News

Sep 15, 2023

Public Health responds to syringe exchange claims

Reporter In recent weeks both the El Dorado County Board of Supervisors and Placerville City Council have voted in favor of sending letters urging the California Department of Public Health to not

Reporter

In recent weeks both the El Dorado County Board of Supervisors and Placerville City Council have voted in favor of sending letters urging the California Department of Public Health to not permit the Sierra Harm Reduction Coalition to continue operations in the county, claiming the group causes more harm than good.

SHRC's website states that the organization is focused on "non-judgmental and non-coercive provision of services and resources to people who use drugs and the communities in which they live to assist them in reducing attendant harm." The group provides direct outreach services including exchanging used needles for new ones, supplying emergency overdose medication such as NARCAN and testing drugs for fentanyl to both homeless and housed county residents.

The board-submitted letter, signed by Board Chair Wendy Thomas and El Dorado County Sheriff Jeff Leikauf, lines out multiple concerns the local government and law enforcement agency have with the needle exchange's operation in the county. A presentation given to the board and later revisited by the City Council laid out the concerns in further detail, including arguments the coalition's efforts did little more than enable drug use, did not notably mitigate spread of diseases such as HIV or hepatitis C in the area and was cited as a factor in increased crime.

Harm reduction organizations in California must have their authorization to operate in a county renewed yearly; SHRC's next potential renewal date is Sept. 1. Though an official decision is not expected to come until that time, a representative from the CDPH who did not give their name has responded to the Mountain Democrat with information that challenges claims made in the county and city letters.

A concern voiced at both county and city meetings regarding SHRC's operations was that the organization's needle exchange led to an increase in the number of used needles discarded in public streets and parks.

"It exposes our public to dangers and the less needles on the street we’re better off," Councilmember David Yarbrough said at the June 27 meeting.

Though no specific numbers were given, councilmembers Yarbrough and Jackie Neau both stated they had seen a uptick in the number of discarded and presumably used needles while on walks.

An article published by the Centers for Disease Control, "Summary of Information on The Safety and Effectiveness of Syringe Services Programs," provides an alternate perspective. Recognizing the risk of accidental jabs — CDC data shows as many as one in three law enforcement officers will experience such a situation in the line of duty — multiple studies have looked how syringe exchanges may factor into potential risks.

Study findings cited in the CDC article appear to make a definitive argument that exchange programs do more to keep needles off the streets rather than adding to them:

"A study compared the prevalence of improperly disposed of syringes and self-reported disposal practices in a city with SSPs (San Francisco) to a city without SSPs (Miami) and found eight times as many improperly disposed of syringes in Miami, the city without SSPs. People who inject drugs in San Francisco also reported higher rates of safe disposal practices than those in Miami. Data from CDC’s National HIV Behavioral Surveillance system in 2015 showed that the more syringes distributed at SSPs per people who inject drugs in a geographic region, the more likely people who inject drugs in that region were to report safe disposal of used syringes."

When presenting property and drug crime statistics to the board in June, Leikauf indicated the downward trend in crime was attributable to EDSO's "total enforcement" approach. Leikauf also noted the decline may stem from changes in laws that came with Propositions 47 and 57 that decriminalize drug offenses and reduce severity of property crimes; additionally, corporate retail policies have begun to not enforce or report thefts such as shoplifting.

Leikauf's argument highlighted that, although crimes may be reported less, they are still happening and can be attributed to the population SHRC serves. County officials claim in the board-signed letter that the coalition’s services in the county are undermining efforts to reduce the homeless population that commits some of those now-unreported crimes.

"With our Sheriff’s Office we are constantly chasing these people and trying to keep our community safe,” Leikauf said.

Communication from the CDPH disputes the county's rationale, attributing causes of crime to other factors.

"Studies have demonstrated there is no correlation between the presence of a syringe program in an area and crime rates; rather, systemic factors such as poverty, trauma and a lack of educational and employment opportunities persist in driving most crime," a CDPH representative states in an email.

The representative added that other efforts in the county could provide long-term improvements in terms of crime reduction.

"Efforts in El Dorado County to open a navigation center as well as other social services are examples of a public health approach to social inequities that may have lasting positive effects in the community."

One pervasive point in the conversation about SHRC was the limited spread of disease in the community presently, calling into question the necessity of an exchange program in the area.

CDPH reports show eight people were newly diagnosed with HIV in 2021 and six diagnosed in 2020; there were 181 reported cases of hepatitis C in 2019, with the number dropping to 145 by 2021, according to El Dorado County Communications Director Carla Hass.

Though the case numbers are low, the CDPH representative states the risk of spread was still worth considering.

"15% of people living with HIV in El Dorado County reported injection drug use as a risk for transmission. The average statewide is 12%," the CDPH email states. "When public health prevention programs work as they should, its effects are invisible. It is only when something goes wrong that people become aware of the silent role these interventions. While rural counties such as El Dorado may currently have relatively few residents with diagnosed cases of HIV and hepatitis C virus, the presence of a syringe program can make all the difference in preventing an outbreak like the one in Scott County, Indiana in 2015, where 215 people in a small, rural community were infected with HIV before public health officials were able to bring transmission under control."

Though studies have found harm reduction program users were five times as likely to enter a treatment program and nearly three times as likely to stop using drugs, EDSO has not seen SHRC as a reliable road to recovery. Leikauf shared with the board that a confidential informant had reached out to the organization for help ending their addiction but was told no rehab resources were available and were instead given drug use supplies, fentanyl test kits, alcohol swabs, condoms and lip balm.

“We already have the tools and resources available here if they want help to overcome (drug addiction),” Leikauf said. “We remain an agency that is committed to total enforcement on crime and criminals and total care for our victims, witnesses and community.”

Reporter

Do people still trust data? How about we just look around and trust our eyes and experiential reality! No common sense at all - just trust the data given by the trustworthy folks who keep us in the mess? C'mon....this is a no-brainer.

I'm convinced that some people post here who don't bother to read the initial article. The MD has a comment section for people to respond to what has been published in their paper, and have a discussion with those who actually read the article. Some people want to use this as their own personal soapbox and consider the article's comment section as only a space to vent their personal greivances. Read the article, research, form an opinion, and then share. Really not that hard.

Im sure its true that some people don't read, some don't understand, and some use it as a soapbox... as far as i can tell, you fall into all of those categories on a regular basis.

'really not that hard'

Mary Mary Mary And I was just starting to like you lol

San Francisco has a high needle exchange rate because the city runs injection sites to retrieve the needles right after injection. One California city collected 14,000 used needles from public areas and decided to end the program. This is suppose to be a one for one exchange, and anyone who walks off road in this county knows that there is a possibility they or their pet will find at least one. This needle "exchange" program has been a failure at protecting public safety, what should be its main goal.

Nice job parroting the same false narrative the leikauf and thomas have been spewing. This isn't about San Francisco.

"People who inject drugs in San Francisco also reported higher rates of safe disposal practices than those in Miami." Did you even read the article before commenting? Also, I am not a parrot and form my own opinions.

LOL... i love that you can't come up with an example from outside of the text of this 'article'

What the CDPH is saying in their response is that if we had Safe Shooting Sites like they do in San Francisco we would have less improperly disposed of needles. One of the objections to this program is that needles are handed out without one being turned in. Programs like this are suppose to keep stats on needles going out vs being returned and the information presented to the supes and city officials. If anyone denies that needles aren't found where local people hike and congregate, they are in denial.

If they are unwilling or unable to understand the data, it is our responsibility to recall Leikauf and Thomas. Programs like this work, period.

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