The L.A. County Public Health Harm Reduction panel included (left to right): Barbara Ferrer, Schoshanna Scholar, Dr. Brian Hurley, Veronica Lewis and Dr. Gary Tsai.
The reason that Los Angeles has so many drug users living on the street, according to L.A. Department of Public Health Director Dr. Barbara Ferrer, “If you don’t have a house, you’ll do your drugs in a public space.”
At a Los Angeles Department of Public Health two-hour forum held in March, Ferrer defended free needles for users and explained the benefits of “Harm Reduction.” https://www.youtube.com/watch?v=rO7KYTh8YP0&rco=1
Among the places that needles are given away are the three public parks in Santa Monica: Reed, Tongva and Palisades.
How does Harm Reduction stop drug use? It does not. It keeps addicts alive until they are ready to take the steps to go into rehab.
The Harm Reduction program as defined by the County allows those that are not ready to give up drugs to receive Naloxone, syringe exchange and linkages to treatment.
The five experts on the panel, Ferrer, Dr. Gary Tsai, Dr. Brian Hurley, Veronica Lewis and Shoshanna Scholar, agree the program is important because it allows an addict to go through stages: Precontemplation, contemplation, preparation, action, recovery and maintenance.
Tsai, director of L.A. County’s substance and Abuse prevention and control division, said Harm Reduction was needed because “Overdose rates are currently the highest in both local and national history.”
About 3,220 people die from fatal drug overdoses in L.A . County every year – or about eight to nine people daily die from overdose. “The numbers are continually going up,” Tsai said.
Eight to nine people die daily on L.A. County streets because of overdoses.
About 95 percent of substance users don’t receive treatment. “And 95 percent of those users did not perceive the need for substance-use treatment,” Tsai said, and added that the goal is “meeting people where they are” = hence Harm Reduction.
In 2022-2023, the county estimates that 3,600 lives were saved (overdose reversals). That 52,000 naloxone doses were distributed, and more than 14,000 fentanyl test strips distributed.
One person asked the panel, How many people were able to transition from Harm Reduction to treatment? What are the metrics for decline of HIV or infectious diseases, which the needle program is supposed to prevent?
“One thing that is very hard about public health data is, we use trend lines, it’s hard to show you how much disease we’re preventing in the moment,” Ferrer said. It’s hard to see what we’re preventing—that’s based on modeling. Everyone needs to look at the data and then think about some other markers.”
“We want to keep people alive, so they have a second chance, and they can be all they can be,” she said.
Psychiatrist Dr. Brian Hurley, who is the County’s Medical Director of the Division of Substance Abuse Prevention and Control, blamed country residents for lack of support.
“One of the biggest challenges is not enough Harm Reduction services,” Hurley said. He noted that one of the biggest barriers against people going into rehab is the stigma and judgment people have internally – and in the neighborhood. “People used terms that don’t humanize people . . .that kind of judgement—‘I’ll only help if you don’t drink or do ever drugs again.’”
The Public Health Office said Harm Reduction is practiced in health care and Ferrer gave diabetes as an example. More than once she equated drug use to people who have diabetes.
“That’s like telling people who have diabetes they have to get their weight under control, they have to be eating healthier or you’re not going to treat them,” Ferrer said. “That you have to do a bunch of work before you get care, seems contrary.
“There’s no one treatment for diabetes,” she said. “We need to have an open mind, as people go through their [drug] recovery treatment.”
Several people pointed out that equating diabetes with drug use was offensive. If someone is not treated for diabetes, a disease of the pancreas and insulin production, they die.
Harm Reduction does not require someone to stop using, a point that one participant pointed out during comments.
“A lot of this language today is normalizing illegal drug use,” the participant said, and then spoke of a flyer that was handed out to those in the audience, with the top concern listed was eliminating HIV and hepatitis in drug users by providing free needles through Harm Reduction.
“These people are not going to live long enough,” she said. “The last concern [on the flyer] was providing recovery services, that should be on the top.”
The speaker also challenged County Health to support 12-step programs, because “they work.” She was told that they don’t work for everyone.
An eight-year-old Santa Monica resident caller, via zoom, said “there is something scary happening in our parks. Lots and lots of needles are left everywhere. They can make you sick if you step on them or touch them. I know people need help, but it’s making it scarier for people like me.”
When a Santa Monica public parks commissioner asked if the program could be moved out of a public park, Ferrer said, “We are not going to stop doing needle exchange, it is a proven strategy, it has decades of evidence. We’re not going to stop. I want to suggest that wherever we go with our mobile team there will be complaints.”
When queried if she had ever been to the Santa Monica Parks, Ferrer said, “No.”
The panelists answer to the discarded needles was that more “sharp” containers be installed. That means that when users failed to exchange needles when they got new ones from the County, there would be more places to dispose of them.
Another caller pointed out that people, such as Santa Monica sanitation workers were paid to pick up the needle litter. Fairly or unfairly, it seems the environment is not drug users biggest concern.
John Alle documented the needles were found in the Santa Monica Parks and in storm drains.
Photo: John Alle/Santa Monica Coalition
It was acknowledged that there were several Santa Monica residents in the audience and more attending virtually. The panelists made it clear that the problem was not the drug users, but the communities inability to understand the importance of Harm Reduction and the importance not to stigmatize the homeless or the junkies.
The Santa Monica Parks Commissioner acknowledged that she understands the importance of the program, but could the County move the needle exchange out of parks. “Could you find alternate sites that are not children’s playground, community centers, schools and parks,” she asked.
Scholar said, “The notion of the most extreme manifestation of poverty is homelessness. Evicting people from outdoors who have landed there because of inequities is a very convoluted system, related to racial dynamics.
“Were they not using before harm reduction?” Scholar asked, “People were using already. I understand the frustration of children having to be expose to that, the violence that might associate, walk over needles and tools, but because there’s nowhere to put them [users], our system doesn’t have enough affordable housing.”
It was explained that drug users’ public space is everyone’s space, and that L.A. County Department of Public Health selected that area [Santa Monica Parks] because there was a lot of people using.
“Public drug use happens because people have nowhere to go,” Scholar said.
Ferrer told people from Santa Monica that maybe their town “could be one of the first places to have a safe-consumption space” like they do in Barcelona (her team was sent to observe the program).
Lewis, Director of Homeless Outreach, who had flown to Barcelona on taxpayer dollars to examine their drug program pointed out that “Substance use changes over time.
“They [drug users] had no relationship – no one caring about them,” Lewis said. “Harm Reduction is compassionate care and inviting them into community.”
Ferrer added that, “People have their own right to compassionate recovery.”
On speaker pointed out that with nine people dying daily on the streets that L.A. County should have better solutions about how to save lives. “You are responsible for all humans in your county,” the caller said. “You should keep all humans safe [including residents and children], not just certain humans.”
Santa Monica paramedics were able to revive the man who had taken a drug overdose in Tongva Park.
It’s good that the 8 year old learn now that criminals and the homeless have more rights than rule following taxpayers in todays California.