One of the confusing aspects of the intensifying local debate about providing clean needles for drug addicts in Santa Cruz is just who is overseeing the distribution.
Based on public documents, it’s clear Santa Cruz County public health officials have been supportive and aware of needle exchanges — and that the county did not properly oversee these programs.
But the city of Santa Cruz hardly comes off well, either. The city only began to act after newly elected Councilwoman Pamela Comstock, a founding board member of the group Take Back Santa Cruz, and other raised awareness. The needle exchange program was further spotlighted in a series of Sentinel special reports and Editorials in recent weeks.
In a story published last week, the Sentinel found the volunteer needle exchange in the county exchanges twice as many drug needles to addicts as a government-run program in Santa Clara County — an area with six times the population. The local needle exchange, run in recent years by Street Outreach Supporters, had been handing out free clean needles to intravenous drug users for 24 years outside a laundromat in the Lower Ocean area of Santa Cruz — until late last month when the owner of the property at Bixby and Barson streets insisted the exchange leave. That move came as the city, under increasing pressure from residents fed up with drug crime and dirty needles, notified the owner the exchange constituted an unpermitted use.
Since then, the needle exchange has sought to set up on additional days at the county health facility on Emeline Avenue, where they already distribute on Sundays. In addition, the Santa Cruz City Council will meet Tuesday to discuss recommendations that the county take over management of the exchange and work with the city to find a different location.
While there’s little argument that providing clean needles cuts down on the transmission of disease, the scope of the local program and the location remain highly controversial. Santa Cruz has been burdened by a reputation for harboring more than its share of drug addicts and transients, and some council members would like to see the exchange somewhere other than the lower Ocean Street area, a neighborhood long afflicted by drug-related crime.
And while it may be a circular argument, it makes public-health sense to provide clean needles in locations with a high population of addicts. But such a location needs to be in an area zoned for medical uses. That clearly wasn’t the case with the laundromat parking lot.
The city also needs to be above board in how it informs the public about a potential location — and not hide behind a spurious closed-to-the-public session to discuss code enforcement.
That’s what happened last month, when city officials, citing the threat of potential litigation, met out of public scrutiny about how to change the needle exchange location. Whatever the location, the county needs to step up oversight. That’s what was supposed to happen, based on a 2009 agreement where the county’s Health Service Agency gave official recognition to Street Outreach Supporters as an authorized needle exchange program. The memo of understanding between HSA and SOS stated the latter would provide documentation on the number of participants and needles exchanged to the HSA for an annual report to the county Board of Supervisors.
Such oversight either hasn’t occurred or hasn’t been effective. Meanwhile, the exchange reports turning over 240,000 needles annually to the county for safe disposal.
One major component of a county-regulated needle exchange should include one-to-one exchange; i.e. a dirty needle for a clean needle. The failure to insist on an equal exchange is one reason dirty needles have become commonplace in certain areas of the city, including beaches and parks.
The county should also require more collection boxes be placed in well-lit public spaces in areas where drug addicts congregate. This is pressing since state law allows pharmacies to sell 30 clean needles to people without a prescription or an exchange — but not all of the pharmacies take dirty needles in return or sell disposal containers. Closing down the Santa Cruz distribution also could lead to more discarded dirty needles.
Santa Clara County’s program has set up multiple exchange sites outside residential areas, while requiring membership cards, one-on-one exchanges and more disposal boxes — all the while distributing half as many needles as given out in Santa Cruz.
A county-regulated program, built on aspects of the neighboring needle exchange in Santa Clara County, would be a major step forward in showing the city and county are seriously listening to residents outraged over the proliferation of addicts and dealers. Clean needles should be exchanged to prevent the spread of disease among intravenous drug users — with the recognition that dirty needles and drug crimes are public health issues as well.
This post is the Sentinel Editorial for Feb. 10, 2013