An advertisement on the subway warns the public about illegal drugs laced with fentanyl. Photo: Kalah Siegel

Genesis of Bronx harm reduction: the church

Needle exchange programs were illegal in the United States at the time, despite their documented success by both the Government Accountability Office and the Center for Disease Control (CDC).

An advertisement on the subway warns the public about illegal drugs laced with fentanyl. Photo: Kalah Siegel. 

It was snowy that first night.

And Joyce was standing outside, pregnant, beside her open trunk full of syringes.

Luis was making his way around the neighborhood – St. Ann’s Avenue between E. 139th and E. 141st Streets – as he often did. So often, in fact, that he knew most of the drug users and dealers in the area.

Joyce did not look to be one, or the other, that he recognized.

The first time he passed her, he thought she was selling food from her trunk, so he continued on walking. But the second time, he decided to go check.

Luis recalls the encounter. “Young lady,” he asked, “what are you doing here in this crazy weather? You’re going to get sick.”

“Well,” Joyce responded. “If you don’t want me to get sick, let me inside the church.”

Luis, at the time the new priest-in-charge of St. Ann’s Episcopal Church, agreed. On that snowy December night in 1990, St. Ann’s Corner of Harm Reduction was born.

Well, in theory.

“Luis” is Rev. Dr. Luis Barrios, who, that night, let Joyce Rivera – the founder and now executive director of the organization – into the church.

But needle exchange programs were illegal in the United States at the time, despite their documented success by both the Government Accountability Office and the Center for Disease Control (CDC).

In 1988, Congress passed a ban on the use of federal funds to support needle exchange programs, classifying syringes as drug paraphernalia. The sentiment was that, by giving clean needles to injection drug users, the programs were encouraging addiction.

Barrios has always rejected that assertion.

“People were getting concerned that we were promoting drugs,” he says. “Listen. This is the same bullshit that people are saying when we give out condoms – ‘We’re telling people to have sex.’”

But the reality is, Barrios says, “People are having sex. People are getting high. So let’s educate.”

In 2001, the CDC published a report on the HIV and AIDS epidemic in the United States from 1981 through 2000. The report stated that injecting drugs was responsible for 25 percent of all cases of HIV transmission, second most after male-to-male sex, which was responsible for 46 percent of cases.

Both Rivera’s and Barrios’s families had been touched by the health crisis.

Rivera lost her brother to AIDS before meeting Barrios in 1990.

Barrios, 65, grew up in “the projects” of the Santruce neighborhood in San Juan, Puerto Rico.

Six of his seven brothers died from complications following the contraction of HIV and AIDS. All of them were injection drug users.

“It was a heavy epidemic in Puerto Rico,” Barrios recalls. “I can deal with drug addicts with no problem, because I see my brothers.”

His father was a drug dealer, and Barrios says that was the family business originally intended for him and his brothers. But, he says, when he was 12, his mother arranged for him to meet, and study with Father Alberto, a local priest.

“She saw that I was going to be something different in the future,” Barrios says about his mother. “She got me involved with the local priests, and they protected me. I thought that she was rejecting me, but then I became aware that she was not rejecting me, she was protecting me.”

Barrios enjoyed the ministry, and by the time he was 15, had decided to pursue the priesthood.

But, a strong desire to one day have a family led him to reconsider the pursuit of a positon in the Roman Catholic clergy. So, Barrios converted to the Episcopalian Church – a socially progressive Christian denomination.

When Barrios met Rivera that night in 1990, he had recently earned his Master of Divinity degree from New York Theological Seminary. Rivera and Barrios spent the first two years of the ’90s refining their practice. Trying new means of outreach and clean needle collection. But as the program gained momentum, the church faced increased surveillance, they said.

According to Barrios, police managed to get their way into the church “on three or four occasions” in search of evidence of the illegal exchange program.

Barrios says during those times, he and Rivera hid needles in religious paraphernalia, as well as in the church’s cemetery.

“This was the 40th Precinct, and it was illegal,” he says. “We’re aware that we were breaking the law. We had to show that this was going to work.”

The needles were sourced from an outreach organization based in Australia. It’s been so long Barrios said he cannot recall the name. The country was at the forefront of the legal needle exchange program movement.

In 1990, Dr. Alex Wodack – the Director of Alcohol and Drug Services at St. Vincent’s Hospital in Darlinghurst, Australia – wrote an op-ed in the New York Times that strongly criticized the decision to close, at the time, New York City’s lone needle exchange center.

“Outlets for sterile needles and syringes have been established in almost every country in Western Europe,” Wodack wrote. “I understand that Canada has also opened such exchanges. In Australia, outlets for sterile needles and syringes are available almost throughout the country.

“A recent independent evaluation of the needle and syringe exchange program was commissioned by the state government from a leading research company. This evaluation concluded that the exchange program has been an outstanding success and recommends its further extension.”

In addition to the ongoing battle with law enforcement, the church faced backlash from other faith leaders.

“The biggest challenge has always been educating people. And, specifically, people in church,” Barrios says. “Because there’s the stereotype that you’re promoting — you’re telling people to go out and have sex and be promiscuous, or get high and using drugs, which is not true.”

In 1993, Barrios was suspended by the Episcopal Diocese of New York for misconduct.

“He is out of touch with what the Episcopal Church stands for,” Rev. Canon George Packard – an assistant to the then-Episcopal Bishop of New York – said in a piece published by the Times that year. “What is heartbreaking is that he is an enthusiastic and concerned community leader. But he has to remember that he is also an Episcopal priest.”

“Our attitude was, ‘These needles and these condoms are different because we bless them,’” Barrios recalls. “And for sure, we were blessing them.”

He cites the second chapter of the Book of James as his motivation to continue the work that he and Rivera began, despite the challenges.

“The book of James is my favorite book of the Bible,” he says. “Chapter Two says, ‘Don’t tell me that you have faith. Show me what you’re doing, and I will tell you if you’re a person of faith.’”

“A lot of people want to deal with Christianity as a way of thinking. This is not a way of thinking, it’s a way of living. That’s why it’s so difficult.”

After nearly eight years, Barrios says, he and Rivera were able to take St. Ann’s above ground.

“Joyce is an anthropologist and was compiling research as we worked,” he says. “We were able to show that needle exchange programs can reduce the incidence of HIV/AIDS by 35 percent.”

Barrios now serves on the board at SACHR, and has opened a harm reduction center in the Washington Heights neighborhood in Manhattan, where he is the priest-in-charge of Holyrood Episcopal Church.

He volunteers as part of the field team at SACHR on Tuesday afternoons, and on Fridays near 149th Street and Third Avenue.

Barrios says that he’s happy about the increased legality and public acceptance of needle exchange and harm reduction, but that the recent acknowledgment of opioid use as a public health crisis – as opposed to a criminal one – is bittersweet.

“When it’s black people, or Latino, they don’t give a shit. Okay?” he says. “But now that it is white people—Staten Island has the highest incidence of people dying of overdoses of heroin. And these are white people. They’re not black and Latinos. Anyway, we’re going to take advantage.”

Read our special series Opioid Addiction: Local Face on a National Crisis