Tacoma Clean-Needle Program Is Backed by Addicts, Opposed by Others

Dave Purchase spends most afternoons trading gossip with a slow parade of drug addicts on a gritty downtown sidewalk.

But Purchase, a cheerful, engaging man, has something else to trade with the drug users he calls “just folks” and counts among his friends.

“How ya doin’, Pumpkin?” he asked a woman with haunted eyes as he handed her a clean hypodermic needle for the used one she dropped into a little red box sitting on a folding table. “Not too bad,” she said with a tired smile.

“That’s great,” Purchase boomed. “That’s great.”

Brings in Pair of Needles

A woman with a headful of tiny black braids brought Purchase a pair of needles she had used to feed a heroin habit. She lingered in the feeble sunshine with fellow junkies to watch the action. Down the street, a squad car screeched to a stop and a policeman alighted to drag a fallen-down drunk to the curb.

“I shoot heroin . . . I’m a dope fiend,” the woman with braids said to a visitor. “But I come down here most every day for clean needles. I like the high, man, but I don’t want to die for it. I don’t want no AIDS.”

The 31-year-old woman, who gave her name only as Stephanie, talked of enrolling in a treatment program to kick her 10-year habit. She pointed at Purchase. “The rig man there--he cares what happens to us.”

In this neighborhood of half-abandoned buildings, sagging fences and weed-choked lots, Purchase and his crew of county health workers have built what is hailed as the nation’s first successful program to reduce the number of dirty needles among drug addicts in an attempt to slow the spread of AIDS.

Other Cities Adopt Plan

The program, which swaps 1,500 clean needles for dirty ones a week, is being studied or at least partly duplicated in places like Honolulu, Boulder, Colo., and San Francisco. Observers are impressed by an unexpected bonus: new access to elusive inner-city addicts and a chance to help break their habits.

Critics include Bush Administration officials, who say backers of such programs have yet to show that they slow the spread of AIDS. State lawmakers and some treatment experts say Tacoma’s program not only violates the state’s drug paraphernalia law but that it tacitly sanctions illegal drug use.

“To put up a little table to exchange needles like Mr. Purchase does is like Alcoholics Anonymous’ putting up a bar on the sidewalk and giving out free drinks while passing out pamphlets against drunk driving,” said the Rev. Joe Ellis, whose Tacoma Rescue Mission is just up the street from where Purchase hands out needles every afternoon but Sunday.

Purchase has little patience for critics like Ellis. “You know what these people are really saying? They are saying, ‘Let ‘em die.’ Either that or they haven’t seen the evidence that needle-sharing is spreading AIDS.”

Began as Personal War

Purchase, 49, a former drug counselor, received local government funding and a staff in January after starting the program with his own money a year ago as a personal war on the spread of acquired immune deficiency syndrome.

The $45,000 program’s purpose is simple, he said. “If you want to slow the spread of AIDS, you have to slow the spread through dirty needles.” Sharing of needles has surpassed homosexual contact as a cause of AIDS’ spread.

Intravenous drug users account for 27% of all AIDS cases nationally; as of mid-July, 99,936 Americans had contracted the disease and 58,014 of those had died. In Washington state, 1,383 AIDS cases have been reported and 753 of them have died.

Purchase’s war on dirty needles has drawn applause in the sad underground of street addicts and among many health officials. But he is quick to note that he would be out of business if authorities decided to enforce a misdemeanor state law against delivering or possessing syringes without a prescription.

Permitted to Continue

Tacoma officials have permitted the program to continue because “these people are not trying to commit criminal acts” but rather are waging a war on AIDS, Tom Felnagle, chief criminal deputy prosecutor for Pierce County, said.

Purchase, a drug counselor for 20 years, said he owes addicts a great deal, which is why he contracted with a medical supply house a year ago to distribute needles himself, no questions asked.

“I worked in the business since 1969. These people paid my mortgage, put food on my table; I mean I’ve been living off their misery for 20 years like any decent social worker. I decided to do something for them.”

Dr. Al Allen, the county health director, is excited by the new bridge to this industrial port city’s most elusive underclass--longtime IV drug users. “You do have to go to people you might not feel comfortable with, on their terms, and be willing to wash their feet, so to speak, if you want to reach them.”

Working out of a van, Purchase and his crew hand out condoms also, as well as little bottles of bleach to clean needles--and blueberry muffins. A health worker is always with them, ready to offer counseling and other help.

Needle-Sharing Declines

County officials say they have found a “substantial decrease” in needle sharing as a result of the program and have referred more than 150 addicts to treatment programs after Purchase and his crew cultivated a relationship with them.

Opponents like Ellis and state lawmaker Charles Wolfe, a Spokane physician who failed this year to obtain passage of legislation against needle exchanges, note that backers have not demonstrated that the program slows the spread of AIDS.

Worse, Ellis asserts, the program is unnecessary because AIDS among local IV drug users is nowhere near as bad as in New York City and elsewhere. “They are using East Coast statistics to justify the idea here,” he said.

He bristled at the suggestion that he would just as soon let AIDS victims die. “We spend over $2 million a year on drug and alcohol programs. Does that sound like somebody who wants to let them die?”

Proof May Take Years

Another heath department spokesman, Terry Reid, said it is unfair to expect the program to demonstrate in less than several years that it slows the spread of AIDS. “How can you demonstrate success a year after the program starts when the incubation period for the disease is about seven years?”

Purchase puts it another way: “If we’re wrong, then we wasted a few cents a needle. If we’re right, we saved a lot of lives.”

As a steady stream of addicts stopped at Purchase’s table, Stephanie leaned against a wall and explained addicts’ willingness to use the program:

“We don’t have to give our name. We don’t have to do nothin’ but bring the rig man a dirty needle for a clean one, and the cops don’t bother us. It’s easy, and I think it’s workin’. Hey, dope fiends aren’t sharin’ their needles like they used to, ‘cause they can get clean ones without a lot of problems.”