"I just worked and hung out and smoked pot and drank a little beer," she says of that time. "It was pretty mellow, really."

When she was seventeen, though, Beth fell in love with an alcoholic, and things got complicated. She wanted nothing more than to be with him constantly, and he wanted nothing more than to hang out with his friends and get drunk. In the midst of the turmoil, she went back to New Mexico and visited some friends. She discovered that they had graduated from taking acid and doing speed to shooting heroin. They invited her to try it, and she did.

Once she saw what heroin use looked like, she realized that her friends in Denver were doing it, too. Beth didn't want to be left out. "That was the beginning of the end," she says.

Beth began using heavily, partly to numb the pain she felt over her breakup. "I didn't want to be present," she says. "I didn't want to be on the planet. Heroin, it lets you be here without having to be here."

Her life soon unraveled. She met another man through her friends in the injection drug world and eventually married him. But they lost their apartment and took to living in run-down hotel rooms they shared with other addicts. They worked day labor, scrubbing toilets and picking up trash, to support their habit. (Beth says she was always too "chickenshit" to steal and too revolted to become a prostitute, common ways that users make money for drugs.) They spent almost all of their money on dope.

"I always say I never worked so hard for nothing in all my life," Beth says.

While she was using, she heard about hepatitis C, a virus that attacks the liver, from other drug users and outreach workers. The Centers for Disease Control and Prevention estimate that 90 percent of injection drug users get infected from sharing dirty needles. Beth was curious and started talking about the disease with other users, warning them about dirty needles and encouraging them to use clean ones and to bleach their injection supplies, or "works." For her, it was a turning point.

"I remember the first time the concept of harm reduction was presented to me, I was like, 'Oh, my God, why doesn't everybody know about this? This is the most beautiful, logical thing I've ever heard,'" she says. "Harm reduction" is industry-speak for ways to keep drug users safer until they're ready to quit. It's based on the notion that every life is worth saving, even that of a junkie.

Three years after Beth started shooting heroin, the consequences of her drug use — homelessness, unemployment, paranoia — grew tiring. She started methadone treatment at 21 and quit using at 22. But Beth, now thirty, didn't stop spreading the message to junkies that clean needles were key; in her spare time, she became an advocate for users.

It was still just talk, however, since needle exchanges are illegal in Colorado, which frustrated Beth. "It was just this conversation, this circular conversation that went on for way too long," she says. "For years and years, I'd sit in rooms...with people and we'd be talking about the needs of the injection drug use community...and, of course, syringe exchange programs would always come up. Every single time, in every single conversation, again and again and again."

Finally, Beth decided to take action on her own. An anonymous person had donated thousands of clean syringes after hearing about her work, and Beth figured out how she could get some grant money from the North American Syringe Exchange Network, a Washington-based organization that supports needle exchange programs. She asked a friend who had experience working with drug users if he wanted to help her start an underground program. They recruited two more people and started holding meetings to figure out the details of how, where and what they would exchange.

On January 12, 2008, USED was officially launched. Since then, it's grown to eight members who are available to exchange syringes for a total of nine hours per week. In February alone, they gave out more than 1,600 clean needles.

Imagine, USED members say, if the law allowed for legal, fully funded syringe exchange programs in Colorado, where the estimates of current injection drug users range from 11,500 to 18,000 people. Denver has a disproportionate share; the city's Office of Drug Strategy figures that there are 4,490 junkies in the city.

So far, USED has exchanged with 27 of them, though their clean needles have reached dozens more through what is known as "secondary exchange": users exchanging with other users. Still, there are thousands more out there.


For a while in the late 1980s and early '90s, it seemed that Colorado was on the cutting edge of harm reduction.

It started with Boulder County. In 1989, the county health department discovered that seven residents, all IV drug users, were HIV-positive. Six of the seven were married couples with children. At the time, Anne Guilfoile was in charge of AIDS prevention for the county. "It was a compelling story. We could diagram out these families and say, 'This is how many kids [are affected],'" she says now. "That was a different picture than what most people had in mind when they thought of drug users, and the consequences of doing nothing were really clear."

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