Remembering US Needle-Exchange Pioneer David Purchase

The needle-exchange movement has been an important development in the effort to reduce the spread of infectious diseases, especially HIV/AIDS, among drug users. A good amount of credit for the growth of the movement in the United States can be attributed to David Purchase.  In fact, there are unconfirmed reports that Mr. Purchase’s needle exchange work in Tacoma, Washington beginning in 1988 was the first such offering in the United States.

A drug counselor, Mr Purchase used the $3,000 he won in a settlement after being struck by a drunk driver while on his motorcycle to begin to provide clean syringes to his clients. Sadly, Mr Purchase passed away from pneumonia on January 21  at the age of 73. His Point Defiance AIDS Project and the North American Syringe Exchange Network are responsible for keeping 15 million potentially harmful syringes off the streets each year.

His obituary in the New York Times for Mr Purchase detailed the importance of his work.

“Whether or not he was literally the first to hand out syringes to stop AIDS, he was undoubtedly the godfather of needle exchange in America,” Mr. Nadelmann said in an interview. “He was a mentor and adviser to activists and public health workers around the world.”

In the early days of the AIDS epidemic, when many critics argued that needle exchanges encouraged drug use, Mr. Purchase “was able to get political acceptance in Tacoma and obtain public funding,” said Don Des Jarlais, the director of research for the Chemical Dependency Institute at Beth Israel Medical Center in Manhattan.

When Mr. Purchase set up shop, he was without official government sanction or financial backing and, he said, was prepared to go to jail for 90 days for the misdemeanor offense of possessing drug paraphernalia. But he soon received support from the Tacoma police chief, Ray Fjetland, who suspended enforcement of the syringe law.

Mr. Purchase also worked closely with the county health department. The program became something of a model.

By 2011, according to a survey by Dr. Des Jarlais, there were 197 known needle-exchange programs in 36 states, the District of Columbia and Puerto Rico. That year, those exchanges distributed more than 36 million syringes.

“Given that over the course of the epidemic there have been several million people who injected drugs,” Dr. Des Jarlais said, “the efforts of Dave and people like him have literally saved hundreds of thousands of lives.”