CHICAGO - As the use of heroin and opioids increase across the country, so does the risk of spreading deadly diseases like HIV and Hepatitis C.
33 states have opened up clean needle exchanges to address the problem. Missouri is not one of them. Illinois is.
5 On Your Side traveled to Chicago to the University of Illinois at Chicago, School of Public Health Community Outreach Intervention Program (COIP), at their Humboldt Park field station, to verify if this program actually works.
How it works in Chicago
Michael Zelasko made it clear to us early on, he doesn't want to be here. Michael is a step-father, holds a full-time job and lives a normal life. He's also a heroin addict and believes the UIC clinic is his best ally in his fight for sobriety.
His friends introduced him to heroin at school. He was just 14.
"I did a bump and as soon as I did it, I knew I shouldn't have done it," says Zelasko.
Still, at the time, it didn't seem like a big deal.
"When my family would get high around me when I was a kid, they all got happy when they would do drugs, so I never associated with the bad stuff," he says.
Michael tried to avoid using dirty needles off the street, but when he was desperate, he'd use whatever he could find.
"When you're strung out on drugs, you're not thinking right. If there's only one needle, you're going to use it," says Zelasko.
Ten years ago, Michael discovered UIC's exchange program. It may have saved his life.
"I don't have AIDS, I don't have Hepatitis. I've never had any diseases. Places like this, this is what they're for. They're here to help people," he says.
Matthildur "Matta" Kelley is a longtime volunteer and employee in this clinic.
"They're just people who are stuck. They are your sons and daughters and fathers and mothers who are just stuck," says Kelley.
She says, people from all walks of life, come in with one thing in common - seeking clean supplies to inject heroin.
"We prefer that they bring their old syringes because we want to get them out of the streets. We don't want them throwing them out in the streets, we don't want them flushing them down the toilet," says Kelley.
Patients are guaranteed clean syringes, even if they don't bring in used ones. Still, the more dirty needles they bring in, the more clean ones they'll take home.
"We don't want anybody stuck with a dirty syringe. We don't want no kid to pick up a dirty syringe out on the street and say, hey mommy what's this?" she explains.
The clinic also supplies everything from the tourniquet down to clean cotton balls.
"We don't want them using rags that are full of blood or somebody else's that has blood on it," says Kelley.
All of this work, comes with one goal in mind - preventing the spread of deadly diseases.
In Chicago, the results are staggering.
The Illinois Department of Health shows new diagnoses of HIV are down by 27 percent over the last decade.
In that same 10 years, new cases of HIV in the city of St. Louis dropped more than 8 percent. That's more in line with the national average of 7 percent.
Below the radar, outside the law in St. Louis
Chad Sabora, the co-founder of MOSAFE, says those numbers are good, but could be a lot better.
MOSAFE, also known as the Missouri Safe Project, is a harm reduction, education and training organization centered around drug use in St. Louis.
MOSAFE runs one of two needle exchanges that operate in Missouri, under the radar and outside the law.
His team of eight people distributes supplies every day in some of the most drug infested St. Louis neighborhoods.
"I know what somebody looks like sitting in their cars waiting for that phone call from the man, so I'm just going to walk up to their cars," says Sabora.
He knows, because he's a former addict himself. For the last three years, Sabora has been fighting to overturn the Missouri law that bans owning and passing out drug paraphernalia.
Sabora says, changing the law opens up a world of opportunities.
"We could expand, we could do more direct to consumer marketing to really reach active users," he says.
While he's handing out clean supplies, he's also encouraging addicts to seek sobriety.
Sabora claims if he can get them into his clinic, he can save someone's life.
"80 percent are in treatment within 90 days of initial engagement of walking in the doors and saying I want to talk to somebody," says Sabora.
Michael Zelasko was clean for more than a year, up until last month.
"I was at a methadone clinic. I was there for over a year and they just closed their doors without no warning or nothing," says Zelasko.
Without methadone to dull his urges, he found himself facing an impossible decision.
"It was either lose my job or lose my sobriety," he explains.
Zelasko hopes his relapse is only temporary.
I'm a convicted felon and I've got a pretty decent job right now and I can't get jobs like that. I can get my sobriety back, I can't get my job back so I had to go use," says Zelasko.
He's enrolled in a new methadone clinic and envisions only making a few more trips to the UIC needle exchange.
After all, Michael doesn't want to be here, but he's grateful it's an option.
"Maybe in a couple more days I won't be sick," he says.
Where Missouri Stands
Legislation to establish a clean needle exchange died in a Senate committee Wednesday morning. Prior to that, the legislation appeared to be on the right track. The House voted earlier in the session, 150-13.
Supporters are optimistic it will be passed next year.
Medically speaking, almost every major medical association, including the World Health Organization and the American Medical Association, support clean needle exchanges and say it leads to sobriety.
The question becomes, do tax payers want to pay for needles for drug addicts?
Supporters say, it's a lot cheaper than expensive Hepatitis C and HIV medical treatment.