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Conscientious Injectors (Part II) 

The enforcement of drug laws should be less hurtful than the dangers inherent in drug use itself, say the "harm reductionists" at Prevention Point, who practice what they preach by distributing 1.5 million needles to the city's drug users.

Wednesday, Jun 28 1995
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The Webster Exchange
On another sunny Tuesday night, two white guys stand in front of any empty, cyclone-fenced lot on Webster Street just north of Eddy, solidly in the Western Addition. Charles Pearson and Alex Kral, volunteers for Prevention Point, stand there with several hundred syringes that resell on the back market for between 50 cents and $2 each. They've got the de riguer small steel table with all the trimmings, a biohazard buxket, and a small portable radio playing KMEL. Nobody hassles them. Ever.

Webster Street's low volume - averaging one client every three or four minutes - allows time for casual talk, which volunteers at the high-volume sites can't afford. Most passers-by know Kral and Pearson by sight; the needle exchange is pure human contact for marginal people in a marginal community.

"Free condoms?" Kral offers a young woman pushing a stroller.
"No, thanks, I already have some," the woman replies, embarrassed.
What possesses the two to volunteer to help junkies, er, IDUs?

Kral spends his days crunching IDU numbers for Watters' Urban Health Study. He says, "I believe in knowing more about the topic, knowing more about the people. I want to see how the system works ... I think it's really important to have some kind of direct-service thing, just for the psyche. If you work in the world of numbers and writing papers and stuff, you don't often see any finished products, you don't get any thanks, you know?"

Pearson also mixes the personal and the professional: As an ethnographer with the San Francisco Urban Institute, he researches the lives of homeless heroin addicts.

"It's a direct application of public-health activism," Pearson says. "You somehow get more involved in more people's lives that way."

Webster Streetis mellower than Duboce, 14th Street, or the Tenderloin site with its reputation for chain-reaction alcoholic fistfights. Typically, there are 35 exchangers per evening, generally men in their 40s. Kral says younger kids tend to either snort heroin rather than inject it, or they smoke crack or abstain from drugs. The needle volume is still high, though, up to 1,800 a night, or about 50 a person, as many IDUs turn in their friends' points for them.

Pearson and Kral started the site in April 1994 after working at a site in the lower Haight and realizing the Western Addition was exchangeless. Prevention Point offered to provide needle and other goodies, so the two scoped out Webster Street.

After making inquiries of some people in the area, they settled on a site just around the corner from what Pearson calls "the drug stroll" on Eddy Street, a sedate-looking block of row houses that during the day is the local Crack Central. It's a block from the Plaza East project, nicknamed "O.C." for "Out of Control."

They also talked to local church groups, the cops at Northern Station, and tenant associations. And talked and talked. The tenant associations were hesitant; they said, "Just what we need, now the cops will know who to bust for having paraphernalia." Pearson says he took this concern to a lieutenant at Northern Station, and the lieutenant got Capt. Richard Carnes to write a letter saying his officers wouldn't stake out the exchange or bust people without cause. Good enough. In April 1994, the Webster Street site went into business.

It's a drive-through site par excellence as folks pull up, leave the engine running, jump out with their points, grab a fresh set plus some alcohol wipes and cotton, and drive away.

It's also a bike-through; a bike messenger comes by every week around 6:30 just to get condoms, and on my second visit I am dumbfounded by an immense bag of pot protruding from his shoulder bag.

"Uh," Kral says, "you should make sure your bag's closed."
"Nah, it's OK," the messenger replies, happily riding off with a fistful of lubed rubbers. Prevention, prevention, I think.

The site's driveability can cause problems. One strung-out-looking guy pulls up in a cab and falls in line behind a man who is counting out his points into the biohazard bucket just a little too slowly.

"Hey, I got a cab waiting, man."
"We've all got to wait, brother," says the gentleman ahead of him, turning briefly from his count to touch the speaker's shoulder.

"Don't touch me. I'm not your brother," the first guy snaps.
The slow guy sighs, stops counting his points out, and steps aside for Mr. Civility. By this time, the cab driver has gotten out of his car and is looking on, wondering what's up. His fare is counting maybe 20 used hypodermic needles into a bucket and arguing with a bunch of guys standing, for some reason, in front of an empty lot.

"You feeling OK?" asks a nurse practitioner who also is visiting the site that night.

"Yeah, yeah, feeling fine," says the guy, avoiding eye contact as he ans the stoic cabby return to the car and drive away.

"He probably here from another part of town," says Pearson.
The outreach of needle exchange has brought many stigmatized IDUs in contact with officaldom for the first time. The nurse practitioner at the Webster site is doing a "needs assessment" to determine how the Department of Pubic Health can help the city's addicts. The Haight-Ashbury's Women's Needs Center attends to women at the 14th Street site every other week, and UCSF routinely sends its docs down to check on the Sixth Street clientele.

Prevention Point is working its own needs assessment, says the organization's chief, Roslyn Allen, so "injectors can tell us what, when, and where" to do exchanges. Allen, with a master's in clinical psychology, has headed the group since January. She says Prevention Point is establishing a program to screen active injectors and teach them proper injection techniques, with the goal of having them teach their comrades - in a phrase, peer-group education. But this program requires funding that Prevention Point has not yet received, she says.

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