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.
|
