Magazine article Foreign Policy

The Needle Exchanger: Marta Nascimento

Magazine article Foreign Policy

The Needle Exchanger: Marta Nascimento

Article excerpt

IT'S ALMOST MIDNIGHT when Marta Nascimento strides up to a young sex worker and her john who are loitering in Lisbon's run-down Martim Moniz neighborhood. Nascimento opens her backpack, which is brimming with syringes, aluminum foil, and crack pipes. The sex worker asks only for condoms, though--she doesn't need drug paraphernalia tonight. Confused, the john asks if Nascimento is carrying. "She doesn't sell drugs," the sex worker explains, "just distributes the material to do them."

Zipping up the backpack after handing the woman several condoms, Nascimento interjects to correct her: "It's to make doing drugs less risky."

A psychologist by training, Nascimento, 37, works for Crescer na Maior, a public health organization that facilitates needle and pipe exchanges among Lisbon's drug users. The group's methods reflect Portugal's unique drug policies. In 2001, the country became the first in the world to decriminalize personal use of all narcotics. Dealing and trafficking are still illegal, but individuals are allowed to possess small amounts--up to two grams of cocaine, for example--without running afoul of the law. The government has also invested in harm-reduction initiatives for addicts, including methadone programs and needle exchanges. (Crescer na Maior is partially state-funded.) The results have been significant: From 2001 to 2014, new AIDS cases among drug users fell from 518 to just 42.

Not everyone supports the government's approach. Nascimento says users and even some colleagues have been harassed for what critics say is "enabling drug use." Yet she sees her work as necessary. "I don't believe a drugs-free world is possible. Some people will always turn to substances to find solutions to their problems," Nascimento told FOREIGN POLICY in October. "This way, we're improving their lives."

1

Cellphone

I give our work number to anyone who wants it. Users call when they need new needles or a safe place to stay the night. One of my patients used to call frequently, threatening suicide. Eventually he went to an addiction rehabilitation program.

2

Pants

We encourage users to collect their discarded material, but we help them. I always cover my legs when picking up needles to keep from getting stabbed. In summer, I wear loose satin trousers to stay cool. …

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