A Denver non-profit called the Harm Reduction Action Center has been offering injection drug users free clean needles for nearly a year. We hear from injection drug users and from the center's director, Lisa Raville. We also learn about the difficulty of obtaining treatment from Art Schut at Arapahoe House, the largest non-profit drug treatment center in the metro area.

This is a transcript of Eric’s story. 

Ryan Warner: If you talk to people familiar with Denver’s street culture, they’ll tell you heroin and other hard drugs are easy to find.

Knoll:  I’m pretty sure we could even walk and get it done in half an hour. 

Warner: That’s what injection drug user Fowler Knoll told CPR’s Health Reporter Eric Whitney. Eric has this look at how Denver’s new needle exchange program for drug users is working. 

Reporter: Knoll says Heroin and Coke are not only easy to find, they’re pretty cheap, too.

Knoll: Basically, if you want to do what a lot of people call a speedball, or around here they call it a one-and-one, one part heroin, one part cocaine - so, you’d need about 20 bucks, or maybe 16 if we were in the mood to stick around and maybe get the price down. 

Reporter: Harder to find, until recently, has been a clean needle to inject those drugs. 

Needle exchanges for street drug users were illegal in Colorado until 2010. A new state law opened the door, but it would take two more years to set up a functioning, large scale needle exchange in Denver. They can be hard for neighbors to accept, and plenty of people think they’re a bad idea overall.

McNulty: In my opinion, having needle exchange programs only encourages the use of illegal drugs. You are putting the tool out on the street which encourages the use of this illegal drug. 

Reporter: That’s Colorado House Speaker Frank McNulty, a Republican from Douglas County. He voted against the state law in 2010. His argument is eminently logical: Make the tool that addicts need to inject drugs harder to get, and fewer people will use them.

But logic doesn’t really apply to people who are hooked on heroin. People like Cynthia Standing Water.

Whitney: It’s not like, oh, well, I can’t find a clean needle, I’m not gonna use?

Standing Water: No, it’s not like that at all. 

Reporter: Standing Water knows people should never share needles. She knows that doing so puts her at risk for HIV and hepatitis C infections. She knows that, but she’s done it.

Standing Water: There was probably about five of us, and nobody had a needle. Well, one guy goes, well, I know – he went down by the railroad tracks, he rolled over a log or a railroad tie or something like that, and he pulled out a needle that he had stashed. I was like, oh, God no.  I said you guys gotta be kidding me. He goes, it’s OK girl, we’ll let you go first. And I’m thinking – and know what? And I did, and it was sick. And after me, I don’t know how many people used it. But, oh my God, dude. No, they’re not, they’re not going to say, oh, I don’t. No. It’s not gonna happen like that.

Reporter: Stories like that are what drive Lisa Raville to provide clean equipment to injection drug users. Raville runs the largest of two needle exchange programs in Denver, at the Harm Reduction Action Center just south of downtown on Santa Fe Drive. 

Raville: We live smack-dab in the middle of reality, and people are using drugs, and they’ve been using drugs forever. This is just what’s going on in our world, and so we believe that we want to keep people safe right now.

Reporter: So five mornings a week, Raville and her team give away new needles, sterile gauze and clean “cookers,” people can use to turn powdered heroin they buy on the street into an injectable liquid.

Raville doesn’t take a position on whether people should or shouldn’t use drugs.

Her Harm Reduction Action Center does everything they can to help people who come there get into rehabilitation. Bu she knows not everyone will choose that, at least not right away. 

Raville: If they want to live a life of recovery, we believe that they shouldn’t have to live with HIV or viral hepatitis, we’re also getting them tested as well. So we’re reclaiming individuals right now, during their use, because we think there’s one positive thing they can do today. We do that in a non-judgmental and compassionate way. 

Reporter: Most public health officials in Colorado supported the state’s needle exchange bill in 2010. Among them, Dr. Mark Thrun at Denver Public Health.  His agency tested blood from a sample of the city’s injection drug users in 2009, and Thrun says it showed they were at huge risk for getting serious infections. 

Thrun: Of those almost 500 people that we tested that year, 73% -73%!-  were infected with hepatitis C. That compares to probably about 1.5% in the overall Colorado population, so enormous disparities. About 5% were infected with HIV, and that compares to probably a half-percent in the general population in Colorado.

Reporter: Hepatitis C is hard on the liver, and can be deadly 

Denver’s needle exchanges have been operating for less than a year. No one has done a follow-up survey to see they’re reducing Hep C or HIV infection rates. Around the world, though, cities with longer-standing syringe exchanges have lower infection rates than cities that don’t.

Those arguments helped compel a majority of Colorado lawmakers to OK needle exchange legislation, but they don’t sway everyone. Again, Colorado House Speaker Frank McNulty. 

McNulty: It doesn’t make sense to encourage the use of illegal, illicit drugs. They hurt kids, they hurt families, they hurt our communities, and we need to stay focused on what the real problem is, and that’s helping people kick their addictions, and there are lots of good private programs out there to do that, there are many public programs out there to do that, and that’s where our focus needs to be. 

Reporter: Needle exchange backers, like Dr. Thrun at Denver Public Health say the city needs both treatment programs and syringe exchange. That’s what research suggests. 

Thrun: Actually the people that sought services through syringe exchange were more likely to end up reducing their drug use, were more likely to get into treatment centers. That’s huge from a public health perspective, in my opinion. 

Reporter: Lisa Raville, who runs the needle exchange on Santa Fe, says that so far this year 85 people have asked them for referral to addiction treatment. That’s out of about 400 people who come by regularly.  That makes her feel good, because it means they’re building trust with their clients, most of whom are homeless and have suffered some kind of psychological trauma. Many are mentally ill, she says, or are veterans from the recent wars or Viet Nam. Raville says winning her clients’ trust is the first step to them accepting help that can save their lives. 

Raville: And it’s a long relationship that we start to build. These folks sometimes don’t trust anybody for a very long time. Sometimes they’ll sit in the corner with a cup of coffee and they can’t believe a place like this exists, because we’re nice, and we’re glad to see them, and we’ve got health education classes, and we want to talk to them about what’s really going on in their life. They don’t have to lie or bullshit with us. We can push forward together, that’s why we’re here. We’ve got the resources and referrals that they may not have out there.

Reporter: It’s been eight months since the Harm Reduction Action Center has been running its needle exchange. Raville says they’re on track to meet their goal of getting about 500 people enrolled in their first year.

Beyond that, they’re trying to get a bill next legislative session to legalize off-site syringe exchange. Legally, the only place they can give users syringes is at the downtown location. But it can be hard for people to make it there during their limited hours. Raville regularly sends out teams of outreach workers and she’d like for them to be able to offer syringes on their rounds of places homeless addicts gather. 

[Photo: Flicrk user NathanF]