On a searing Thursday afternoon, Carlos Franco saunters down an Overtown sidewalk with a navy backpack slung over one shoulder. Inside are 18 wrapped syringes. Locals call out to the 66-year-old retired rehabilitation specialist: “Hola, Profe” and “¿Que onda, Tío?”
Two men approach, their eyes scanning the street for cops. Franco hands a middle-aged Cuban two wrapped syringes. The man quickly stuffs them under his shirt in the waistband of his jeans. A taller man with bright-blue eyes leans in and whispers, “¿Tienes drogas?” Franco shakes his head and continues his stroll.
Franco isn’t a drug dealer or even a drug user, but what he’s doing is a third-degree felony. That’s because Florida is one of about two dozen states where handing out clean syringes to low-income intravenous drug addicts is considered delivering drug paraphernalia.
Franco sees it differently. For more than 25 years, he’s been risking jail time and fines in a bid to cut down on HIV and hepatitis C cases caused by dirty needles.
Born in central Havana, Franco arrived in Miami when he was 12. He graduated from Miami High and went on to receive a bachelor’s degree in psychology and a master’s in vocational rehabilitation from the University of Florida.
In 1984, he returned to Miami and met his girlfriend, a student at Miami Dade College. A child of the ’60s, Franco says the pair used marijuana and cocaine recreationally. The then-37-year-old fell for the woman. But a year into the relationship, she admitted to using heroin. Over the next four years, he watched her spiral into addiction, stealing from him and prostituting herself when he wouldn’t give her money.
His covert needle operation began one evening in 1990, when he saw his girlfriend and ten other people share the same needle, ignoring his warnings about HIV.
“At first, I was very naive. I knew this was wrong, but I didn’t know how to handle it,” Franco says. “No one wants to use a dirty needle.”
Eventually, Franco had to break up with her. But he was struck by the problems he saw among drug users and couldn’t understand why needle-exchange programs were banned in Florida. He found that studies have shown exchanges prevent the spread of diseases and help direct users into rehab. But conservative legislators have lumped needles into their ongoing war on drugs.
So Franco reached out to a network that provides needles to exchanges across the nation. He was awarded a grant and shipped three large boxes with roughly 6,000 syringes. Franco then went out into the streets and began handing them out.
(Beware from here, pictures could cause you to lose your lunch.)
At first, no one could understand why he was doing this for free. Addicts usually rely on diabetics to sell them a spare insulin needle for as much as $4. “People who use dirty needles off the ground — they do it out of desperation,” Franco says. “They know it’s bad for them, but they’ll do what it takes to get straight.”
When the syringes from his first grant ran out, Franco began paying out of pocket — usually $15 for a box of 100. Now, after working at mental health treatment centers in the city, he’s retired and relies on donations. But he still tries to pass out syringes at least once week. He says it’s a miracle he hasn’t been arrested while distributing tens of thousands of needles in Miami.
In recent years, he has expanded and helped form an underground regional network. He supplies the needles to a pastor living in the Pork ’n’ Beans projects, who passes them out in Liberty City, and to a young woman in Broward County. Downtown Miami, Overtown, and Wynwood are Franco’s turf.
The problem is only getting worse. Miami-Dade and Broward have the highest number of new HIV cases in the nation. And the Centers for Disease Control and Prevention found that heroin use has increased significantly across all demographic areas after Florida’s pill mills shuttered.
Medical professionals have been working with state legislators to pass a bill that would make what Franco does legal — and help expand his efforts. One study found that a legal needle exchange would save Jackson Memorial Hospital $11.4 million. But the bills have died in committee three straight years.
“There’s always been a stigma about helping drug users,” Franco says. “Legislators are so disconnected from what happens on the street. These are people’s brothers, sisters, and children.”
Back on the streets in Overtown, a middle-aged woman on a bike pedals over to Franco. She lifts her sleeve to reveal a trail of infected pricks on her upper arm. She’s been shooting heroin for the past six years.
“Carlos really helps me a lot,” she says. “Don’t get me wrong. We like seeing him, but we know this could all be avoided. My arm — I’m in so much pain.”
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A block down the street, an older man in a wheelchair creeps toward Franco. He’s been injecting heroin for 30 years. A swollen abscess peeks out from under his cargo shorts, dripping pus down his leg. Franco hands him two needles. A minute later, a 61-year-old woman smiles at Franco and then looks away. They don’t speak. She opens her yellow purse, and Franco stuffs five needles inside. She began using heroin 20 years ago, when her eldest son unexpectedly died from a heart attack. “The pain was too much,” she says. “I want to stop, but until then, I need Carlos.”
Ten minutes later, Franco passes a middle-aged man crouched on the sidewalk. “¿Necesitas gancho?” Franco whispers to him. The man shakes his head and nods toward a police car inching down the street behind Franco. He calls it a day and picks up his pace on his way to the Metrorail station.
“I’m almost out of needles. I just have a few left,” Franco says. “In a few weeks, I’ll gather the money, put in a money order, and try to get more. I do what I can, but I know it’s not enough, not even close.”