Test Positive Aware Network has operated a syringe exchange program in conjunction with Chicago Recovery Alliance for the past seven years. It's a free, legal and non-judgemental service that began as a study with Yale University and funding from the Chicago Department of Public Health (CDPH).
The program was begun to help further the proof that providing clean needles to injection drug users (IDUs) drastically reduces the rate of new HIV and hep C infections. Naturally, this harm reduction model is still considered controversial to some and though time and again studies have shown that the programs do not increase drug use, it still has its naysayers. The program is simple: bring in your dirty needles and we'll replace them with new ones. That's it. We will never tell a client that using is bad or that they should quit. Our focus is to teach them how to do it safer without being judgmental until they decide for themselves that it's time to get help. Only at that point do we start the process of referrals into addiction centers or counseling. If, along that road the client is open to a little education on safer injecting, or learning a bit about HIV or hep C, perhaps even going so far as to be tested, then we feel even more successful.
I entered into my new program with a not-so-open mind. The clients I saw were shockingly diverse to me. Everyone from suburban housewives (yes, very desperate housewives like the ones you've seen sobbing with Oprah), surprisingly young teens on heroin, transsexuals using hormones, corporate professionals on meth, hookers, students, bodybuilders, men on the down-low, women on the down-low, and one parent of a blind, aging diabetic Labrador named Sadie. Sadie needed insulin needles. Actually I believe each of these groups have had their time sobbing with Oprah, right?
The one common denominator among all the IDUs was that each one came through the door with a huge amount of shame. Most came to us with heads held low; some couldn't make eye contact, some so tweaked that they couldn't focus on anything. Each acted as if I was a vice squad member about to bust them.
Over the next few months, as the staff and I became more familiar to the clients, I could see that they were beginning to trust me a little. Perhaps they wouldn't wear the dark glasses each time, or they would chat for a minute and not rush right out. I'd even see a meek smile once in a while or perhaps a handshake. Each one began to express his appreciation of the service we were providing, but there was still a huge underlying element of shame. Shame in the way they walked, shame in the way they held themselves, shame in the way they talked or didn't talk, shame in their tired, weary eyes. A shameful "yes, sir" or "no, sir" to my few questions showed me that they still viewed me as an authority figure, an image I didn't want them to have. With each visit that window into their world opened a tiny bit, a good sign that we were making some progress with our service.
I've always had my favorites. Not that they were special, but because they began to trust me with compelling bits of information that gave a very slight bit of insight into who they were. Since our NEP (needle exchange program) is an anonymous service, I began imagining names, or more accurately, assigning "titles" for my favorite clients.
Mr. Clean was there to get needles for his steroids and growth hormones and "other things." Over the next few visits I learned that Mr. Clean also had a very heavy heroin addiction, had been in and out of rehab, was a "hustler" (his words, not mine) who serviced a male and female clientele, was HIV-positive and HCV-positive and engaged to be married to an unknowing fiancé in a few weeks. He came in a few months ago and was trying rehab once again. A few weeks later he reappeared, this time feeling more guilty and ashamed than ever. He had dropped out of rehab for the umpteenth time. He cried in my office as his beeper continued to alert him that there was a client interested in his services. He dried up, wiped his face, popped a Viagra and dashed out. I've not seen him again and miss him. He called a few months later to ask if I had access to steroids. If I'd had access to them, I'd be doing push-ups on my office floor.
Double Logo Girl was employed by one of the high-end boutiques in the downtown area. You know, the type of shop you have to be buzzed in to. She was beautiful and sexy, like Nastassia Kinski (circa "Cat People" or the famous 1980s Richard Avedon snake poster). DLG made me question my homosexuality and that's hardly questionable. She would enter the doors dressed immaculately in the store's double logo couture. As if she were on a runway, her long dark hair was perfectly imperfect, but she had none of the confidence of a Naomi Campbell or Tyra Banks. She always looked sad, like one of the young girls in the old Margaret Keane paintings who had a huge head and huge tearful eyes along with a kitten or puppy with the same odd physical traits. She always wore double-logo sunglasses and never removed them. I later learned that one of DLG's big sad eyes was always blackened. She was so gorgeous I got nervous and tongue-tied when I talked to her. I remember one time, when I was trying to compliment her on how incredible she looked I blurted out, "Wow! You look great with clothes on!" God, what an idiot! Where did that come from? I could literally feel my already ruddy face become crimson as I frantically looked for a drawer to crawl into. Just like in elementary school, I'd made an idiot of myself in front of a girl again. Later I learned that this beautiful, fragile little girl was being beaten by her boyfriend any time she mentioned trying to give up heroin, thus explaining the sunglasses. I tried to talk about where she could get help, but she claimed to be double-parked and quickly darted out. Just like Lady Goodwill, her shame was her barrier to treatment for drugs and domestic abuse.
I think because of assumptions like these I was occasionally invited to various drug and sex parties. One snowy Monday night a guy came in for supplies. He confided that he was bisexual and had spent the entire weekend methed up at several Boystown sex parties and was now returning to his wife and two young sons in the suburbs. He had stopped in for next weekend's supplies. His emotions were all over the map during our brief talk. His giddiness and laughter would quickly break into tears and desperation and then quickly back to flirting and giggling. I could tell he was about to experience a mean crash. At one point in our conversation he leaned over my desk just a few inches from my face and softly said, "You have the most beautiful eyes. Would you come out to dinner with me tonight?" I assured him that I was flattered but that "it was my night to wash my hair." His sobbing suddenly got heavier as if he'd heard the worst news possible. I really don't think he even realized that I'm as bald as an eagle and had responded that way so as not to embarrass him. I couldn't help to wonder what his wife and little boys would think.