He's young, maybe 21 at the most. His clothes look neat and clean, his hair recently cropped. When he gets out of a late-model SUV and crosses a downtown street, a plastic grocery bag in one hand, a woman gets out and follows him. She looks even younger, possibly in her teens, wearing tight jeans and a spaghetti-strap tank top. The man walks up to two other women, Beth and Lynne, who've been sitting on a stoop, and hugs one of them.
"That's 350," he says to Beth, handing her the plastic bag, which is full of containers of dirty syringes. She only has 200 clean ones to give him in exchange, though, and tells the man he now has a 150-needle credit. The teenage girl, who's been hanging back, asks whether the credit should be even higher since a similar thing happened last time. Beth says she'll credit them another twenty syringes, but the man shrugs.
"I'm not picky," he says, with a genuine smile. "I appreciate the service."
Lynne, who's been scanning the intersection, leans in to Beth. "There's an officer at the light behind you," she says calmly.
Beth opens her arms to give the man another hug, and the police car rolls by without pausing. The man and his companion then cross the street, get into their SUV and pull away. The interaction lasts just five minutes, but it could save the man, and those around him, from death or a lifetime of disease.
Beth and Lynne are volunteers for Underground Syringe Exchange Denver, or USED. At its most basic level, the group's mission is to swap injection drug users' used needles for new ones to stop the spread of diseases such as HIV and hepatitis C.
But syringe exchange advocates — and dozens of scientific studies, some of them federally funded — say syringe exchange programs have a far greater impact. For one, the population they protect from disease goes beyond the addicts themselves to their sexual partners and their children. The programs also prevent dirty syringes from being discarded so often in parks and dumpsters, lessening the chances that a child or a garbage man will find them. They can even benefit police officers, by reducing the likelihood that a cop will get stuck by a dirty needle while patting someone down.
Furthermore, supporters say, needle exchange programs serve as a way to educate drug users about safe sex, how to avoid an overdose and how to avoid injection wounds that require expensive — often taxpayer-funded — hospital visits.
Although most needle exchanges don't push drug treatment, they can help when a person is ready to get clean, and often make referrals to detox programs.
Several major cities, including Washington, D.C., Chicago and Portland, have exempted needle exchange workers and participants from laws that typically prohibit the possession of syringes. Boulder has a program through a partnership with local law enforcement that does something similar, and Denver is considering a pilot program.
But needle exchanges, like the one Beth and Lynne carried out — their third that afternoon — are illegal in Colorado. State health advocates have been pushing for years (and as recently as three months ago) to change that, but their proposals have been repeatedly rejected by lawmakers, who believe the programs will make drug use easier.
That's why USED has to operate underground and off the police radar. The members of USED asked Westword to use only their first names — and, in some instances, to change them — to protect their identities.
For Beth, needle exchange is personal.
She was first labeled an "at-risk youth" at age eleven. The youngest of three sisters, she was raised by her mother in northern New Mexico. Despite a loving environment, Beth grew up angry. She hated school, where she had few friends. Although she was bright, she was put in special-education classes for what teachers termed "behavior problems." So she acted up even more.
One night when she was in middle school, Beth stole her sister's car and drove it to a party. A police officer was waiting in her driveway when she came home, and over hot chocolate prepared by her mother, he explained to Beth how she'd worried her family. A court put her on probation for six months.
She kept violating the agreement by skipping school, and her probation period grew longer. When she was fourteen, Beth, who'd been smoking pot for a while, tested positive for the drug and was sentenced to a year in a juvenile treatment facility.
She says she had a great therapist there and excelled in her classes. When she returned to her public high school the next year, her former teachers pulled some strings to get her into an AP English class. Beth was excited, but her enthusiasm didn't last long. On her first day, the teacher snubbed her. When Beth asked about the work she'd missed, the teacher told her to ask her classmates. "She knew that nobody would talk to me," Beth says. "I was a total outcast." It was the last straw.