(Editor’s note: This is a two part series about the L.A. County Department Health’s Program that provides needles to addicts. There are no statistics to show the program works to help addicts. Photos: John Alle.)
A Palisades resident John Alle discovered used needles and condoms littering three Santa Monica parks, Palisades, Reed and Tongva.
As a Santa Monica Promenade businessman, he’s had increasing trouble with addicts, “smash and grab” crime and the mentally ill roaming the streets. Business vacancies have skyrocketed.
Alle is a member of the Santa Monica Coalition, a group trying to restore public safety to the downtown area. He was upset upon discovering the needles and mirrored the concerns of many residents who didn’t want children stepping on used condoms or sharps at playgrounds.
He discovered the needle program had started in 2019 through L.A. County Department of Public Health under Dr. Barbara Ferrer. The SM Coalition reached out to Ferrer and her colleague Dr. Gary Tsai, requesting a meeting.
Members of the coalition met with Ferrer on May 22 and according to a report from the meeting, there were no metrics of the success of the needle exchange program, and there were no records or names of those who asked for needles. The group was also told that there are no referrals or contacts for follow-up mental health of sobriety/drug rehab programs.
CTN reached out to L.A. County DPH on May 27 to ask about the program, which is administered under the idea of “harm reduction.”
Ferrer’s office responded in a May 31 email to CTN “Harm reduction services have been demonstrated to reduce overdose deaths, reduce the public use of injectable drugs, reduce transmission of communicable diseases such as HIV/AID and hepatitis, increase access to substance use services, reduce the use of emergency medical services, and prevent the disruption of public safety.”
“For example, in high-risk populations, upwards of 20% of naloxone doses distributed may result in overdose reversals, meaning that a life is saved for every 5 doses of naloxone distributed,” her office responded, but did not send statistics to back that claim.
Circling the News asked for the statistics for the program’s success. There are none available.
CTN also asked for the research that shows “harm reduction,” which first instituted a needle exchange program in the late 1980s is successful at treating addiction.
Harm reduction was a concept introduced in the late 1980s, largely because of the HIV/AIDS epidemic (HIV-human immunodeficiency virus and AIDS-acquired immunodeficiency syndrome).
AIDS was spread not only sexually, but also through intravenous transmission via needles At the time heroin was one of the drugs most injected.
A National Library of Medicine “(AIDS.2008) study “The Role of Harm Reduction in Controlling HIV Among injecting Drug User,” noted that “It has been known since at least the early 1990s that HIV among IDU (injecting drug users) can be easily controlled by the early and vigorous implementation of a comprehensive ‘harm reduction package.’ This package consists of education, needle syringe programmes, drug treatment and the community development of drug users.”
By 2005, there were 22 nations that approved of harm reduction as a method of HIV prevention, the US was not one of them.
The report also noted, “The debate about the essence of illicit drug use is still unresolved. Zero tolerance supporters see any illicit drug use as intrinsically evil, whereas harm reduction practitioners focus on trying to prevent damage.”
Ferrer’s office was asked for data to support the current needle exchange program. Three studies were sent to CTN, a 2000 “Effectiveness of Syringe Exchange Programs in Reducing HIV Risk Behavior and HIV Seroconversion Among Injecting Drug Users,” which was based on 48 studies. The authors concluded there were issues with the study because there were no control groups and no randomized trials.
The authors wrote “an ideal study would involve a prospective cohort recruited and interviewed before implementation of syringe exchange, such that IDU (injecting drug user) who would later go on to use an SEP (syringe exchange program) could be clearly differentiated in terms of risk from those wouldn’t.”
The second study Ferrer’s office sent was from the Journal of the American Pharmacist Association (2022) “Expanding the Accessibility of Harm Reduction Services in the United States: Measuring the impact of an Automated Harm Reduction Dispensing Machine.”
A vending machine was placed in Cincinnati that allowed addicts the following products every seven days: two doses of IM naloxone, two doses of naloxone nasal spray, a sharps container, a safer injection kit, a safer smoking kit, a Personal Protective Equipment kit, a safer sex kit, a pregnancy test and a box of bandages.
The paper concluded that “the machine was associated with a lower countywide incidence of unintentional overdose death and HIV. The association with decreased overdose death and HIV incidence should be further investigated to assess causality.”
Once again, the study pointed out there was no measured cause and effect.
The third article was a 2014 article from the International Journal of Drug Policy (“The Cost-Effectiveness of Harm Reduction,”) funded by the Australian National Health and Medical Research Council and the World Bank Group.
It concluded that needle-syringe programs, combined with Opioid substitution therapy and antiretroviral therapy for people, was cost effective when compared to the medical lifetime cost savings.
“Numerous studies have examined the effectiveness of each harm reduction strategy” the article said. “Each approach has clear evidence of impact on reducing drug dependency on reducing risk behaviors and ultimately averting HIV transmission.”
Harm Reduction, in the articles sent by L.A. County to CTN is about preventing the transmission of AIDS among drug users, who’s preferred method was injection. At one time, heroin was the injected drug of choice of drug users. Heroin deaths reached a high of 15,482 in 2017 and since have declined: 9,173 deaths were reported in 2021.
Many may remember that HIV is the virus that causes AIDS and the first cases in the United States were reported in 1981. By 1986, AIDS was considered an epidemic and to be diagnosed was a death sentence. As of 2018, about 700,000 have died of AIDS and about 13,000 people die annually.
Antiretrovial therapy was developed. Although it doesn’t cure HIV, the medicine can lower the virus to undetectable levels where it can’t harm the body.
CTN stopped by the Santa Monica Police Department on June 2 and asked which illegal drugs were most often used in 2023.
“Methamphetamine and fentanyl,” was the response by the officer, who explained that fentanyl generally comes in pill form and that users think they are taking another drug. Meth, which looks like rock salt, can be snorted, smoked, ingested or injected.
More than 109,000 persons died from drug-involved overdose in 2022, and it’s estimated that 67 percent of those deaths were from fentanyl.
(“Needle Exchange Coming to Your Neighborhood, Part 2,” Will Run Tomorrow.)