To Shoot Up or Not to Shoot Up – Why That’s Not the Question

Kait Leonard

In the middle of Skid Row, men and women filter into Homeless Health Care of Los Angeles (HHCLA) on a sunny, Thursday morning. Each holds a bag containing used syringes. These needles were used to shoot heroin into arms, legs, feet, any body part not already too damaged. These bags will be traded for a new one containing clean syringes and the supplies necessary to cook and inject drugs as safely as possible

Needle exchange programs rub some people the wrong way. We live in a society that rates drugs. Alcohol is fine over a certain age, and marijuana is becoming more and more acceptable. After that things get murky. Some folks even think hallucinogens are fine, but when you get to injectibles, the disapproval runs deep.

We’ve all seen the documentaries showing the filthy addict passed out on a toilet with a hypodermic needle still hanging from a vein. We’ve heard of the “shooting galleries” where people go to inject, and sometimes die. There’s just something about intravenous recreational drugs that makes them sound like a step too far.

As I stood in the lobby of the clinic, which provides needle exchanges through its Center for Harm Reduction program,  a man came to the counter speaking quickly, arms in herky-jerky motion and eyes darting everywhere.

“I’m a tweaker,” he said, glancing at me.

“He’s a hero.” added Darren Willett, Director of the Center for Harm Reduction with HHCLA.

Willett explained that this man had given Narcan, a drug used to reverse opioid overdose, to more than one person on the verge of death. He gets the Narcan from HHCLA, where they give it out after training people to administer it. The tweaker, or perhaps the hero, took the compliment in stride. The Center also has an Integrative Treatment Program and a Housing Program.

I’m ashamed to admit that I expected to be shocked by the those who showed up to get new needles. But being the professional that I am, I braced myself to remain stoic no matter how horrible the scene became. I anticipated seeing addicts stumbling through the door, possibly sick, ranting, or even violent. But no matter, I would bravely confront whatever came my way.

Nothing came my way.

People with old needles talked and joked with those on the other side of the counter. Clearly, many were regulars because the staff knew their names and asked about things going on in their lives. The whole scene reminded me a little of being in a coffee house in Hollywood. Just a group of people, perhaps a bit scruffy, shooting the breeze while waiting for a latte, or whatever.

Still, the people who came to the needle exchange weren’t going to be dealing with a case of caffeine jitters when they left. At some point that day, each of them would be cooking heroin and injecting it. Some would overdose. This wasn’t Starbuck’s.

So I understand objections to needle exchange programs. It can seem like the normality of the interaction gives a thumbs-up to shooting up. And there’s the problem of the slippery slope. What comes next? Injection sites, where people can go and safely inject themselves? Decriminalization? Who knows?

Joe, standing outside of the HHCLA needle exchange clinic, says he wouldn’t be on Skid Row for long, “because that just isn’t who I am.” Photo by Kait Leonard

I spent hours at HHCLA. I talked to people, some friendlier than others, just like everywhere else. But here’s the thing—I didn’t hate even one person. Isn’t hatred what it would take to choose to allow them to suffer? The people I met struggle with addiction. Most aren’t even trying to get high. They’re simply hoping to avoid getting “dope sick,” the term used for the horrible symptoms that occur during opiate withdrawal. And the fact is, these people were going to shoot up with or without a new needle.

We could deny clean needles. We could allow the spread of HIV, hepatitis, and anything else that can be passed in blood. We could condemn addicts to tissue damage and infections. We could let them suffer because we need to make a statement that some drugs are very, very bad.

Before I left, I got trained to use Narcan and took a selfie with Joe, a very friendly man outside the clinic who explained that he wouldn’t be on Skid Row for long because that just isn’t who he is.

I honestly wished him luck. 



Kait Leonard

Kait Leonard, Ph.D., holds graduate degrees in literature and psychology. She shares her home with five parrots and her American bulldog, Seeger. Her writing interests include psychology, holistic wellness for both people and animals, and whatever human interest topics cross her path.

1 Comment
  1. Perhaps the unspoken point in Kait’s article is that it is easier to hate people who we do not know. By going to Skid Row and into an environment where she got to see them as people, Kait reminds us that each of us is a human being not just an abstraction painted and disparaged by the media and others who never take the time to talk to them, the act of which might force us to see them in a different light.

    Thank you, Kait, for your insight and for these wonderful articles.

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