A young man in a pink IZOD shirt stood on a freezing West Atlanta street earlier this winter, seeming out of place as he waited to get a clean hypodermic needle.
His was the only white face among the heroin users in this bleak neighborhood called the Bluff, within view of the Georgia Dome and Georgia Tech, and he was the only one wearing pastel. His Patagonia fleece jacket, his white sun visor with the Masters golf tournament logo, seemed more appropriate in an East Cobb County subdivision or a rural town than here in Atlanta’s most notorious outdoor drug market.
But he is the new target demographic coming to a long-running needle exchange program in the Bluff.
“I’ve noticed more suburban license plates, from Cobb, Clayton, Paulding, Henry and on out. Even out of state,” said Mona Bennett, head of the Atlanta Harm Reduction Coalition.
Twice a week, Bennett and her colleagues pilot a used Winnebago to a street corner in front of the burned-out ruin of St. Mark’s church near English Avenue. Here they collect dirty needles from heroin users and hand out clean ones. On this day they are also handing out pizza, bagels, bottled water and condoms. She operates the needle exchange to cut down on the transmission of diseases such as HIV, which can come from dirty, used needles.
“We knew that the syringe was a vector of infection for HIV and viral hepatitis, and something had to be done, and no one seemed to be wanting to do anything,” Bennett told WABE radio station in a recent feature on the group’s quasi-illegal program. “As long as I have breath in my body we are going to be on that corner somehow in some way.”
But there is a more ominous and quicker-killing danger for users. Heroin use is rising, moving out of the ghetto to the suburbs and even to the upper reaches of society, as illustrated by the recent overdose death of actor Philip Seymour Hoffman.
And as the potentially deadly drug spreads out of its stereotypical home of poor urban neighborhoods, Georgia legislators have noticed and introduced one piece of legislation to provide ways for drug users to get anti-overdose drugs, and another “Good Samaritan” bill that would give immunity from drug-related arrests to those who call 911 to report overdoses or otherwise help. Several people died in Georgia in recent years because those with them during the drug use failed to render such aid for fear of being prosecuted when authorities arrived.
The rise in heroin use is sometimes ascribed to the nationwide ubiquity of pain pills such as OxyContin. Those addicting compounds snare some users, and can act as a gateway drug to heroin. And even former heroin users who have kicked for years, including the Oscar winning Hoffman, can be drawn back to heroin when the use of pain pills, legally or not, reignite those pleasure centers.
Hoffman’s overdose death earlier this month signaled a new chapter in the ongoing public health war against opiate abuse.
It’s an old war for Bennett. She has been fighting it for 17 years.
Using salad tongs, Bennett dumped dirty needles she collected in a red plastic Sharps biohazard container. She gave the young man ten new needles, and he went on his way. Those at the needle exchange will be less likely to use or share a dirty needle and transmit HIV or Hepatitis C. But the danger of overdose will always shadow users.
According to the Centers for Disease Control, 38,000 Americans died of a drug overdose in 2010, more than double the number from 1999. Most of those deaths were from pharmaceutical opioids, such as hydrocodone and OxyContin, according to CDC figures.
Georgia has cracked down on “pill mills,” making it harder to obtain such pain pills. One result is that some drug users have turned to heroin, which can be cheaper and easier to buy. Heroin use has increased by 50 percent nationally from 2002 to 2010, according to the Substance Abuse and Mental Health Services Administration.
Georgia overdose deaths have tripled since 1999. And the traffic is spreading beyond neighborhoods like the Bluff.
“You don’t have to go to the Bluff to buy drugs now,” said Heather Hayes, an Atlanta-based interventionist who helps bring drug users into treatment programs. “Now they’ll bring the drugs to you.”
The new customers for heroin include young men like Stephen Cardiges, a 20-year-old Eagle Scout from Lawrenceville.
Cardiges was a dedicated outdoorsman who taught blacksmithing and orienteering at Boy Scout camps and who, in the summer of 2012, had completed paperwork to enter the Navy. Then on August 12, a police captain knocked on his parents’ Lawrenceville door in the middle of the night to tell them their son was dead of a heroin overdose.
“I was the naive good Scout mom,” said Stephen’s mother Robin Cardiges. “I thought it was something in the movies.”
She learned that Stephen’s friends had driven him around in a car as he went into respiratory failure, then parked it in a Snellville driveway. The adults in that home called 911, but Cardiges was dead on arrival.
His friends “were afraid to take him to the emergency room, they were afraid they would be arrested, they were afraid to call 911,” said Robin Cardiges.
She is lobbying state legislators about her son’s death and how it could have been prevented. She and a small group of activists, including the mothers of other young people who have overdosed, advocate passage of Georgia House Bill 965, which would offer legal immunity from arrest to those who seek or try to help in cases of overdoses.
Justin Leef, a law school student and coordinator of GeorgiaOverdosePrevention.org, said 14 states have similar medical amnesty laws that offer limited immunity to those calling for help and those suffering the overdose.
“People are dying because nobody calls 911,” said Leef.
The Atlanta Journal-Constitution’s Georgia Legislative Navigator, which predicts proposed laws’ viability, gives it only a 33 percent chance of passing this year.
Tanya Smith, a lieutenant with the Holly Springs Police Department, said some prosecutors might object to letting drug users have a free pass. But Smith’s feelings on the topic changed when her 20-year-old daughter Taylor died of drug-induced asthma after her friends left her in front of a Jasper mobile home last September. She said her daughter had used heroin since age 18, and was trying to kick the drug.
“I think that most mothers would agree with me, if you ask them, ‘do you want the people that were with your child arrested for drugs, or do you want your child to be alive?’” said Smith.
A separate bill, House Bill 966, would allow doctors to prescribe and pharmacists to fill prescriptions of opiate blockers such as Naloxone, which can rescue drug users from an overdose, without fear of losing a license to practice. It would also protect from lawsuits those who apply the drugs to those who have overdosed. The drug comes in nasal spray or injectable forms.
“It’s a prescription drug,” said Bennett. “You’d make a request of your doctor. If you were on any sort of opioid, you should have access to this.”
Police officers in some states have been trained how to use the drug and carry it with them. It is credited with saving more than 120 lives in Massachusetts, where similar legislation was passed.
The ajc’s legislation nativgator gives it a 45 percent chance of passing this year.
Most of Bennett’s clients, lined up on a freezing Wednesday in the Bluff, know some of this already.
Bennett cautions the longtime users in her group never to shoot up alone. An overdosing junkie usually can’t bring himself back from the brink. She also discretely hands out a Naloxone kit to an older, gray-faced African-American man in a blue sweatshirt.
He’s seen it used in the past, he says. “Without it,” he says, “there would have been three funerals.”