The Harm Reduction Institute, a nonprofit based in Santa Ana, has applied to the California Department of Public Health to add home delivery and pick-up of syringes to its current program. Santa Ana officials say they want no such services to operate in the city.
The nonprofit currently offers overdose prevention and harm reduction services, such as the distribution of naloxone, first aid supplies and fentanyl test strips, to about 300 people via street outreach. It also provides case management and treatment navigation services for participants who need medical care, as well as social and mental health services, including treatment for substance use disorder.
To reduce the spread of HIV and viral hepatitis, HRI is proposing additional services, which would include the distribution of sterile syringes, the collection and free disposal of used syringes, and rapid testing, its leadership says.
But Santa Ana leaders are remembering the Orange County Needle Exchange Program that operated in the city between 2016 and 2018, before shutting down after city officials denied it a permit in 2018, saying the program had resulted in needles littering the area in and around the Civic Center. In November 2018, a judge barred the same group from running a mobile needle exchange program in four Orange County cities, saying volunteers didn’t have adequate resources to prevent or clean up needle litter, pointing to the estimated 250,000 syringes that were unaccounted for during its time at the Civic Center.
“The (Orange County Needle Exchange Program) is a very different organization compared to the (Harm Reduction Institute),” Carol Newark, executive director of the Harm Reduction Institute, said. “We now have five full-time staff members; we do outreach in the community Monday through Friday. OCNEP was operating one day a week and it was all volunteer-run. That’s not to say that there’s anything wrong with an organization like that, but we are in a very different position now.”
If approved, the program wouldn’t offer syringe services from its office location, instead providing home delivery and pick-up services on Mondays and Wednesdays within Santa Ana, Neward said. Participants would be able to contact the organization through a hotline number to schedule services. Residents who see syringe litter would also be able to use the hotline to contact the institute to collect and dispose of them.
Newark said there is no estimate as to how many syringes would be exchanged as part of this plan since a home delivery method has never been used before, however, the organization plans to report data to the California Department of Public Health on a regular basis.
“No one wants to see syringe litter ever, and we do not want to be the cause of it. A lot of our efforts are going to be focused on disposing of syringes safely, in addition to giving out the sterile ones,” Newark said. “I think we all actually have the same goal, which is to make sure that there’s no syringe litter and we would be providing a free service. And we’ll come to you, people don’t have to go anywhere to dispose of needles. We will actually come and get them.”
“That was really the solution that we could come up with that best fit the concerns of the community and also the public health need that exists in Santa Ana for a needle exchange program,” she said.
Santa Ana Mayor Valerie Amezcua said changes to how to syringes are distributed won’t stop needle litter from happening.
“I think we’ll still find needles in our neighborhoods, in our schools, in our parks, still find them in our streets, because if they have people in their homes that are using needles for drug use, drug use doesn’t just occur in the home and drug users share needles,” Amezcua said. “So therefore, how are they going to guarantee that that needle is not, one, going to be shared, and two, walk out of that home and be used outside by somebody else or by that person.”
Amezcua said her priority is the quality of life of Santa Ana residents, adding, “We bear the weight of so many things already and we cannot bring this back into our city.”
Newark said the organization wants to operate in Santa Ana because of the high rates of HIV and Hepatitis C transmissions being seen. According to a 2021 HIV fact sheet from the OC Health Care Agency, Santa Ana and Orange have the highest rates of HIV diagnoses.
Newark added that data specifically points to Santa Ana having the highest rate of HIV transmission. “If you’re trying to prevent the spread of HIV, you have to go where the problem is,” she added.
“A lot of the opposition I do believe comes from stigma. It’s like there’s an ‘us versus them’ sort of thing. ‘The public of Santa Ana is being threatened by this organization,’” Newark said. “I see that in the news or on Facebook … that we shouldn’t be allowed to open because we’re a threat to the public, which kind of insinuates that people who are using drugs and live in Santa Ana are not actually a part of the public. And I just don’t think that’s right.”
In a letter to the California Department of Public Health, Orange County Public Health Officer Dr. Regina Chinsio-Kwong also raised concerns over the group’s proposal, saying it lacks “adequate accountability for safe syringe disposal and syringe collection,” adding that although participants have other options for disposal, improperly disposed syringe needles pose a direct threat to public health.
“To overcome well-founded community concerns, HRI will need to demonstrate safe and effective methods of appropriate syringe disposal and collection, provide behavioral health support/referrals, with close follow up, and work collaboratively with the community, collect data and monitor both negative and positive impacts to the community,” she said.
Newark said if its application is approved, the organization will still have to figure out how to proceed given an ordinance in Santa Ana that bans needle exchange programs.