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Bill Day is a familiar face out under the San Antonio viaducts, where skinny addicts shoot drugs into their bruised arms. Day, 73, is the source of something many of them desperately need: clean syringes, the distribution of which Day sees as his calling from God to prevent the spread of disease.
Bill Day is a familiar face out under the San Antonio viaducts, where skinny addicts shoot drugs into their bruised arms.
Day, 73, is the source of something many of them desperately need: clean syringes, the distribution of which Day sees as his calling from God to prevent the spread of disease.
Authorities see it differently. Backed by an opinion from the Texas attorney general, District Attorney Susan Reed says she can prosecute anyone in possession of drug paraphernalia, regardless of the reason they have it.
Unless the legislature makes it otherwise -- which some members say they hope to do next year -- Day can do no more than exchange nods with the addicts he once helped and wonder what will happen to them. He's been off the streets since police ticketed him in January.
"I am really angry," Day said, pointing to piles of used needles in the brush under a bridge on the city's west side. "Every day we're not out here, someone is getting HIV."
Richard Wolitski, acting director of the division of HIV/AIDS prevention at the Centers for Disease Control and Prevention, said three major reviews of needle-exchange programs have shown that they "decrease HIV transmission and do not increase the use of illegal drugs." The programs also provide drug users a way to get into treatment programs, Wolitski said.
"No one says to themselves, 'They're giving away syringes, let's go get some heroin,'" said Day, who cofounded the nonprofit Bexar Area Harm Reduction Coalition in 2003. "You're first the addict and you do it whether you have a clean syringe or not."
But David Murray, chief scientist for the Office of National Drug Control Policy, said recent research shows needle-exchange programs don't change addicts' behavior.
"When it comes to the distribution of needles, we know that it carries an enablement of continued drug use," Murray said. "And we fear, the evidence is strong, that it does not succeed in its effort to control the contagion" of disease.
Murray said needle-exchange programs don't address the core of the HIV/AIDS problem, which is the high-risk behavior associated with drug use, such as venereal disease and multiple sexual partners. He advocated instead funding treatment programs.
According to the North American Syringe Exchange Network, there were 186 syringe-exchange programs in 36 states; Washington, D.C.; and Puerto Rico as of November 2007.
Some exchanges are authorized by state or local law, some aren't, and some operate underground. But even where they aren't authorized it's rare for law enforcement to take a hard line on such programs, said William Martin, a senior fellow at the James A. Baker III Institute for Public Policy at Rice University. He said authorities often look the other way because they believe the needle-exchange programs provide a public service.
Day, who has AIDS but didn't get it through drug use, started passing out needles in San Antonio regularly a little over a year ago. Around the same time, the state legislature authorized Bexar County, which includes San Antonio, to set up a separate pilot program.
State representative Ruth Jones McClendon, a Democrat from San Antonio, said lawmakers hoped to use the pilot program to consider passing a statewide program during the 2009 legislative session.
But Reed said in August that anyone with a needle, even in the program, was breaking the law. "It's just a question of law," she said.
Attorney General Greg Abbott backed up Reed, saying people who possess drug paraphernalia as part of a needle-exchange program can be prosecuted because the law didn't specifically exempt them.
Reed said the cases against Day and two associates cited with him are on hold until the Legislature meets next year.
Jones McClendon, whose amendment created the pilot program, said it was never lawmakers' intention to subject anyone to prosecution.
"To me it seems quite shortsighted that our state lags so far behind in this important concept of preventing such diseases," she said.
Day said if he gets back on the streets, it will be months before he's able to regain the trust -- and dirty needles -- of those he's worked with.
When he started, he would get only 15 or 20 dirty needles a month because the addicts didn't trust him. In the six months before he quit, he said he got back more than 10,000. (AP)
