“T hese guys keep the costs down for me,” Flaco says. On a Friday evening the 52-year-old comes to collect needles and tourniquets from the syringe-exchange van parked beneath the west Bronx’s elevated train line. Flaco started using drugs at the age of six. The free needles keep him safe, he says, and make things just a little bit easier.
The van Flaco frequents is run by OnPoint NYC, one of 185 syringe-exchange programmes across America. Having started as an underground effort by non-profit groups in the 1980s, such exchanges took off as the AIDS epidemic burgeoned. The logic was simple: if barriers to obtaining needles were removed, drug users would stop sharing them and rates of HIV infections would fall. The schemes were a test of “harm reduction”, the idea that de-emphasising abstinence and destigmatising drug use would improve outcomes for addicts.
Critics feared that harm reduction would encourage drug use. Upon launching a pilot needle-exchange programme in New York City in 1988 the city’s health commissioner was accused of running a genocidal campaign against black constituents. That same year Congress banned the use of federal funds for syringe exchanges.