving especially popular.
Volunteer Hazel Smith tells everyone she loves them. "I come on the van or I'm on the street, and I try to let people know that people love them," she says. "They have to learn how to love themselves, but I'll love you until you learn how to love yourself."
Volunteer Hazel Smith puts together kits of fresh needles for the often homeless addicts who come to the PreventionWorks mobile unit.
Volunteer Hazel Smith puts together kits of fresh needles for the often homeless addicts who come to the PreventionWorks mobile unit. Petra Mayer/NPR
The van travels the same route every afternoon. It's important to keep a regular schedule, so that clients know where and when to show up. PreventionWorks executive director, Dr. Philip Terry, says it's an effective way to bring health care to people who wouldn't get it otherwise.
"We take clean syringes, we take access to health care, we take access to treatment, access to detox, we take it to the people where they are, where it's needed most," he says.
But these programs could effectively be shut down by two pieces of legislation currently before Congress. And here's where things get a little complicated.
Congress actually banned the use of any federal funding for needle exchanges back in 1988. President Obama hasn't yet acted on a campaign promise to lift the ban. So the House and Senate both passed bills this year that would end it — and then they tacked on restrictions forbidding federal funding of needle exchanges within a thousand feet of schools, parks, recreation centers and anywhere else children are likely to gather.
The situation is even more complex in Washington. Rep. Jack Kingston, a Republican from Georgia, has added an amendment to next year's appropriations bill that would completely ban any needle exchanges within that thousand-foot limit.
Alex Wong/Getty Images
U.S. Rep. Jack Kingston (R-GA), seen here in a 2004 file photo, says conducting needle exchanges where children can see sends "a mixed signal."
U.S. Rep. Jack Kingston (R-GA), seen here in a 2004 file photo, says conducting needle exchanges where children can see sends "a mixed signal." Alex Wong/Getty Images
"There's a mixed signal when we're telling kids stay off drugs, but in some cases 200 feet away, we're allowing people to exchange needles," Kingston says. "And we think, you know, if you got to do it, just keep out of sight of children."
Mary Beth Levin, PreventionWorks' director of programs and services, says if these bills become law, they'll leave needle exchange programs with nowhere to operate. "We joke that the only two places where we could legally do needle exchange would be in graveyards and the middle of the Potomac," she says. "But actually more accurately, it would be in the middle of some national parks, and on the steps of the Capitol are pretty much the only places where we would not be in conflict with the current law."
Needle exchange does seem to help stem the tide of HIV transmission. The Centers for Disease Control calls it an effective part of comprehensive HIV prevention programs. And in 2000, then-Surgeon General Dr. David Satcher issued a report that said "syringe exchange programs ... are an effective public health intervention that reduces the transmission of HIV and does not encourage the use of illegal drugs."
For PreventionWorks volunteer Hazel Smith, it's the human element that's important.
"I didn't know that these type of trucks existed when I was out," she says. "I was just an addict on the streets, walking from here to there, sleeping here and there, and nobody ever seemed like they cared."