America’s opioid crisis can be seen right in our backyards. Over the last decade, Orange County has developed a massive drug problem—specifically with heroin and prescription opiates—which has taken the lives of thousands of people. In February 2016, Orange County opened its first needle exchange—a progressive and essential move for an opioid addicted, conservative town with a population size larger than some states. Every Saturday from noon to 3pm, people fled the Civic Center in Santa Ana to get syringe-waste buckets, clean needles and syringes, tourniquets, doses of Naloxone—the overdose reversal drug—and access to basic health care, like STD, HIV and Hepatitis testing.
But on Wednesday, Jan. 17, 2018, the City of Santa Ana denied OCNEP’s application to obtain a permit that would allow the non-profit to continue operating in the Civic Center. Kyle Barbour, one of OCNEP’s founders, says the city’s had problems with the needle exchange since its inception. But when the California Department of Public Health granted OCNEP’s recertification in mid-January, it seemed as though things were on track; as if they had leverage, even.
“The City didn’t get back to us about our permit for a really long time,” says Barbour. “So we continued to operate every Saturday while we waited to hear back. Per our conversations with [the City], if they didn’t give us the status of our permit then we could operate. So that’s what we did.”
But the Santa Ana Police Department wasn’t happy about that. Cops showed up every needle exchange during the time OCNEP waited to hear back about their permit. Their presence didn’t exactly resemble a welcome mat for the population the program serves. These types of “scare tactics,” as Barbour calls them, are nothing new. If it’s not the police disrupting the non-profit, it’s another level of city bureaucracy. Prior to getting the permit denied, the city required the Solace Foundation, the non-profit that distributed Narcan (or Naloxone, the overdose reversal), to separate themselves from OCNEP and operate in a different part of the Civic Center. Aimee Dunkle, the founder of the Solace Foundation, complied by setting up a table near the tent encampment next to the flags. According to Barbour, however, that impacted the effectiveness of Naloxone distribution, thus raising the possibility of more avoidable overdoses occurring in Orange County.
Similarly, the City tried to make the Aids Service Foundation, now known as Radiant Health Center, also separate from OCNEP. But they refused, arguing that people wouldn’t get tested if it wasn’t readily available to them.
“It’s upsetting this is what it’s come to,” says Barbour. “We are more than willing to collaborate with [the City]. We’ll help open more sites and more places, we will pick up needles, we will give people sharps containers. We already do all this. But [the City’s] continued to say they want us to be open in more locations. If that’s actually what they want, then they should be supportive of us; and If they don’t want us to be at the Civic Center we’re fine with not being at the Civic Center, but they need to let us be somewhere. They are not doing anything about the problem by eliminating us.”
Santa Ana City Councilman Jose Solorio says OCNEP wasn’t approved for a permit because it created major health hazards, giving the City many reasons to deny the application. “There was an ever-increasing number of public health concerns and complaints from children and parents about finding dirty needles in the city’s main library.”
That said, Solorio says 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.”
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. Opiate addiction has affected all of OC, from South County to the homeless encampments of the Santa Ana River, and has claimed everyone from the children of police officers and firefighters to third-generation addicts. Additionally, 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, Barbour 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.”
While it was briefly up and running, OCNEP operated only one day a week, while most other needle exchanges are open seven days a week, and for more than just three hours per day. And 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. According to Barbour, however, the team always disposed of syringe waste they found in the Civic Center.
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.
With OCNEP closed, the nearest needle exchanges are Homeless Health Care Los Angeles, LA Community Health Project and San Diego’s Clean Syringe Exchange Pilot. Let face it: one needle exchange was never sufficient—especially considering the severity of our heroin problem. But traveling over an hour to get clean supplies isn’t a reality for most of these people. It also assumes they have access to transportation. “These people are part of our community,” says Barbour. “They deserve the right to live somewhere, have clean food and water, have access to health care, and public institutions should respect their needs. Orange County needs to uphold this. It’s our ethical responsibility to our fellow man. Eliminating the needle exchange will hurt people— and not just those who use needles. It’s not economically, socially or legally defensible to allow people to get hurt or die just because you don’t like them.”