My experience in Washington was consistent with Fauci's view. Addicts who came for needles were generally in their 40s and 50s. The availability of clean needles no more caused their addiction than the provision of clean shot glasses would cause alcoholism.
The main purpose of needle exchange, according to Reggie, the supervisor of the mobile unit, is to keep people alive until they can get clean -- a process that can take years, if it happens at all. Needle-sharing is the third-leading cause of HIV infection in our nation's capital. It is also a major contributor to the spread of hepatitis C, the main cause of liver transplants in the United States. Reggie is well acquainted with these facts because, while an addict, he contracted both diseases. "If they had a truck like this in the '60s, '70s and '80s," he told me, "maybe I wouldn't have gotten infected."
The staff of PreventionWorks! builds long-term relationships with people no one else knows by name. Because of this, they have a good feel for when addicts are ready for treatment. While I was in the RV, Reggie signed up two addicts for detox. Teefari used her own car to drive one addict, with whom she had been working for eight years, to treatment. "He's ready, ready to go," she said, fighting tears.
Critics claim that needle exchange programs create a moral hazard by legitimizing drug abuse. But it does not legitimate drug abuse to help people with the clinical disease of addiction avoid other deadly diseases until they are ready for help. Sacrificing the lives of addicts to send an "unmixed" moral message actually sends a troubling moral message: that the unwanted have no worth.
As each addict leaves the RV, Hazel -- who was an addict on the street herself four years ago -- tells them, "I love you." When I asked her why, she said: "If someone years ago had told me they loved me, it might not have been so long."
Street addicts are connected to the rest of us by only a few invisible strands -- people such as Hazel, Reggie and Teefari -- and those strands should not be severed.