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2006-2007 | PreventionWorks!
1407 S Street, NW 202-588-5580
Washington, DC 20009
Even though needle exchange seems to have a bad reputation, and many believe it actually promotes
drug use, the facts prove otherwise. Where needle exchange programs have been implemented, rates of HIV
actually decrease AND more drug users sign up for drug treatment programs. Though some might
consider the method unorthodox, these programs are safe, effective, and really do make a difference in
Service Learning Team Members:
Erica Adams Dermont Maher
Julie Dunderdale Meaghan Nelan
Lauren Mabanta Paul Weisbruch
Mary Beth Levin
Ron Daniels, Program Manager
Paolo Barahona, Executive Director
Our team worked with the organization PreventionWorks! to reduce the spread of blood-borne diseases
through contaminated needle use among drug addicts in Washington, DC. Specifically, we individually
volunteered on the PreventionWorks! mobile van that travels to communities throughout DC, providing clean
needles to injection drug user in exchange for dirty needles. The main goal of this program is harm-reduction.
In other words, PreventionWorks! does not encourage drug use, but instead, provides a safe way for people,
who would use drugs with or without this type of program, to inject drugs. As a result, PreventionWorks!
decreases the spread of disease, such as HIV/AIDS.
In addition to assisting with the needle exchange, we put together safe sex and safe smoking kits that are
also distributed on the van. These kits are important since PreventionWorks! does not only focus on injection
drug users but also considers anyone who might be at risk for contracting a blood-borne disease, for
instance, a sexual partner of a drug user or a crack smoker.
PreventionWorks! is the only needle exchange program in the Washington DC area. Its purpose is to provide
harm-reduction, decreasing the spread of blood-borne diseases such as HIV/AIDS and hepatitis.
In the1990s, a federal law was passed, prohibiting the use of public funds for needle exchange programs.
PreventionWorks!, funded exclusively by private funds, was founded in response. Since its start on December
2, 1998, each year PreventionWorks! has reached more and more people, now serving approximately 2,000
Mostly, PreventionWorks! provides services to its clients through a mobile van that visits eleven sites
throughout DC, where injection drug use is prevalent. PreventionWorks! also reaches clients through walk-in
hours at its office in Northwest.
In addition to exchanging used needles for clean needles, PreventionWorks! provides condoms, smoking kits,
clothing, food, information about rehab services, HIV testing, and referrals for medical care.
Prior to working with PreventionWorks!, I had always supported needle exchanges without fully
understanding their real impact on the community. I understood that they helped prevent communicable
diseases, but I had no clue that their role in the community was as far-reaching and critical as I have seen it
to be. It is truly a vital service to the community that has wide implications for public health beyond
injection drug users. When describing my experiences to family and friends, especially those opposed to the
idea of needle exchanges, I try to emphasize that needle exchanges actually promote healthier behavior
through the harm-reduction model, and that the work we do meets people where they are with the overall
aim of helping them improve their lives. It does not encourage drug addiction, nor does it support drug use,
but it does support the individual in an accepting way that is critical to reaching them. Not everyone who
comes to the needle exchange will stop using drugs, but through the exchange they will have a safe space
that can connect them with many vital resources in the community to improve their health and help them
address their drug use on their terms. I can't imagine a more effective means of reaching out to a
population that is largely ignored by standard public health interventions, and this is what I try to share
with anyone who may question what we are doing.
PreventionWorks! mainly serves injection drug users,
crack users, and sex workers in areas throughout DC
that are hit hard by AIDS and other blood-borne
diseases. However, people of all ages with various
needs come to the van. Even though typically people
visit the RV to exchange needles, some just want
clothes and food, others are there only to get
condoms, and a number come to ask about HIV
testing or drug rehabilitation. Also, not everyone
resides in DC. Some clients come from Virginia and
Maryland. PreventionWorks! reaches a wide range of
The PreventionWorks! program meets the needs of people other than injection-drug users. It should be noted that
there is a large number of people who come to the van for other needs. Some people come for the food services it has
available on certain days. Younger people often come for condoms, while I also noticed a few diabetic patients come
for needles for their insulin. Finally, there are some people who just come for health information.
What impresses me most about PreventionWorks! is the commitment of the staff who have dedicated their
lives to caring for people who are struggling every day with drug addiction. The staff honestly cares about the
health, safety, and well-being of every person who boards the RV, and even reaches out to those who do not
make it to the van. The unique and special thing is, some of the staff members have fought their own battles
with addiction in the past, and now they selflessly serve others as part of their own daily walk in continued
recovery, without asking for anything in return. I know they inspire me; I can only imagine what they do for the
A Day in the Life of a PW! Volunteer:
11:40 Catch the GUTS to Dupont Circle
12:06 Hop on the Red Line to Union Station.
12:21 Board the X8 bus to the Hechinger Mall.
12:33 Meet the RV in the Safeway parking lot.
1:00 Ride over to Division Ave and Nannie Helens Burrough, NE. This is the first stop of the afternoon.
1:10 Turn on the laptop. Open the database. Set up the exchange kits. Put out the food containers.
1:15 Greet the first client. Invite him to sit down. Enter his date of birth and first name into the computer.
him a sharps container for the disposal of his used needles. Ask, "What type of works do you want?
Apples? Blue heads? Groins? Diabetics?" Record the exchange, and ask, "Is there anything else I
can do for you?" He might request a referral for detox, food, clothes, a safe smokers kit, or condoms.
Or, he might just talk about his life since the last time I saw him. What is important is that each client
receives individual attention and gets as much time as he/she needs.
1:20-2:45 Continue serving the people who have formed a line outside the RV door. This is a big stop, I will
serve between 25 and 50 people.
2:46 Close the RV door. Shut down the computer. Put away the needles. Clean up the van. Pull out onto
Divison Ave and take a left on Nannie Helens Burrough to head toward the next stop.
2:54 Pull up behind the old liquor store on New Jersey Ave in NE. This is the second stop of the
afternoon. Start up the laptop again. Re-open the database. Organize the exchange kits again. Set out
the salads and Ensure.
3:00 Open the door.
3:00-4:30 Assist the clients that stop by. Most are regulars, so take time to catch up. Wipe down the tables
in the RV. Organize the file folders of information. This is one of the smaller stops, I will only serve
approximately 10 clients before my time is up.
4:40 Jump on the Green Line at Navy Yard, heading toward Greenbelt.
4:48 Transfer at L'Enfant Plaza to the Blue Line in the direction of Franconia.
5:00 Arrive at Rosslyn.
5:05 Hitch a ride on the GUTS back to Georgetown.
"As we drove away from the capital, the building progressively became more rundown. My
roommate, a DC native, turned to me and stated that she'd never been out this far into
Northeast and she did not know exactly what to expect...neither did I. Scanning the streets, I
noticed that we had become the minority. Everyone that we passed not only was of a different
race from us but also they had a different style and a different manner. Clearly, I was going to
standout. As we approached the corner of Division and Nannie Helens Burrough, I quickly
realized that nothing was there, only a rundown store and some abandon buildings. People
were meandering down the sidewalks, leaning on trash cans, and resting against the store
walls. Some were talking, while others appeared to be just passing the time. Most were dressed
in shabby clothes that looked as though they had not seen a washing machine in weeks. A few
carried grocery bags, while several clutched backpacks that held all their belongings. As we
took a right onto Division, I easily spot the RV, parked in a dirt spot on the side of the road,
directly across from a city park. Outside the RV door, a group had gathered, waiting for their
turn to exchange needles...waiting for me to help them."
One of the biggest services that I witnessed people
receive on the van is a sense of stability and community.
The example that really stands out is when a man boarded
the van and quietly started to exchange his two needles.
Then he broke down crying. He explained that he had
been clean for several weeks but had relapsed recently
and was concerned that he never would be clean and that
his life would just be messed up forever. The
PreventionWorks! staff reassured him that it really didn't
matter that he relapsed because most people trying to quit
relapse at some point. They also told him that the bigger
picture was the he was trying to quit and that there are
people who care that he stays healthy until that day. I
could tell that this changed his mindset about the whole
situation. He agreed to take the new needles but
commented that he would attempt not to use them. I think
that most of the people who come on the van are not
primarily looking for needles, but are looking for a place
where somebody is going to make a gesture that lets them
know that somebody cares. If you have to express this
through needles, then fine.
By the Numbers...
Med Students Involved: 8
Number of hours served so far: 76
Number of people served so far: 499
Estimated number of hours served by end of the semester: 102
Estimated number of people served by end of the semester: 670
Collective experience: PRICELESS
Above and Beyond:
~A major problem shared by many of the clients of PreventionWorks! is the lack of a medical home. Lauren
and Erica took the first step to address this problem by creating pamphlets that map out the clinics within a
three mile radius of the eleven sites that PreventionWorks! serves. An example is given below:
Where to Find Medical Help: Division & Nannie H. Burroughs, NE
~Dehydration is one of the often overlooked problems of injection drug user and the poor. John and Paul
spearheaded an effort to collect donated bottled water from local businesses.
~Frequently injectioning drugs without using the appropriate methods and taking the proper precautions is
likely to lead to injection site wounds and infections. Dermot and Zach are in charge of developing
educational materials about wound care for the clients of PreventionWorks!.
It didn't take long for me to become aware of my own prejudices when interacting with the
PreventionWorks! participants. During one van trip I caught a glimpse of how varied these
peoples lives can be. Some participants were indistinguishable from anyone you might see
walking down the street, arriving with groceries, presumably stopping off at the van as part of
their daily/weekly routine. Others arrived with weathered faces and rough hands, open
wounds, and unwashed or tattered clothes. At one point I realized I had to stop myself from
thinking "How could you let your life come to this?" It was at this point I realized I was passing
judgment on these people, and it was interfering with how I interacted with them. Our job out
on the van, and in dealing with any set of patients, is not to judge but to serve. For the rest
of the trip, what I concentrated on instead was that these people were making the choice to
participate in needle exchange, and in so doing, were engaged in harm reduction. Everybody
has addictions and everybody struggles with self-control-- medical students, doctors, everyone.
My role is simply to provide a friendly face with an open ear and informed voice, should
the opportunity arise.
I learned about the specific problems that injection drug users face in addition to getting clean; for example,
they worry about their family, keeping warm in the winter, and wound care.
My experience on the van has helped illuminate the complexity of the challenges facing the DC area. We are so
fortunate to live in the NW section of DC, cause as many of us have learned from service learning, life in the other areas
is not nearly as comfortable or safe. There are so many people outside of NW who have been left behind by government
and the rest of the community. Programs like Prevention Works can only accomplish so much to help many of its clients
who live on the streets find homes and find healthcare and begin to gain more control over their addiction and life.
Links of Interest
Video: A Case for Patience and Kindness
A Living HIV Quilt
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Julie Dunderdale & Meaghan Nelan
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