Street roots., December 19, 2014, Page 3, Image 3

Street roots
Dec. 19, 2014
Naloxone is one o f the tools the sta ff and
volunteers a t Outside I n ’s syringe exchange
give to their clients. The drug shuts o ff
opiate receptors, allowing breathing to
resume. Training provided a t the clinic
enables drug users to adm inister naloxone
on their own. Since training began last July,
clients have reported 550 reversed overdoses
to Outside In staff.
P HO TO BY M A A Y A N SIMCKES
BY EM ILY GREEN
Read Outside In Executive Director Kathy
Oliver’s commentary on the obstacles to
opening the needle exchange program 25
years ago. Page 12
STAFF W R IT E R
ridget didn’t want to buy syringesat
the pharmacy. It was too humiliating
an ordeal for the champion gymnast
turned heroin addict to go through. Not too
long ago she was doing well in high school,
never dreaming she would be a junkie within
a few years’ time. Now, nearing the bottoih
of her downward spiral, she says she was
deeply ashamed Of who she had become:
It started when she was 16. Her father
kicked her out .of his home, and she quickly
followed in his footsteps and starting using
hard drugs. First it was meth and cocaine.
By the time she was 21 she had progressed
to injecting heroin - a move she says took
her way down, real fast. She admits she
didn’t really know how to inject properly -
often sharing and reusing needles. Someone
showed her how to shoot Up dne day and
that was it. She took it from there. ’
Bridget^ who requested Only her first
name be used, spent much of her early 20s
condoms and giving out sterile syringes
B
2 5 years o f Outside I n ’s needle exchange program
i^ o u c h s u r f in g a n d liv in g o n th e s tr g y ta o f
Portland’s Chinatown and Northwest
neighborhoods. She was often depressed,
feeling invisible and worthless. She says she
often thought that if she died, no one would
care, let alone notice she was gone.
And then she discovered a syringe
exchange on Southwest Main Street, where
she could get clean needles for free. Bridget
remembers that at this exchange, operated
by nonprofit health clinic Outside In, she
was treated differently. The staff was kind to
her. They smiled. They listened. They didn’t
judge her.
They told her they understood if she felt
like she couldn’t quit doing drugs - they
simply wanted to help her use drugs in a
way that, would keep her alive so that if one
day she wanted to quit, she could.
After a long road to recovery, Bridget w as,
able to overcome her addiction and get off
the streets. Last spring, she graduated from
Portland State University with honors. Now
30, she works as a program coordinator at a .
community health organization - a career
choice inspired by her positive experiences
with the staff at the syringe exchange.
Outside In’s syringe exchange program
was Portland’s first, and it’s the product of
another era. It was born out of a time when
contracting HIV was a death sentence, and
people throughout the nation, many of them
members of the gay and injection drug using
communities, were dying from the mystery
illness at an alarming rate. All the while
Nancy Reagan’s “Just Say No” campaign was
inescapable, and billboards and public
service messages on television depicted
eggs sizzling in frying pans, also known as
“your brain on drugs.” It was in this climate,
that Outside In Executive Director Kathy
Oliver dared to declare that she wanted to
save the lives of drug users — by supplying
them with clean needles.
The idea came to Oliver in the mid 1980s
after two pregnant women, both HIV
positive, visited the clinic where she works.
One of the women had contracted the virus
from her partner, and the other from
intravenous drug use. HIV meant neither
they nor their babies would live. Oliver
needed to find a way to protect her patients,
and to her, the answer was easy. “Giving out
w ere th e two logical things tQ dp,” she says.
exchange has been “steadily increasing”
since its doors opened 25 years ago. On a
typical day, 200 people visit Outside In to
Once she began the process to open a
exchange dirty syringes for clean ones.
needle exchange, she was met with
disapproving politicians, hostile protests and Wheelock is projecting an exchange of
800,000 needles this year — almost double
angry phone calls. One caller told her what
the exchange 10 years ago. The old needles,
she wanted .to do was like giving a rapist a
room to rape in. Through it all, Oliver fought which must be turned in to receive new
ones, are incinerated,
to make her idea a
and cléañ syringes are
reality. By November
provided free of
of 1989, it had taken
Jast doesn't m ake sense
two years to clear the to me that other places don't questions. Staff and
volunteers believe in
way for the city’s first
h a w this« We saw llw s —
meeting the drug :
syringe exchange.
users where they are
(See Kathy Oliver’s , every day/'
in life, an approach
_ cory
guest commentary on
R R E M E D S T U D E N T A N D NEEDLE EXC HAN G E
page 12) It was the
' v G l o w & er known as harm
reduction. At Outside
third in the nation,
In it’s believed addicts
but some say it was
are more likely to use
Oliver’s efforts th a t.
the service if they don’t feel like they’re
made opening a needle exchange anywhere
being judged while they’re there. So at
in the U.S. a possibility.
Outside In, while they have plenty pf
“She’s a warrior and a hero. I don’t know
treatment information readily available, they
that either of the other two (syringe
don't lecture clients about getting clean. -
exchange) programs would have been able
They simply provide tools to make them -
to pull it o f f without Kathy’s hutzpah up
safer while they aren’t.
front,” says Haven Wheelock. Today,
One such tool is naloxone, also known as
Wheelock is the exchange’s sole full-time
Narcan. The drug shuts off opiate receptors,
employee, and she operates on the same
belief Oliver championed all those years ago: and in the case of an overdose, it helps .
breathing to resume. Until recently, only
Drug users’ lives are worth saving. And
medicài professionals could administer the
because of Portland’s early adoption of a
drug, but Oregon lawmakers made it more
syringe exchange program, Wheelock says
widely available last year. Three horns after
the HIV rate among heroin users never
it became legal to distribute, Outside In
reached the epidemic proportions
became the first agency in the state to teach
experienced in other areas of the country.
péople how to use it. Since then, it has
This year the publically funded program '
trained more than 900 people while,
turned 25, but today it operates in a
supplying visitors with free life-saving doses
changed city. With treatment, HIV is no
longer an immediate death sentence and the of the drug. This has led to 550 reversed
overdoses among its clients - and that’s just
well-documented effectiveness of syringe
the number of cases reported to the Outside
exchange programs has led to greater
In staff. Multnomah County’s seen a 29
acceptance. But some things haven’t
percent reduction in fatal heroin overdoses
changed. Oliver still runs Outside In, and
the syringe exchange is still very relevant — ànce naloxone was made more available.
In addition to supplying clean syringes
it may be saving more lives now than ever-
and naloxone, the exchange also provides
before. It’s aiso. saving taxpayers a lot of
free HIV and hepatitis C testing acts as a
money. While syringes cost Outside In 4
cents each, which translates to about $146 a bridge to treatment for those who ask for
help, and connects clients with detox,
year for the heaviest of users, the cost of
treatment and housing services. It also
treatment for a person with AIDS is
refers about 500 people a year to the main
estimated to be at least $400,000.
Outside In clinic around the corner for
Oliver says the number of clients at the
health care when an infection or abscess is
spotted. Wheelock accomplishes all of this
with the help of one part-time employee, 10
volunteers and a bare-bones budget - just
$235,700 last year. Multnomah County,
which provides the bulk of the exchange’s
funding, also operates a syringe exchange
program.
“I- spend 90 percent of my day talking
about drug treatment,” says Wheelock. The
“33-and-a-half-year-old” has been working at
syringe exchanges for 13 years, and she
seems more than genuine when she says
she loves her clients. “They’re amazing, and
they’re overlooked, and they’re so
stigmatized and so ashamed that people
m iss how awesom e they are,” she says. “All
th e y s e e is d r u g u s e w h e r e a s t h e r e a litv o f it
is’they are human beings with a life.^ *
But the job can be tough. When a client
expresses the desire.to quit, unless they are
willing to white knuckle it — or in some
cases go through withdrawal while sleeping
qutside - there is about a week-long wait to
get into, detox. Often the user changes his or
her mind by the time the week is up, and
it’s an opportunity lost. Wheelock says the
sheer lack of resources also makes her job
difficult :
“I hate when I’m Working with somebody
who is desperate to get help, to get housing,
to get a safe place to sleep, to get into
treatment, and they get turned away or
aren’t able to get in because of their drug
use,” she says. “It’s hard When you have
people who are not wanting to get back in
trouble, but wanting to get on probation so.
they can get into a drug treatment
program.”
On a Tuesday' afternoon in December, a
steady stream of visitors walks in and out of
the exchange. Some clients are economically
stable, some are homeless, some are middle-
aged, and some are young - in recent years
there’s been an upward trend of addicts
ages l9 to 24 visiting the exchange.
Volunteer Cory Nichols, a 27-year-old pre­
med, student is working in the back of the
clinic, handing out new needles. “It just
doesn’t make sense to hie that other places
don’t have this. We save lives every day,”
says Nichols. Some states, such as Idaho,
Florida and Texas, don’t house any syringe
exchange programs, due largely in part to a
ban on federal funding.
For staff and volunteers at the exchange,
it’s rewarding wqrk. Wheelock says she
loves running into former clients who are in
a better place and knowing the exchange
played a part. One such former client is
Bridget, who now works in health care
helping people with the same harm-
reduction approach she first saw practiced
at Outside In.
“I have a great life today,” says Bridget.
“I’m a productive member of society, I did
great in college, I don’t have HIV, and I
don’t have any irreversible damage because
I had to use dirty needles.”
emily@streetroots.org