Needle Exchange Workers Witness Opioid Epidemic Up Close
EDDINGS: In Cleveland, there are two men who’ve had a front seat – literally – to Ohio’s surging opioid epidemic. 60 year old Chico Lewis and 44 year old Roger Lowe are the sole outreach workers for Circle Health Service’s syringe exchange program, the first and oldest such program in Ohio. Weekday mornings, on Cleveland’s West Side, and weekday afternoons on the city’s East Side, these two recovering alcoholics sit inside a white van and dispense clean syringes to intravenous drug users. Their one for one syringe exchange helps addicts avoid HIV AIDS and other blood-borne diseases that can be spread through sharing needles
This morning began with a bang on the outside of the van, parked on West 25th Street near MetroHealth Center. The sound interrupts Chico Lewis in the middle of telling me how he got sober 27 years ago.
LEWIS: So therefore I didn't know…hold up. (The van door slides open.)
CLIENT, MALE: Good morning.
CHICO: What's up?
CLIENT: Same old, same old.
ROGER LOWE: How many you got?
LOWE: Alright. First initial?
LOWE: Last four of your Social?
LEWIS: What size?
EDDINGS: First initial. Last four digits of a Social Security number. ZIP code. What size needle and how many of them are being returned for exchange. These are the only vital stats Roger Lowe will enter into his laptop. More than 700,000 needles were exchanged from 5,247 clients. That’s a big increase from the 2,425 served in 2012, when the heroin epidemic was hitting its stride.
LOWE: When I first came out eight years ago. most of Chico’s client demographic was people his age, between my age and his age, which is 44. Late 40s, 30s, old school users older people in general. In the last three years it’s been a 100 percent increase in all new clients, clients being between the ages of 18 and 26. And still rising.
CHICO LEWIS, to a young female client: What's going on?
YOUNG CLIENT: What's going on.
LEWIS: You been here before, right?
EDDINGS: One woman looking to be in that age range comes to the van. She’s dressed like a weekend suburban mom – sneakers, black leggings, white T-shirt, and a big black purse, into which she drops a box of 20 syringes before heading back to her car.
LEWIS: There you go.
YOUNG CLIENT: (cheerily) Thank you!
EDDINGS: Cleveland’s needle exchange program was launched in 1995, under an emergency order by then-Mayor Michael White, in an effort to address an outbreak of HIV/AIDS among IV drug users. Chico Lewis started working at the exchange two years later. He says he didn’t understand the concept of “harm reduction” at first.
LEWIS: They explained it to me, but I didn’t like what they was saying at first because I thought it was enabling IV drug users. And they said, no no no, the whole purpose of this is to stop the spread of HIV and hepatitis.
LOWE: Yes, we give out needles. Yes, we educate. Our main job, Chico and I, is to earn trust. Because no one else is going to listen to these people. Everyone else is going to judge these people.
EDDINGS: Lewis says he notices when clients are low, and perhaps ready to get help. He says he’ll use the opportunity to tell them how to get a bed at Matt Talbot, the treatment facility where he and Lowe also work.
LEWIS: A lotta times they don’t use that information. A lotta times they do use that information And when I know that they do use that information, when me and Roger show up at Matt Talbot in the evening, we look around and one of the clients will be in one of the dorms looking for us. So that’s a success right there, we look at that as a success.
EDDINGS: Clients are tested quarterly for HIV/AIDS; according to Circle Health Services, there hasn’t been a positive HIV result in the last three years, despite rising IV drug use in the ten counties the syringe exchange serves. For years, Cleveland’s program was the only one in Ohio. Recently, Portsmouth, Cincinnati, Dayton and Columbus have added needle exchanges.
LEWIS, to Eddings: Could we stop for a second? (He opens the van door. Two women are standing there.) I was in an interview.
WOMAN: Yeah? Important stuff, huh?
LOWE: You know it. (LEWIS laughs) We love these ladies. First initial?
EDDINGS: Their affection for their regular clients is obvious. Does it ever bother them that they’re providing these people with the tools that could lead to their death?
LOWE: I've given a needle to someone who's just gotten out of the treatment center that we work at. (Long pause.)
EDDINGS: And what happened? How do you feel about that?
LOWE: And he died.! We saw him on Monday he got out on Tuesday and by the end of the week he's dead. And, and we know the needles that I gave him, he probably used. Unfortunately that's one scenario to the thousands of people who don't have HIV and/or people who don't have children who have needles under their feet again.
LEWIS: Do it run across my mind? Yes. But that decision that they're making is out of my control.
LOWE: First initial.
LOWE: Last four of your Social?
EDDINGS: It’s nearly noon. The last two clients of the morning approach the van with their used syringes. (Sound of needles being dumped into a plastic hazardous medical waste container.) Lewis and Lowe estimate they’ve taken in 1,600 so far, from about 40 people. They’ll collect more in the afternoon, when they drive to their East Side site at East 86th and Cedar for another two hours of exchanges.
LEWIS: (closing the van door) Whooo! That was intense!
EDDINGS: Sure was.
LEWIS: You got to see it first hand, at full blast!