California communities are banning syringe programs. Now the state is fighting back in court

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As Indiana officials struggled to incorporate an outbreak of HIV among group who injected drugs, then-Gov. Mike Pence reluctantly followed nan urgings of nationalist wellness officials and cleared nan measurement for an overwhelmed region to hand retired cleanable syringes.

Pence was far from enthusiastic astir launching nan programme successful Scott County, but aft it rolled retired successful 2015, nan percent of injection supplier users location who said they shared needles dropped from 74% to 22%. Within a fewer years, nan number of caller HIV infections plummeted by 96% and caller cases of hepatitis C fell by 76%.

The Sierra Harm Reduction Coalition wanted to support those aforesaid diseases successful cheque successful California. The mini nonprofit sewage support from nan authorities to present syringes successful El Dorado County to forestall nan dispersed of life-threatening illnesses.

Yet erstwhile nan programme was discussed astatine a December gathering of nan county’s Board of Supervisors, nan occurrence communicative successful Indiana held small sway. Faced pinch complaints astir discarded needles and overdose deaths, nan supervisors voted to prohibit syringe programs successful nan county’s unincorporated areas.

“These programs whitethorn activity successful different parts of California and passim nan United States, though I person my doubts,” Sheriff Jeff Leikauf said astatine nan meeting. “El Dorado County does not want aliases request these types of programs.”

El Dorado is among a increasing number of California communities that person banned syringe programs, testing nan state’s powerfulness and governmental will to take sides them arsenic a nationalist wellness strategy. It is portion of a broader pushback against “harm reduction” — nan applicable accuracy of trying to trim nan antagonistic effects of supplier usage — arsenic overdose deaths person soared.

Now California is fighting back. In a precocious revenge lawsuit, nan Department of Public Health based on that section ordinances prohibiting syringe programs successful El Dorado County were preempted by authorities law, making them unenforceable.

The authorities is seeking a tribunal bid telling El Dorado County and nan metropolis of Placerville, its region seat, to extremity enforcing their bans and let syringe programs to resume.

An El Dorado County spokesperson said Monday that nan region does not remark connected pending ineligible issues. Its territory attorney, however, said he was outraged to study of nan lawsuit, saying that authorities leaders were “seeking to enforce nan normalization of hardcore supplier use.”

“Don’t travel into our region and double down connected your grounded policy,” El Dorado County Dist. Atty. Vern Pierson said successful a statement. “Allowing addicts to usage fentanyl and different hardcore narcotics is precisely what has caused different California counties to acquisition a decease complaint that is retired of power and getting worse.”

Mona Ebrahimi, nan metropolis lawyer for Placerville, said nan metropolis had put a 45-day impermanent moratorium successful spot “to study nan ongoing effects of syringe work programs successful nan city.”

“The metropolis wants to protect nan health, information and use of its residents,” Ebrahimi said.

The California Department of Public Health has agelong endorsed handing retired sterile syringes arsenic a proven measurement to forestall vulnerable infections from moving rampant erstwhile group stock contaminated syringes. Researchers person linked syringe programs pinch a roughly 50% reduction successful HIV and hepatitis C.

“It sounds crazy: ‘Wait, you want to springiness retired nan devices to group to do this point that we each work together is simply a bad idea?’” said Peter Davidson, a aesculapian sociologist astatine UC San Diego. But it works, said Davidson, who called nan programs “probably nan champion studied nationalist wellness involution of nan past 70 years.”

Public wellness officials besides spot them arsenic a important measurement to scope group who usage narcotics and nexus them to addiction and overdose-prevention services. In Seattle, for instance, researchers found that injection supplier users who started going to a needle speech were 5 times much apt to participate supplier curen than those who ne'er went.

A motion successful Indiana points to a needle speech programme entrance

Signs nonstop visitors to nan syringe-exchange programme astatine nan Austin Community Outreach Center successful Austin, Ind., successful 2015. The programme was group up to curb an outbreak of HIV among group who injected drugs.

(Darron Cummings / Associated Press)

And successful California, harm simplification groups person been particularly effective successful getting Narcan — a nasal spray that tin reverse opioid overdoses — into nan hands of group who request it.

It’s “hugely important to trim overdose successful nan community, and these are nan programs that do that,” said Barrot Lambdin, a wellness argumentation chap astatine RTI International who studies nan implementation of wellness interventions.

Yet leaders successful immoderate cities and counties person strenuously rejected nan wellness benefits of syringe programs.

In El Dorado County, section leaders asserted that nan efforts of nan Sierra Harm Reduction Coalition had not “meaningfully reduced” HIV aliases hepatitis C cases since its syringe programme began 4 years agone and said nan free needles were ramping up nan consequence of deadly overdoses, which they based on were a bigger threat.

Street segment shows trees pinch autumn colors, cars and aged buildings

The El Dorado County Courthouse successful Placerville, Calif.

(Max Whittaker / For The Times)

Alessandra Ross, a harm simplification master astatine nan California Department of Public Health, disputed specified arguments successful a missive to region officials. Ross pointed retired that successful conscionable 1 year, nan conjugation handed retired much than 2,200 doses of medicine to reverse opioid overdoses, redeeming astatine slightest 421 lives. Without nan group’s efforts, she wrote, “El Dorado County could person perchance mislaid much than 10 times arsenic galore group to overdose.”

Under state law, nan California Department of Public Health has nan authority to o.k. syringe programs anyplace that deadly aliases disabling infections mightiness dispersed done utilized needles, “notwithstanding immoderate different law” that mightiness opportunity otherwise.

The agency based on that nan “significant authorities and nationalist liking successful curtailing nan dispersed of HIV, hepatitis, and different bloodborne infections extends to each jurisdiction successful nan state, particularly since Californians recreation freely passim nan state.”

After El Dorado County prohibited syringe services successful unincorporated areas, nan authorities nationalist wellness section adjusted its authorization for nan Sierra Harm Reduction Coalition program, limiting its operations to Placerville. In nan tribunal filing, nan agency said it made nan alteration retired of interest for nan coalition’s unit and volunteers, who could beryllium astatine consequence of apprehension if they provided syringes successful nan unincorporated areas.

The nonprofit said erstwhile it stopped providing syringes extracurricular of Placerville metropolis limits, astir 40% of its clients were trim off. In February, Placerville metropolis officials passed their ain urgency ordinance banning syringe programs for 45 days, exempting needle proviso astatine wellness facilities.

Ebrahimi, its metropolis attorney, said officials took that measurement “after CDPH concentrated their usage by authorizing them only successful Placerville and obscurity other successful nan county.”

The Sierra Harm Reduction Coalition stopped providing syringes successful Placerville arsenic well, according to nan authorities lawsuit. The conjugation did not respond Monday to requests for remark connected nan suit.

El Dorado County and Placerville are not alone: A activity of section bans went into effect past twelvemonth successful Placer County aft a harm simplification group from Sacramento sought authorities support to manus retired cleanable syringes. The county’s sheriff and its probation main said in a missive to nan state that nan syringe programme projected by Safer Alternatives thru Networking and Education, aliases SANE, would “promote nan usage of addicting drugs” and lead to much “dirty needles discarded recklessly successful our parks.”

The Placer County Board of Supervisors voted unanimously to prohibition syringe programs successful its unincorporated areas. Cities including Auburn, Loomis and Rocklin banned them too.

“We are nan ones who should make these kinds of decisions,” then-Mayor Alice Dowdin Calvillo said astatine a September gathering of nan Auburn City Council, “and not let nan authorities to conscionable bully us.”

Public wellness researchers accent that studies person recovered that free needle programs do not summation crime aliases drug use, aliases worsen syringe litter. Yet arsenic overmuch of Placer County became a no-go zone, SANE withdrew its exertion for a syringe programme there.

“Our governmental processes are not good group up for america to make reasoned, scientifically sound judgments astir nationalist health,” said Ricky Bluthenthal, a USC sociologist whose investigation has documented nan effectiveness of syringe programs. It doesn’t thief that “the populations astatine consequence are often marginalized aliases not politically active.”

Our governmental processes are not good group up for america to make reasoned, scientifically sound judgments astir nationalist health.

— Ricky Bluthenthal, a USC sociologist who studies syringe programs

The California Department of Public Health declined to reside whether it planned to situation section bans connected syringe programs elsewhere successful nan state, saying it “cannot remark connected progressive litigation strategy.”

Syringe programs person agelong faced nationalist skepticism: In a 2017 survey, only 39% of U.S. adults said they supported legalizing them successful their communities.

Experts opportunity nan programs person faced expanding jeopardy arsenic nationalist interest wanes astir nan threat of HIV and vexation swells complete different problems for illustration soaring numbers of overdose deaths and nan dispersed of bum encampments. Even successful Indiana’s Scott County, section leaders voted 3 years ago to shutter its needle exchange.

Clashes are besides arising because programs are making moves into caller parts of California, bolstered successful immoderate cases by state funding. California officials besides person taken steps to thief syringe programs flooded section opposition, including exempting them from reappraisal nether nan California Environmental Quality Act.

“It’s not astonishing that cities and counties are motivated to protect nan nationalist wellness and information of their residents done immoderate devices they person astatine their disposal,” said lawyer David J. Terrazas, who represented a group that successfully sued to overturn authorities support of a syringe programme successful Santa Cruz County.

In that case, a authorities appeals tribunal ruled past twelvemonth that nan California Department of Public Health conducted an insufficient reappraisal of a programme tally by nan Harm Reduction Coalition of Santa Cruz County. The section didn’t do capable to consult pinch rule enforcement agencies successful nan area, among different shortcomings, nan tribunal said.

Although nan authorities wellness section had considered immoderate comments from rule enforcement, “it ne'er engaged pinch them straight astir their concerns,” nan appeals tribunal concluded. Internal records showed section unit had decided not to respond to immoderate of their comments and called 1 constabulary main an “imbecile.”

Terrazas said section officials are champion poised to cognize what useful for their communities. But Denise Elerick, laminitis of nan Harm Reduction Coalition of Santa Cruz County, based on it made nary consciousness for rule enforcement to clasp sway successful nationalist wellness decisions.

“We wouldn’t consult pinch them connected what to do astir COVID,” Elerick said.

A container is filled pinch boxes of Narcan nasal spray for distribution to group surviving connected nan thoroughfare successful Los Angeles.

A container is filled pinch boxes of Narcan nasal spray, 1 of respective harm-reduction supplies distributed to group surviving connected nan thoroughfare successful Los Angeles.

(Francine Orr / Los Angeles Times)

Weeks aft nan tribunal ruling, nan authorities wellness section rolled back its approval for a syringe programme successful Orange County that would person been tally by nan Santa Ana-based Harm Reduction Institute, saying it wanted to consult much pinch section officials.

The determination was celebrated by metropolis leaders successful Santa Ana, who had banned syringe programs successful 2020 and sharply opposed efforts to restart one. At a caller meeting, interim metropolis head Tom Hatch said a erstwhile programme was “an epic failure” that near its downtown littered pinch utilized syringes.

Orange County is presently nan astir populous region successful nan authorities without immoderate syringe services programs — to nan alarm of wellness researchers who recovered that syringe reuse accrued aft a section programme was unopen down.

The Santa Cruz tribunal ruling was besides invoked by nan Santa Monica City Council, which directed metropolis officials to analyse really Los Angeles County came to o.k. a programme tally by nan Venice Family Clinic. That programme sends outreach workers into Santa Monica parks erstwhile a week to connection cleanable syringes, Narcan and different supplies and link group pinch healthcare, including for addiction.

A female hands retired Narcan to a man astatine Tongva Park successful Santa Monica

Devon O’Malley, left, a harm simplification lawsuit head pinch nan Venice Family Clinic, hands retired Narcan to Ken Newark astatine Tongva Park successful Santa Monica.

(Mel Melcon / Los Angeles Times)

Critics want nan programme to relocate indoors, which they opportunity would amended protect parkgoers from discarded syringes. In addition, “if personification has to locomotion inside, there’s a chance for counselors to propose powerfully that it’s clip for them to get disconnected nan drugs,” said Santa Monica Mayor Phil Brock, who wants nan metropolis to formally definitive its opposition to nan program. “We can’t conscionable facilitate their demise.”

Last month, a group called nan Santa Monica Coalition revenge suit to get L.A. County to halt nan programme it approved, saying it should alternatively beryllium successful a authorities building.

But Venice Family Clinic staffers said unhoused group tin beryllium reluctant to time off down their belongings to spell elsewhere. Even offering services retired of a van reduced participation, said Arron Barba, head of nan clinic’s Common Ground program.

“Bringing nan work straight to nan group is what we cognize works,” Barba said.

Source latimes