[UPDATE]: The Orange County Needle Exchange Is Fighting To Provide Services To Santa Ana, Orange, Costa Mesa and Anaheim

OCNEP will help minimize and eliminate the syringe waste problem (Photo: Bridget Arias)

[UPDATE: 06/06/18 at 12:18 p.m.] Andrew Do, the chairman of the Orange County Board Of Supervisors, released a statement on behalf of the Board stating that the OC “needle giveaway” was a “proven failure” after allegedly removing 14,000 needles from the Santa Ana Riverbed. In a meeting on Tuesday, June 5, the Board Of Supervisors unanimously adopted a resolution to oppose the pending application with the California Department of Public Health for a mobile needle giveaway program in Orange County. 

“Orange County just cleared 13,950 needles from the riverbed,” said Do in a statement. “This program is a proven failure. Needles end up in parks and on sidewalks and jeopardize the health and safety of Orange County.”

In an email response to the Weekly, OCNEP says the large number of syringe waste found in the riverbed is likely due to a lack of safe disposal services available to those living at the Riverbed when the City evicted them.

“At the Civic Center location, OCNEP volunteers continuously offered free and safe disposal of used syringes, as well as sharps containers, to our clients and the residents of the Civic Center throughout the two years it operated,” OCNEP said in a statement. “OCNEP volunteers were developing a plan to serve the riverbed directly before OCNEP was shut down and the riverbed encampment closed.”

OCNEP says its volunteers routinely collected over 30,000 syringes a week. But when the exchange was shut down on Jan. 17, just weeks before the mass riverbed eviction, the residents who lived there didn’t have access to a proper syringe disposal, thus leaving behind used syringes.

Chairman Do’s statement says, “The program, which plans to operate in a different city each day of the week, will give away 20 syringes for every dirty needle.” Do’s understanding of the model means that if someone came to the exchange to turn in 10 needles, they would receive 200 needles in return.

OCNEP says his statement is “misleading and factually incorrect”, as it is not the distribution model they use. Rather, OCNEP uses an “N+20” model. In other words, for every needle a person turns in, they receive that amount plus 20. The number of syringes a person can receive caps at 200 no matter what. So, if a person visits the exchange and does not have needles to turn in, they receive 20. If a person brings 10 needles to exchange, they receive 30. If they bring 300 needles or more, they’ll only receive 200.

“A person without any needles would have to share a needle with someone, and that is what the program and our distribution model is trying to prevent,” says OCNEP. “OCNEP’s ‘N+20’ model is based on research, which demonstrates that providing a sufficient amount of needles can significantly lower the chances of individuals reusing or sharing syringes, which can prevent the spread of bloodborne diseases.”

If the state grants the OCNEP the permit, Do has asked the county’s attorneys for a plan to fight the needle exchange in court.

[Original Story]: On January 17, the City of Santa Ana denied the Orange County Needle Exchange Program’s (OCNEP) application to obtain a permit allowing the non-profit to operate in the Civic Center. The news arrived a month before OCNEP’s two-year anniversary, leaving their clientele of hundreds of people without clean supplies and access to basic healthcare. OCNEP has since submitted an application to the California Department of Public Health (CDPH) to operate a mobile needle exchange program that would not only provide supplies to injection drug users in Santa Ana, but also those in Costa Mesa, Anaheim, and Orange.

According to Dallas Augustine, an OCNEP board member and Ph.D. student at UC Irvine, this rendition of the needle exchange will operate one day a week in each city. So, rather than providing services and supplies to one city in Orange County one day a week, OCNEP would be allowed to operate a total of four days in OC and distribute their services to more areas. The public comment period ends on June 25. At that point, the CDPH will decide whether or not to approve OCNEP’s new model.

“If we get approved by the CDPH,” Augustine says, “we’ll be cruising around the county in our van serving people who weren’t getting served before. We’ll also have the ability to drive to all of our dispersed clients who were kicked out of Civic Center and the river bed.”

Augustine tells us the non-profit received opposition from Costa Mesa by way of articles quoting city officials saying the needle exchange will pose a threat to people in recovery living in sober living homes in the area. But when members of OCNEP talked to members of the Costa Mesa PD, Augustine says the conversation was amicable and “really promising.”

OCNEP is no stranger to opposition. During their span at the Civic Center, they endured run-ins with the cops, council member pushback, complaints, etcetera. Augustine believes they’ll likely experience the same aversion from city officials in Anaheim and Orange, too. “We are trying to proactively work with the cities and create positive rapport,” she says, “but it seems like there’s already a lot of misunderstanding about what needle exchanges do and the concern of us drawing drug users to their cities.”

The misinformation is rampant. Since getting shut down, however, volunteers have partnered up with Aimee Dunkle from the Solace Foundation to travel to different parks and areas in Santa Ana to deliver Naloxone and harm reduction supplies—except syringes—to injection drug users living on the streets. Augustine and one other OCNEP volunteer were out on a recent Saturday and saw one of their regular clients. He told them he and his girlfriend had reused the same needle so many times that it’s become dull and barely goes through their skin anymore.

 According to the Orange County Coroner, OC has the fourth-highest number of HIV-positive patients in California—a number that’s doubled in less than 10 years. Orange County also has nearly 1,000 cases of hepatitis C, Kyle Barbour, an OCNEP co-founder, told the Weekly in an interview last year. “Providing clean equipment to injection-drug users can drastically reduce the risk of contracting these diseases because the need to share or use a needle more than once is essentially eliminated.”
(Photo: Bridget Arias)

Augustine says when she went to hand out harm reduction supplies, she realized how bad the abscess problem has become. “This is what’s been going on in our absence. Oh, and the fact that we’ve still been hearing reports about needle litter, but our hands are tied so there is nothing we can do about it.”

Syringe waste is the main issue the City of Santa Ana emphasizes as the reason for shutting down the needle exchange. When we spoke to Jose Solorio after OCNEP was denied its permit, he explained the program was a threat to public health. “There was an ever-increasing number of public health concerns,” he said, “and complaints from children and parents about finding dirty needles in the city’s main library.”

But Solorio told us he’s open to a mobile clinic model that serves multiple cities in north, central and south Orange County. “Santa Ana shouldn’t be the only city in the county burdened with allowing this service in their community. Better strategies and disposal cost reimbursement provisions need to be developed to keep dirty needles away from libraries, parks, and schools.”

Augustine explains OCNEP did their best by conducting in depth needle sweeps once a week. But in terms of syringe waste complaints, they wouldn’t hear about the reports until months after the fact. This time around, however, OCNEP is introducing a hotline that people can call, text or email to report improperly disposed of needles. Then an OCNEP volunteer will go to the location and do a sweep. Additionally, that location will be added to a hotspot-map to keep track of the areas in which concentrations of needle litter exist. Augustine explains those locations will be places they routinely visit throughout the week to make sure there is no syringe waste.

While OCNEP was briefly up and running, it only operated one day a week from 12 p.m. – 3 p.m. Most needle exchanges are open seven days a week and for more than three hours per day. Given the 22-month lifespan of OCNEP, it’s questionable if enough time passed to properly assess whether there was an influx of dirty needles in the area. When we first reported on OCNEP in the beginning of 2017, no official records had been kept tracking the amount of syringe waste prior to the program’s inception or through its duration. 

The closest needle exchange programs to Orange County are San Diego County’s and East Los Angeles’. At an OCNEP meeting in early May, a representative from Bienestar Needle Exchange in East LA attended to tell the OC team that Bienestar has seen an overflow of former OC needle exchange clients. More specifically, the rep told those at the meeting about an OC client who rode the bus from Santa Ana to East LA with 19 people’s used syringes and was there to get new ones for everyone. (Imagine how many used needles that is!) This client was only able to ride public transit to get to Bienestar because all 19 people pooled their money together so he could get everyone clean needles.

Statistically, cities that have needle exchanges tend to have less syringe waste than those that don’t because these programs offer proper disposal methods. A survey conducted in 2011 by the National Center for Biotechnology Information compared neighborhoods in Miami (a city with no needle exchanges) to San Francisco, which has multiple such programs. Miami racked up a total of 371 used needles on the ground, while San Francisco landed at 44.

According to the Orange County coroner’s office, overdose fatalities spiked to 400 in 2016—a six percent increase from 2014, and 63 percent from 2006. “There is obviously an unmet need here,” Augustine says. “Riding public transit with all those needles is a huge risk. It’s a risk for that client and the people around him. It’s heartbreaking to hear stories like this when a solution is to let us run our program. We all would really love to start putting our energy back into serving people instead of into fighting to operate our program.”

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