Inside the Life of Heroin User and Crusader for Harm Reduction for Addicts
The old "this is your brain on drugs!" sizzling egg TV ads have nothing on Mark Kinzly. He knows what a life looks like on drugs: jail, homelessness, street dealing, a chest of stab wounds and bullet scars, a family left behind. And yet the 54-year-old also credits drugs with saving his life.
Because of drugs he became an educator and researcher at Yale University. Because of drugs he found his calling to help others who struggle with addiction. Because of drugs, he has saved countless lives from HIV and narcotic overdose.
All his life Mark Kinzly has inhabited the space where the destructive and healing powers of drugs intertwine. He has hated it, feared it, learned from it and eventually embraced it. It is part of his story.
Kinzly's journey with drugs began in 1978 when his older brother was killed near their home in New York. The boys had been very close and the loss was more than 17-year-old Mark could bear. As he searched for something to numb the pain, he was lulled into heroin, which he describes as “the warmest blanket on the coldest night.”
Kinzly's experimentation with drugs quickly became consuming and chaotic. He quit school and spent over a decade moving around New England, taking up odd jobs, checking in and out of rehab. By the late 1980s he wound up in Connecticut during the heart of the HIV/AIDS epidemic. Injection drug users were dying daily in scores.
“I was scared to death [of AIDS] but I couldn’t stop using,” Kinzly says. “Many mornings I woke up and swore I would never take drugs again.” His voice trembles. “I meant it. I meant it a lot. But I would get so sick from withdrawal that I couldn’t make it through the day. There were mornings when I cussed the creator for waking me up. Why would he keep me alive?”
A Harm Reduction Epiphany
The answer to Kinzly's prayers came in a most unusual form. One day while on the street peddling dope, he ran into a former cellmate. He wasn’t sure what shocked him more – that his cellmate, once in the throes of crime and addiction, held a steady job and was living drug-free, or that he was handing out sterile syringes to injection drug users.
Syringe exchange, a disease prevention strategy that provides people who inject drugs with clean needles in exchange for their used ones, was enormously controversial at the time. In many parts of the country it still is. But Kinzly felt inspired by the opportunity to combat the fearful virus that plagued his community and decided to become involved. He didn’t know it yet, but he was a pioneer in what would become a massive movement toward harm reduction, or the idea of “meeting people where they are at” and encouraging any positive change instead of demanding strict adherence to abstinence.
Harm reduction programs are now present in almost every state and 18 states run legally sanctioned syringe exchange programs. Decades of empirical evidence have shown that rates of HIV and hepatitis C among injection drug users plummet when they have access to sterile injection equipment. In communities where syringe exchange programs are present, used needles that once crowded playgrounds, alleys and public bathrooms disappear into collection bins and rates of needle-stick injury to police officers drop by more than half. Moreover, decades of research show that syringe exchange programs do not lead to increases in crime or drug use, as opponents claim. In fact, the opposite occurs. Syringe exchange program participants are five times more likely to enter drug treatment than non-participants because the accessibility of harm reduction services facilitates contact with rehabilitation programs.
A few months after the reunion with his cellmate, Mark Kinzly landed a job with the New Haven Health Department as an outreach worker for the first legal syringe exchange on the east coast. It was a job perfectly suited to him. He was out in the world he knew, on the streets, among the same drug users he had sold to and bought from. But it was different this time.
Not Rock Bottom
“Working with syringe exchange changed my life,” says Kinzly. “I never saw so much hope in people as I did when I handed them a clean needle. When you are wrapped up in the hustle [of drug culture], it can be really ugly. Sometimes the conversations at the syringe exchange were the only kindness that people were shown in the course of a day. Seeing that changed my spirit. Something got touched deep inside me that hadn’t been touched since my brother was killed.”
After years of wandering and hopelessness, Kinzly had found his calling in the toughest streets of New Haven where death by violence, drugs or HIV was considered par for the course. As he fell in love with life again, the need to use drugs as a coping mechanism fell away, and he quit. He was 30 and had battled addiction for 13 years.
Kinzly's story, and the stories of countless others who have successfully stopped drug use, fly in the face of the myth that people need to hit rock bottom to get better. In fact, the opposite is true. Find a reason to live again, realize your worth, and drugs start to lose their necessity.
This idea of using positivity to create change is central to the idea of harm reduction. Most programs that serve people with drug dependency do so only with caveats. “We will only help you if you stop using drugs.” Put another way, “You are only worth helping if you stop using drugs.” But when people like Mark Kinzly show love, compassion and acceptance to those who have long given up on themselves, not only do they connect people to much-needed health services, but also bring hope that life can be different.
As Kinzly explains, “People tell drug users all the time, You are ruining your life; why don’t you just stop?" He pauses and shakes his head incredulously. “I don’t know one drug user who doesn’t know those things. We know how society looks at us. The stigma doesn’t drive us away from drug use, it drives us towards it.”
Why Don't Drug Users Just Get Treatment and Quit Using?
The difference between perception of drug use versus reality is perhaps best illustrated by the most common criticism of people who use drugs: if only they went to treatment, they could get better. People whose lives are not caught up in drugs often imagine that quitting drugs is as simple as deciding to stop, calling up the nearest treatment center, and checking in. Then after a few weeks of AA-style lectures and counseling: boom—cured.
The reality is far from that. People who desperately want and seek treatment run into numerous obstacles: there is no treatment available in their area; the treatment centers have no openings; many centers deny patients with dual diagnoses (meaning a person who has substance use disorder and a mental health issue, such as depression or anxiety. Dual diagnosis patients make up half the population with substance issues). A person can be denied entry into treatment if they have a criminal record or an open court case.
And there is the issue of finances. If you are lucky enough to have medical insurance, your company will likely cover the cost of only two weeks of treatment. Not only is two weeks woefully inadequate to treat a person whose life has been ruled by chaotic drug use for years, but it puts people, especially opiate users, at high risk for fatal drug overdose if they relapse once they get out. And if you do not have insurance, the average private in-patient treatment program will set you back $25,000 a month. Treatment is simply not a viable option for most people.
The Wheel Turns...
Kinzly's calling with harm reduction eventually took him to Bridgeport, Connecticut, where the drug epidemic had churned the city to chaos. Over the years Kinzly helped launch new programs, such as outreach to crack users, who are at risk for transmitting hepatitis C through shared crack pipes. In the mid-1990s he helped connect drug users to naloxone, a now-popular medication that reverses overdose from the most commonly used drugs, opiates such as heroin, OxyContin, Percocet and methadone.
He found a partner and they had a son. Eventually he left his job at the syringe exchange and went to work at Yale as part of a research project on public health and drug use. He taught classes to first- and second-year medical students. For the first time in his adult life he had hope, secure employment, and a family. But it wouldn’t last.
Back in Bridgeport, Kinzly had worked with a man named Tony Givens. They were best friends, and when Kinzly moved on to work at Yale, so did Givens. One day the two of them were working on a video project to film people injecting drugs so that medical students could see how it worked. That day Kinzly was accidentally stuck by a used needle belonging to a drug user who was known to have HIV and hepatitis C.
Kinzly wasn’t too concerned, as the incidence of viral transmission through needle-stick injury is quite low (0.3% for HIV and 1.8% for hepatitis C). He told his employer about it and was immediately put on post-exposure prophylaxis treatment, a toxic regimen of drugs designed to reduce the chance of the virus surviving in its new host. One of the well-documented side effects of this treatment is severe depression, especially in people who are already susceptible to it. The depression devastated Kinzly. It affected his work performance, damaged his relationship with his partner, and brought back haunting memories of his brother’s death.
One night, unable to stand the depression anymore, he took heroin. He felt better as long as the high lasted, but once it wore off guilt set in. He had relapsed after 11 years without drugs. He was 42.
Kinzly's relapse affected Givens as well. After 15 years drug-free, Givens began using again and the two plunged back into chaotic drug use together. Their productivity lagged. People at work started noticing and complaining. Then one Monday morning, Kinzly and his colleagues came into work to find Givens slumped over his desk, dead from a drug overdose.
Sick with guilt and grief, Kinzly allowed drugs to once again consume his life. He lost his job, his partner and visiting rights to his child in swift succession. He went back into the same cycle of joblessness and homelessness that had marked his early years. He tried to kill himself.
…And Keeps On Turning
But through it all, Kinzly stayed connected and involved in the harm reduction movement. Through the kindness of friends and co-workers, he started to believe in himself again and to work toward a life free from drugs. Today Kinzly is 54. He lives in Austin, Texas, where he works at a syringe exchange program and advocates for laws to prevent drug overdose. He is trying to build a relationship with his son, who is now 16 years old.
Mark Kinzly’s life is testament to the strange duality of drug use. Many people might point to the years of his life spent lost in drug use, the pain he caused his family, and his influence on Tony Givens, as evidence of destructiveness. But if we consider that we must also consider how many lives he saved through harm reduction programs, how many times he risked his own life on the rough streets to help others, and how many people he has inspired through his own struggles.
The journey through addiction is often so deep and painful that people who haven’t used drugs couldn’t begin to imagine it. Some people need only one chance to recover. Some people need 20. Some people never change. Some people don’t want to. Those who judge from a distance of privileged ignorance may debate who “deserves” another chance or how many interventions, if any, would be reasonable or cost effective, but human life is infinitely more complex than can be assigned an arbitrary value.
Mark Kinzly had countless chances and in the end he prevailed. His life, with its intermingling of despair and hope, loss and redemption, shows that nothing is for certain. And no one is a lost cause.