Circling The News

(Editor’s note: This is part 2 of a series about the needle exchange program in L.A. County Parks. Photos: John Alle)

A Venice Family Clinic van pulls up across from Saint Monica High School and Grade School and parks a half block from a playground.

Two men get out and approach those adults lounging in the park at about 1:30 p.m. on a Friday afternoon. A man stays behind and opens the back door to the van. This is a site for drug users to access clean needles, band aids and naloxone.

This editor is sitting at Holy Grounds, a coffee shop located at the edge of St. Monica School and goes to the van and asks what it provides.

The man, probably in his 30s is friendly and explains that they provide overdose prevention services. A young man comes up to the rear of the van, while we’re chatting. I step back. The Family clinic guy asks if he needs a kit, he says “yes,” he asks if he needs wipes, “yes.” He asks if he needs Narcan, “yes,” he said.

The young man was asked for his initials and his date of birth.  He gives them and says he was born in 1999. Holding his kit and wipes, he walks off.

I asked the guy in the van why they ask for initials, if they track the individuals, and he told me the information goes into a database.

Harm reduction means that the needle-exchange clinicians cannot ask them if they would like help, but rather have help ready if an addict asks for it.

This method of harm reduction ignores the families and friends impacted by an addict’s behavior, who might be looking for them.

As this editor stood listening to the interchange, I wondered about the young man’s mother. Did she know her son was standing in Santa Monica? Did she know her son was alive?

Around the corner from the van, a drug deal is going down in the park.

Reverend Andy Bales, who has worked with the Union Mission in Skid Row and with addicts since 1994, was appointed to the Los Angeles Homeless Services Authority Commission in November.

“I believe in recovery and people that are homeless with addictions — whether the addiction developed because of it or led to it — the addiction still needs to be addressed for them to live a whole healthy complete life,” Bales said in an April 2021 Newsweek Story.

A May 12, 2023, L.A. Times Story (“L.A. County Wants to Curb Riskier Fentanyl Use. Its Approach Worries Some Activists”) it notes that L.A. County has increased its “harm reduction” budget from $5.4 to $31.5 million and that includes giving out glass pipes.

The story points out that many skid-row residents say harm reduction, which in some form has a 40-plus-year history, albeit largely underfunded, hasn’t worked, and they see the pipes as hurrying homeless people along to their destruction.

“‘We’re trying to give them real help. We don’t give them drug tools,’ said Skid Row activist Tony Anthony, whose video of pipe distribution was on local news.”

To which Bales tweeted “With fentanyl deaths soaring, L.A. County is giving out drug pipes and other supplies-NO! We don’t want to keep them smoking!! Thankful to my friends, OG, & Anthony, for sharing some common sense. I’m broken hearted about lack of the same from LA County.”

This woman needed medical attention when John Alle went back to give her numbers to call for aid.

In a February 2023 opinion piece in the Daily News (“Barbara Ferrer and Gary Tsai: We Must Take Bold Action to Halt the Tragic Drug Overdoes Crisis”)

“Harm reduction includes a range of strategies that prioritize the health and well-being of people who use drugs over complete abstinence from substances. It is grounded in respectful and nonjudgmental services that meet people who use drugs wherever they are along the continuum of recovery.

“In fact, harm reduction is an aspect of medical care for many diseases and conditions already. For example, we do not tell people with diabetes that they can’t be eligible for treatment unless they comply with diet restrictions 100% of the time or that people with heart disease can’t receive care unless they exercise.  . . .

“These sites do not furnish drugs to people; they furnish a safer environment for people to use the drugs they are going to use anyway.

“The ability to expand harm reduction strategies should be coupled with an increased focus on addressing the root causes of human suffering with upstream interventions. At its root, substance use is often associated with a lack of connection to meaningful relationships, activities, and purpose.”

Bales, who for 30 years, has dealt with people who have addictions, told KABC’s John Phillips that Ferrer doesn’t know what she’s talking about, and that the department is wrong about addiction.

The County said “clients are provided both intranasal and injectable naloxone to reverse opioid overdoses and hygiene kits. Clients who are interested in substance use treatment are referred to the Venice Family Clinic SUMMIT program. Clients are referred to Venice Family Clinic’s Common Ground program for HIV and hepatitis C testing. If they require medical intervention, the homeless outreach unit from the Venice Family Clinic will go see the patients in their location.”

The county noted that “Each interaction individuals have with outreach staff becomes an opportunity to discuss ways they can decrease their risk for overdose and for residents to connect with treatment when they are ready.”

This editor’s observation, and that of Santa Monica Coalition’s Allen, who was lying on the ground in Reed Park, was no one is asking addicts if they would like to kick the habit, or if they would like to go to drug rehab, or if they want medical help or if they want to talk to someone.

“Harm reduction” has morphed into a movement that is described by the National Harm Reduction Coalition, as “a philosophical and political movement focuses on shifting power and resources to people most vulnerable to structural violence. . . and the realities of poverty, class, racism, social isolation, past trauma, sex-based discrimination, and other social inequalities affect both peoples’ vulnerability to and capacity for effectively dealing with drug-related harm.

“Establishes quality of individual and community life and well-being—not necessarily cessation of all drug use—as the criteria for successful interventions and policies.”

Reverend Andy Bales, in an op-ed piece about Housing First wrote the Union Rescue Mission, founded in 1891, practices a faith-based “recovery model.” The 12-month intensive program includes 2,000 hours of a biblical 12-step program, recovery classes, work therapy, counseling and a physical fitness class.

Even though there are no statistics to show harm reduction works, the county now has increased its harm reduction budget to $26 million.

In three different emails, CTN asked if there was a plan to open needle exchange programs in other L.A. County locations. That question was never answered.

(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.)

The man collapsed on the street, in front of John Alle.

While the Santa Monica Ambassadors we’re trying to decide what to do, Alle called paramedics.

Santa Monica paramedics tried to save the man with Narcan, he died on the way to the hospital.

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.”

Taking drugs in Santa Monica.

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.

After buying drugs, three men share a pipe by the Santa Monica Public Library (one is hidden).

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.)