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http://www.tpan.com/publications/positively_aware/mar_april_01/Onein62.html
One in
62: Young Injectors
by
Laura Jones
Due to the usual limitations inherent in
researching a population as “invisible” as injection-drug
users (IDUs), the number of injectors under age 25 is hard to
determine. However, it’s common knowledge among adolescent
health workers and those operating syringe exchanges in large
American cities that use of injection drugs among youth is
high and rising. Rapidly increasing rates of injection-drug
use have been found among homeless and transient youth—some
studies indicate that IDU rates in these populations are close
to 50%. But many young adult injectors also hold jobs and
maintain regular living situations even while using drugs, and
many school-age youth inject drugs, hormones, or steroids
while living at home. Young injectors also live in rural or
suburban areas that are not targeted for research. These young
people will not be counted in research focusing on “street
injectors,” even though their numbers may also be high.
Youth
Injection
Dan
Bigg doesn’t need numbers to “prove” more and more youth
are injecting drugs—he sees them regularly through his work
with the Chicago Recovery Alliance, an organization providing
legal syringe exchange and other harm-reduction services to
IDUs in the Chicago metro area. Bigg notes that the number of
young injectors taking advantage of CRA’s services “has
increased steadily over the last nine years.”
“Over
the years, working with young injectors to reduce risk has
been a progressively larger part of our work,” states Bigg.
“Most of all the under-24 injectors are white, and around
half female.” While some young injectors also shoot cocaine,
speed and other substances, heroin is still the most commonly
injected substance in this age group.
Bigg estimates that there may be around
6,000 young injectors utilizing CRA services in Chicago and
the surrounding suburbs, “based on 10% of those we see, and
an estimated 60,000 injectors in the area.” He notes also
that most of the young injectors he sees initially come from
the suburban areas surrounding the city of Chicago, and that
the younger injection crowd “is much whiter” than the
over-24 IDUs who use CRA’s harm-reduction services.
Jae’s
Story
“It’s
a part of my history that I’m trying to deal with but
haven’t quite figured out or come to terms with.”
27-year-old Jae* began injecting drugs in
1990 at the age of 17, while working as a political activist
in Seattle. In 1993, she left Seattle and returned to the East
Coast, where she stopped using injection drugs. She is now a
graduate student, married, and the mother of a preschool-aged
child. “I haven’t used needles since I left, in 1993. I
nursed my daughter for longer than I shot heroin. I still have
scars on my arms, however, from shooting up many times a
day.”
While Jae doesn’t fit the profile most
people associate with injection-drug users, her story would
come as no surprise to those knowledgeable of youth injection
trends throughout the United States.
“I
come from a middle-class background, with educated parents. I
went to good public schools, management programs, was a
National Merit Scholar in 10th grade—then I dropped out of
school to travel around the country with a Greenpeace job. I
ended up in Seattle, and soon had a new roommate, a guy in his
mid-twenties who urged me to try shooting cocaine. After a
week of deliberation, I decided it was my mission in life to
experience everything I could and this was a chance I
couldn’t pass up.
“So,
of course, blah blah blah, flash three years ahead to me,
totally strung out on heroin, having done (many times) each
and every thing I had sworn I would never stoop to, 20 pounds
too skinny, with everything I owned in my backpack.”
During her time as an injection-drug user
in Seattle, Jae’s injection peer group consisted of
“mostly white twenty-somethings, about 2/3 male, a few older
black and Latino men, and some mid-teenage street kids. Most
of the people I hung out with were involved in some way
in…the intellectual hippie/punk scene.”
Also contrary to popular opinion, Jae and
her peers were not primarily “initiated” into
injection-drug use by older, hardcore injectors. “Most of
the people I knew sought it out for themselves…I think most
often someone would hint at their own needle use and the
people who were interested in that would follow through by
pursuing that person…the boyfriend/girlfriend element, when
it occurred, really increased the pressure.”
She adds “the young people I hung out
with were really into exchanging needles—not the case with
the older folk—but not safe sex.”
In addition to an age-specific enthusiasm
for needle exchanges, Jae also noticed a generational
difference in comfort level with injection, as well as
specific youth-culture and gender issues that contributed to
her injection use. “The older people I knew who did dope
were either out-and-out junkies or dead set against
needles—mostly against,” she states. “The young people I
knew, even those who didn’t use weren’t too freaked out by
needles. They looked at it as a clinical, exact way to get
really high. We definitely romanticized [poet William S.]
Burroughs and all the dead rock stars and the whole nihilistic
fuck-everything junkie image. Also, shooting up was as bad
as you could get…so, especially for the teenagers, there was
that badness appeal….And for me, as a young woman, I
liked showing how tough I was, I mean, I wasn’t scared of anything.”
Jae
has repeatedly tested negative for both HIV and hepatitis C,
and considers her access to syringe exchange services the main
reason she was able to avoid infection. “At first I would
never have shared needles—being an educated person, I knew
how dangerous it was. Later, by the time I was 19 or so, I
cared so little about my life that I’m sure I would have
used dirty needles if the needle exchanges had not been so
available and convenient. As it was, I had new needles every
week, always had plenty of bleach, and never had to use a
dirty needle.”
The
Importance of Needle Exchange
The
Centers for Disease Control estimate that the percentage of
cumulative AIDS cases directly attributable to IDU in youth
under age 25 are around 9% for males 13-19, 14% for males
20-24, 20% for females 13-19, and 31% for females 20-24. The
percentage of cumulative reported cases of HIV infection
directly attributable to IDU in that age group is 5% for males
13-19, 6% for males 20-24, 7% for females 13-19, and 12% for
females 20-24.
These figures do not take into account
young people infected through sexual contact with an HIV
positive injector, nor can they predict the number of HIV
positive youth who are infected but either have no access to
HIV testing or choose not to test.
Research during the 1990’s yielded a
great deal of data showing that syringe exchange programs can
dramatically reduce the rates of new HIV and hep C infection
in IDUs, and younger injectors in particular appear anxious to
take advantage of available exchange programs. Organizations
such as the American Medical Association, American Academy of
Pediatrics, and the World Health Association all support
making such programs available throughout the United States.
But so far, federal policy has not been enacted to establish
such programs. Currently, syringe exchange programs in the
United States receive funding from their state, city or county
governments, as well as donations from private organizations
and individuals, and only under the heading of research. All
programs are subject to the restrictions their state places on
programs providing syringes and other “paraphernalia” for
the purpose of injecting drugs
Dan Bigg sees a link between the
perceived IDU population and the slow turnabout in
establishing a nationwide policy of syringe exchange, and
wonders if the increasing visibility of young injectors will
have an effect on national syringe-exchange policy. “There
are many effective ways to reduce the harm from heroin
injection which have been slow to be adopted to
date—seemingly because of the race and class of the majority
of users. As heroin use is increasingly seen as a more white
and suburban kid kinda problem it may be society will be
willing to take effective action to reduce sickness and death
associated with heroin use.”
Jae doesn’t care what provokes the
change. Like many who have clearly benefited from syringe
exchange and other harm-reduction services, she is outspoken
about the need for such programs.
“I’ve
been incensed by the local movements against needle
exchange—how can you be against something that saves lives?
And I feel compelled to share my story if there’s a chance I
can help people. I mean, there are bad junkies, and pretty
much all junkies do creepy things, but a lot of them are also
smart and funny and kind and utterly human.”
*
Jae’s name has been changed.
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