MANILA, Philippines – A cheap shot of Nubain, an opioid used as a painkiller, is all it takes to get a high. All for P20 and possibly a shared needle.
The shared needles have, in fact, also contributed to the spread of HIV. The concentrated epidemic in Cebu has been traced to shared needles used to inject drugs. Of the 1,366 HIV infections reported by the Cebu City AIDS Council, about 74% were transmitted by shared needles while injecting drugs. Majority of those who inject drugs are male.
A typical drug user, according to the Dangerous Drugs Board, is male, aged 20 to 29, a high school graduate, and likely employed and married.
The Duterte administration has embarked on an aggressive campaign against illegal drugs, resulting in the deaths of more than 700 drug suspects since Rodrigo Duterte took his oath as president on June 30.
Months before his overwhelming victory, with a reporting grant from the Pulitzer Center on Crisis Reporting, we immersed ourselves in shooting galleries and talked to both users and dealers sometime between October and December 2015. This is what it looks like and this is how one man working with different support groups is trying to save lives.
All photos by Veejay Villafranca
SHOOT. Drug dens commonly known as “shooting galleries” are hidden in plain sight in slum communities. Shanty homes put together by boards of thin wood and corrugated steel or tiny corners haphazardly covered in tarpaulins serve as a shooting gallery. Nubain is the choice drug in these shooting galleries. A shot of Nubain (10 cc) costs about P20. The P20 does not include a syringe – that would be another P8, sometimes P20. For those who can’t or don’t want to pay, there is always a service needle that the pusher provides for free in the shooting room.
PROFILE OF A USER. The Dangerous Drugs Board says a typical drug user is male, between 20 to 29 years old. The most commonly used drugs are shabu, marijuana, and inhalants (contact cement). This is according to a 2012 Household Survey on the Nature and Extent of Drug Use in the Philippines conducted by the Dangerous Drugs Board and the Philippine Normal University.
SHARED NEEDLES. A new unused syringe sells for about P20 but few people who go to the galleries choose to purchase one. It is common for groups to split the P150 cost of a vial of Nubain and pass around a needle to shoot up. Based on surveillance studies conducted by the Department of Health, there are 3 to 5 service needles on rotation at a shooting gallery. Each needle can be used 4 to 6 times before it gets blunt.
USED NEEDLES. Buying nubain is easier than buying a clean needle. Cebu City passed an ordinance banning the sale of syringes without a prescription. Outside shooting galleries, used needles are strewn around garbage dumps where small children or dogs can pick them up.
FRIENDSHIP. Why do people share needles? Economics is certainly one reason. The other is friendship. Brother Paul Bongcaras of the Society of Divine Word in Cebu says it’s no different from sharing a cigarette or a drink.
ADVOCACY. Armed with a sling bag and plastic box with partitions, Brother Paul visits the various slum communities and dark corners that freelance sex workers call their place of business almost every night. The world of poverty, drug use, and sex work all intersect, he says. On these nightly walks that residents and street corner regulars have come to expect, Brother Paul comes bearing gifts – pills for common aches and pains to the old and weary; ointment for nicks, cuts, and rashes of the young and playful; condoms and lubricant for the sex workers; and crackers for anyone who wants them.
NO JUDGMENT. The night walks take hours as people crowd around Brother Paul. Gaunt men sleeping on cots ask him for medicine, for food. The young women shyly accept condoms and lubricants – there is no need to explain why they need them. Young children take his hand and press it to their forehead as a greeting of respect. Some, like this toddler, just wants to be rocked to sleep. Brother Paul stops to talk to all of them, bringing the most important gift of non-judgmental acceptance.
SUPPORT. At Narcotics Anonymous meetings, former and current drug users gather in a circle and share their common experiences. They can talk about their struggles, their fears. Outside the circle, sitting quietly at the side, is the occasional mother or partner looking on. They don’t always know what to say to their loved one who is a “shooter,” Narcotics Anonymous gives them a way to show their support simply with their presence.
NEEDLE EXCHANGE. The Dangerous Drugs Act criminalizes the possession and distribution of drug paraphernalia like syringes. Various organizations and the local health department had to discontinue their needle exchange programs for drug communities.
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