At Anchorage’s busy syringe exchange, everyone has a story

In the midst of an opioid epidemic, Alaska's biggest syringe exchange has been setting records for use. More than 100 people visit the location, in an unassuming office building on Fireweed Lane, every day to get clean needles and other supplies for safer injection drug use.

On Wednesday, Four A's facilitated 106 exchanges, slightly below its average. They handed out 2,929 syringes and took in 3,244, according to Matt Allen, HIV prevention and education coordinator.

Alaska Dispatch News talked to some of these syringe exchange users between opening at 9 a.m. and closing at 5 p.m. that day. To protect their anonymity, they are being identified only by their age and gender. Their stories offer a window into the often-hidden reality of people who are actively addicted in Anchorage.

9 a.m., male, 52

When Four A's unlocked its doors at 9 a.m. Wednesday, one man was already waiting. He leaned his bike against the wall in the lobby outside and came in to pick up a package of 50 needles. He does that twice a week, he said, and has been coming for three years. He'll go through about a third of what he picks up, he said. The rest are for his friends.

[Related: Exploding demand for clean needles pushes Alaska's biggest syringe exchange to the edge]

"If I don't have them, they're using dirty needles or using each other's," he said. "Most of them just don't care."

As a heavy user, his life is horrible now, he said. He's separated from his wife, who told him he can't return until he's been sober for a year.

Now, he's living in a tent, he said, and moves around regularly. He panhandles during the day. He was once left in a snowbank by friends while he was overdosing. That night, he said, Narcan saved his life.

"I've got to call (the Ernie Turner Center) every morning and try to get in. And they have openings; it's just I've been kicked out of there so many times, or I've left, because you just get so sick" from withdrawals, he said.

Before he pushed his bike through the lobby and out onto Fireweed Lane, he considered what it might take to get clean.

"I have no clue. I really don't. Start doing what Jesus wants me to do — that's the only thing that's really gonna work," he said. "Which is easier said than done."

9:40 a.m., male, 29

Halfway through the morning on Wednesday, a 29-year-old man came in for clean needles — ultra-fines, the smaller ones favored by users whose veins are getting harder to tap. He's a soft-spoken, bearded guy in dirt- and grease-stained clothes. His hands and arms are covered in scars.

His drug use began with prescription medication, graduating to heroin about three years ago, he said. He wants to stop, he said, so he can get custody of his three children back.

"I'm currently on pretty much every waiting list to get into treatment programs," he said. "They're just six months or longer, most of them. I've found it's pretty difficult to get help if you want it, which I do."

He said he worked full time all summer. He's done mechanic work, lawn maintenance and drywall. Recently he was clean for about three weeks. It was good: He was making progress on "working his case plan" with the Office of Children's Services.

Then there was a bad day. He made a phone call, and was back on heroin again, he said. The needle exchange, he said, is a place he can come "and not be judged."

Being an addict in Anchorage means security officers follow him in stores and people look at him strangely, he said.

"My clothes aren't dirty because I'm a drug addict," he said. "My clothes are dirty because I'm a mechanic."

10:28 a.m., female, 29

Relationship and family stress seems to trigger drug use for a 29-year-old mother of one. It was like that when she started using 10 years ago, and it's what pushed her back to it after four years of sobriety once, she said. And just when things are tough, just when she's thinking about getting high, she said, she runs into the wrong people.

"It just seems to happen that when something just pissed me off that day, or something went wrong, that I run into either my old dealer or my friend that has (drugs) on them," she said.

She picked up 20 syringes that morning, and planned to use them for methamphetamine. She has seen a close family member go through heroin withdrawals, an experience that was so awful, she said, she resolved to never touch that drug.

"I will never let myself go that far down deep into the rabbit hole," she said.

She considers herself a recreational drug user, and a safety-conscious one at that. She said she did research about shooting up before she started doing it, and would never inject with a used needle, even if she alone had used it.

And she considers herself on the road to recovery, attending support group meetings only when she's sober.

"I barely use, especially now that I'm homeless and I live at a shelter," she said.

11 a.m., male, 40

Around 11 a.m. he walked in sweating but cold, suffering through what he said was his eighth day off heroin. While his kit of syringes was being packed up, he ate Airheads candy. People say the sugar helps with the awful feelings of withdrawal.

He wore athletic clothes and Nikes, his hair in a ponytail. He said he's from the Dominican Republic by way of the Lower 48, and he came to Alaska to stay out of trouble. But at age 36 he tried heroin. He's been addicted for almost five years now.

"I got caught up in this tar stuff. Over there, heroin is in powder form. Up here, it looks like a piece of chocolate."

He hates the need for it, waking up in the morning craving the drug.

"I lost my family over it," he said. "My baby mama. I was with her a long time."

She came from the Dominican Republic to Alaska, and had no experience with drugs, he said. She didn't like finding his needles, he said.

"I just lost her," he said. "Now she won't even let me see the kid. That's mostly why I'm trying to get clean. I want to see my boy."

He and his current girlfriend have been trying to "hold back" from using recently, he said.

"Me and my girlfriend, we're trying to get off this so hard," he said.

This time they've gone eight days, he said. But he feels terrible: sweaty, but his palms are cold. He can't stop fidgeting. He hasn't slept in two nights. All night, he said, he was up sick to his stomach.

In the morning he'd gotten up and walked to the needle exchange, all the way from East Anchorage near the Northway Mall.

He said he knows if he's going to get some heroin, clean needles are the first thing he needs.

"Maybe I'm going to get some dope. Maybe I'm not," he said.

He walked out the door.

4:45 p.m., female, 50

Shortly before Four A's locked the door at 5 p.m., a 50-year-old mother of two came through. She bared her forearms as she explained that she's not a user. This was a grim errand she did for her adult son and his friends.

She believes her son uses methamphetamine and his friends use heroin. She's confident that they will not use clean needles if she doesn't bring them by.

She calls his living conditions pitiful. They don't have food there, she said. She fears she'll be robbed one day, and prays God is looking out for her when she visits. Sometimes she asks questions about why they continue to live like they do, drawn to a drug that puts them to sleep. None of them can give her an answer.

"He's lost quite a few friends, actually. More than I can count on one hand."

Her heart breaks for her son, who is not yet 30.

"On a regular basis, I beg and beg and talk to him. He gets tired of hearing it and then he won't come home. He won't come around."

At Four A's, Rachel Swenarton, of Jesuit Volunteer Corps Northwest, offered her a Narcan kit, part of the state-run Project Hope, which aims to get the overdose rescue drug in the hands of people who might use it in a crisis. She took it.

Her son knew of a woman who died because other users feared that calling for help would land them in jail. That could've been her son who died, she said.

"There are no friends in that clique. They're just a bunch of users I think that hang around each other to see who can get what and who's got what," she said.

"(If) circumstances arises that something like that would happen to him, they'd leave him just like they did her."

She had mixed feelings about coming into Four A's, but said she won't be kept away by the stigma of being mistaken for a user. That would be selfish, she said.

"I had to stop and think about it. I don't care what nobody thinks. I really don't … It's just more important to try and help those that won't do it for themselves."

As she headed for the door, she said she planned to call her son and see if she could come by.