Tookes had encountered such stiff resistance over the past four years while fighting for Florida's first needle exchange program that he'd nearly given up. But now Tookes' vision was coming true: desperate injection drug users would be able to get clean syringes, preventing the spread of infections such as HIV and hepatitis C.
"This is the stuff public health dreams are made of," Tookes says. "Very quickly, this will expand to HIV and hep-C prevention and overdose prevention across Miami and to the entire state of Florida."
Tookes, who is now 35 years old, grew up in Connecticut but moved to South Florida as a teen. After earning degrees at Yale and the University of Miami, he began working at a Miami-Dade County clinic where he saw firsthand the effects of Miami-Dade and Broward harboring the nation's highest rates of HIV.
He knew there was a simple solution: a needle exchange, where anyone could bring dirty needles and swap them for clean ones. Staffers could examine injection sites for infection and distribute pamphlets about drug treatment centers. There are 194 similar programs across America.
The program could drastically lower infection rates, route drug users into rehab, and save taxpayers millions of dollars. A study published by Tookes and his colleagues showed that a needle exchange program would save Jackson Memorial Hospital alone $11.4 million.
But Tookes, who is now a resident at Jackson, had to fight an uphill battle. Distrustful legislators argued that giving away needles would encourage drug use. The doctor first went to Tallahassee in 2012, and each year his bill was blocked.
In the meantime, heroin-related deaths have quadrupled since Florida's pill mills were shut down in 2011. There are an estimated 10,500 intravenous drug users in Miami.
Finally, this year, Tookes broke through. Soon Florida will have its first needle exchange, operated through the University of Miami. More than $500,000 has been raised for the project, and the unwrapped syringes have already arrived.
"I like advocating for my patients; it's what motivates me," says Tookes, who will serve as medical director for the exchange. "It got to the point where we had to do something."