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Indybay Feature

"Revised" Needle Exchange

by Steve Pleich
New Model of Needle Exchange: More Questions Than Answers
The "revised" needle exchange will be operated by the County of Santa Cruz which can only provide services to county residents. As a practical matter, anyone requesting these services would be required to provide their name, address and some form of identification verifying this information. That's at least three (3) items of personal information which will then be in the hands of a governmental agency. While this information will likely be "confidential", it will not be "anonymous". This raises the question of whether or not law enforcement (which will have some oversight role in the revised program) will be able to access this information should they deem it in the interest of public safety.

Anonymity is fundamental to a successful exchange. Clients need to know and believe that their personal information will not be used for any purpose other than statistical compilation or accountancy. Additionally, although the previous exchange, Street Outreach Supporters (SOS), will evdiently retain their role with respect to home delivery, those deliveries will be logged by and through County Health Services; creating a further possibility of uses other than statistical. One other concern is that pharmacies may elect to "op out" of non-prescription syringe sales now permited by state law. This would have the effect of further reducing opportunities for legal, regulated distribution and exchange.

These would be my "concerns" were I a potential client of the "revised" needle exchange. My "fear" is that intravenous drug usuers (IDU) will not access this program in the numbers they have previously. This, in my view, will lead to less exchange by the population the program is designed to serve. This will, in turn, lead to more needle litter in our community, an increase in HIV and HCV transmission and infection and to skyrocketing health costs which will be borne by the taxpayers of Santa Cruz County.

I am perfectly willing to be proved wrong with respect to one or any of these concerns. The thing is, I don't think I am.
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by Left on the streets
I agree with your assessment will likely cause some users to shy away from the needle program, and that as a result there may be an increase in HIV and AIDs exposure among addicts. I don't know if that will cause a skyrocketing of infection of cost though, as at present the reported number of cases in Santa Cruz County is fairly small (139 HIV and 279 AIDS per this 2010 report: (http://www.cdph.ca.gov/programs/aids/Documents/SSQtr2Jun2010.pdf). And of those, a smaller still percentage due to syringe infection as the causal factor.

Where I disagree with you is in your assessment that the new exchange will result in an increase of needles appearing in the public spaces of Santa Cruz. I'd be curious to hear how you arrive at this viewpoint. In my mind, the opposite seems more likely; there will be a decrease.

My assumption is based on the fact that needles will be harder to procure, and so people will be less likely to wantonly dispose of them. As a more precious commodity, they'll be less likely to be tossed in the streets. The Needle Exchange is on record as stating they handed out 120,000 annually. They were also apparently unable to provide any data or evidence of collection quantities. With that ready supply significantly reduced, I expect a downturn in overall supply and thus a downturn in needles on the streets.

I think that the majority in Santa Cruz are sympathetic to the plight of addiction, and in agreement that a needle exchange is beneficial to addicts and in decreasing the spread of HIV/AIDS. But I think that support has been severely tempered due to the unexpected negatives that have recently been thrust into the spotlight: needles littering our public spaces. When the premise was that the program helped addicts and had essentially no negative repercussions for the general community, I think it was an easy decision to support the programs. But when the premise shifted to supporting the program if it benefits addicts but an attendant downside is contaminating your public spaces with discarded needles, I think that support withered significantly. And I think that what's perceived as a lack of oversight in the program was seen as the primary problem.

I'd be curious to hear why you think discarded needles will go up under the new guidelines, and equally interested in hearing your suggestions for any alternatives that could both provide needles to addicts and reduce the amount of same being left on our streets.

by Steve Pleich
Street Outreach Supporters (SOS) of which I am a volunteer and advisor, exchanged an average of 240,000 needles each year in Santa Cruz County beginning in November, 2009. Although you are correct in observing that fewer needles will make the supply more precious, reluctance to exchange at the county operated site will inevitably lead to more needle litter.

Also as I pointed out, local pharmacies which now accept contaminated needles provided they are returned in a bio hazard container, may chose to "op out" of the state permitted sales program and may go the further step in refusing to accept needles for disposal. To answer your question about disposal mechanisms proposed by the county, the program envisions "kiosk" type disposal containers placed at strategic places around, presumably, the city and county.
by Left On the Streets
Appreciate your reply, and the updated information. There are actually twice as many needles being distributed as I'd understood. Can you also tell me if there is any information regarding to how many of those 240,000 are recollected?

I see the logic of your view that fear of reprisal will cause people to dump them. But I also think that a reduction in distribution (by requiring 1-for-1 exchange) will have a significant effect as well, and that as such the overall quantity being left on streets would be reduced overall.

I support a needle exchange program, but I feel (and I mean no personal offense to you as a volunteer) that our's has been too loosely managed. Lack of accountability and retrieval of needles is a big concern of mine, as is the quantity distributed. I'm also not supportive of distributing cooking kits along with the needles. Giving people tools to avoid disease is one thing, but giving them cooking kits? I don't see how that stops disease and it seems to be a facilitation to their addiction.

I've read articles/reports that state that a 90% retrieval rate is desirous and achievable.. Those are numbers I'd like to see our program revamp and strive for. Do you think those are achievable goals? And if not, why?

by Steve Pleich
My job as an outreach site volunteer was to keep the statistics you are asking about. In my experience, nearly all the needles distrubuted were provided on a one-for-one basis and so our return rate was nearly 100%. That being said, even if recent community cleanups found a thousand needles total (which they did not) that return rate would be a fraction of 1% of all needles in circulation.

As an aside, I agree that records keeping practices and efficiency of the SOS exchange could have, and should have, been much better.!
by Steve Pleich
One more item of information I believe your interest and well reasoned observations merit:

During the nearly three years that I worked exchange sites, which totalled more that 150 separate exchanges, I never saw or even heard it suggested that a client could get 30 additional needles over and above the number they were exchanging. Occassionally an exigent or unusual circumstance would merit a few extra needles (perhaps as many as five) but the exchanges I worked, and kept the stats for, where almost without exception one-for-one
by John E. Colby
No one has shown any correlation between the needle exchange and the number of discarded needles found in Santa Cruz or in the surrounding wilderness.

Those who make such extrapolations are creating fictional justifications — fixing the facts around agendas.

The nature of the needle using population is clearly not understood to a point where any conclusions can be made. Those demonizing the needle exchange are creating a tempest in a teapot. It's time to gather information before making ill fated public policy which could have disastrous human consequences.

I predict the restructuring of the needle exchange will provide a self reinforcing reality for angry people by actually increasing the number of discarded needles in Santa Cruz. But the point is civic leaders should be stepping very carefully to craft policy from information not fiction.
by Razer Ray
what_color_is_your_flag.jpg
Let's see... There's the "People stepping on needles at the beach" fiction.

There a fiction that there EVER WAS a halcyon days of a street crime free Santa Cruz in modern history...

There's the fiction that the owner of Mission Hills Ice Creamery spouted at TBSC's little soiree that "I pay a LOT of money to live here", and by extension paying a lot of money to live here means she has more right to the kind 'community' she wants (hint: She's probably never lived in anything resembling a normal community) despite the wishes of the greater... less monetarily endowed citizens of Santa Cruz.

Then there's the fiction John Colby and Steve Pleich subscribe to that the city ACTUALLY has any interest at all in what they and their friends think about anything.

It's the fiction that compromise with the city of Santa Cruz about ANYTHING AT ALL is somehow efficacious. It's called delusional thinking.

That last fiction is the most dangerous fiction of all.

Nice to see you're angry at me Steve. I MUST be saying something right if I trashed some deal you were making with these fascists.
by Left On The Streets
I'm pleasantly surprised to hear your recounting of the level of recollection. Pleased that it's happening and surprised that to date, I haven't been able to find any definitive claims from the Needle Exchange program that an effective program was in place to recollect a signficiant percentage of the needles.

I'll respectfully disagree with you on the issue of whether substantial amounts of needles are being found recently though. I believe they are, based on first hand observation during my time in the Pogonip/DeLaVeaga/San Lorenzo River areas as well as media reports and cleanup group accountings.. I find them with disturbing regularity out there myself.

In any case, here's hoping both sides can have a productive reorganization of the program: finding a way to continue to supply those in need while at the same time bringing some accountability and hopefully fewer discarded needles in public spaces.

Also appreciate the civil exchange of countering opinion...a rarity online.
by ct
yeah - I thought it was an exceptional day when I found three or four bundles of 10 needles rolling around in the surf near the San Lorenzo River, and I thought it must have been an odd event. But then I heard from other people of finding needles in the sand by the boardwalk. It makes you picture that there are lots of discarded needles on the riverbank which are taken out when it rains. There are definitely a lot of pieces of plastic trash going out too
by John E. Colby
To set the record straight, here are some facts:

1. City government, especially our City Council, makes decisions which benefit their constituency who are business leaders in the retail and tourism industries, as well as their rich friends in various fields like property management and development.
2. City government, especially the City Council, does not give a whit about the experiences and concerns of the average citizenry so long as those experiences and concerns do not seem to create political realities they cannot ignore, although they may try (as is the case with the Desal plant) to ignore them.
3. City government, especially City Council members to a greater or lesser extent depending on their pet policies, will misuse what the public, whipped up by the Sentinel and other local media, perceive to be crises, to ram through fascist laws and regulations which they wanted to enact anyways. This is akin to what writer Naomi Klein calls disaster capitalism.

Some fictions:

1. City government, especially the City Council, cares about you when you are not in their constituency as described above.
2. City government, especially the City Council, crafts policy from facts not fictions.
3. City government, especially the City Council, has integrity — they are not thoroughly corrupt.

The inversion principle is that City government, especially the City Council, including the leadership class and many (misguided) regular citizens in this town, believe the fictions I just enumerated.

Setting the record straight.
by Robert Norse
The ignorant and bigoted attacks on Needle Distribution, and those who pander to it (i.e. Pleich and the ever-anonymous Left on the Streets above) will not create the kind of understanding that will actually result in (a) less needles improperly distributed, and (b) a safer healthier community. This a kind of "Just Say No!", "end the enabling", "blame addicts and the homeless" Drug Prohibition frenzy that is being whipped up in Santa Cruz over a small number of needles.

It is a familiar refrain of right-wing Drug Warrior and Law And Order Republican types from time immemorial (no matter how they vote).

Less than 1000 needles have been found in the last half year by The Clean Team, Take Back Santa Cruz, and other Drug Warrior groups (and those in part by scouring the waste in abandoned campsites). More than 100,000 were safely turned in to Needle Exchange, when it was safely operating on Barson Street during the same period according to their records.

It's like listening to a dialogue about "the Jewish problem" or "the colored situation" a century ago. You can be as genteel and rational in your conversation as you'd like--it's still the illusion of a rational exchange.

Strict 1-1 needle exchange is a loser. The augmented distribution/exchange is what I understand has been found to be most effective--with no evidence of an increase in improper needle disposal (not sure if there was a reduction either). Do we have any contrary evidence? Or just the common nonsense being passed off as common sense?

Putting needle exchange under closer medical and police surveillance will DISCOURAGE its use and INCREASE the number of needles improperly distributed (not to mention Hep-C and HIV health impacts and the attendant costs).

There was no documented increase in crime during needle exchange times on Barson St. nor increase in needles found there. Yet the Council ran like rabbits behind closed doors to pander to this toxic falsehood.

Pleich and others were silent on this issue, his finger to the wind to see which way the power brokers were leaning. When homeless activists do this, it'ssad; When former needle exchange workers and "liberal" City Councilmembers do it, it's worse. Telling unpleasant and uinpopular truths is a responsibility of those in public life who are speaking on public issues. Stop trying to be on the winning side of every issue. Hold the ground. Speak truth to power.

Rank propaganda spewed by Deputy-Chief Clark, the Sentinel, and KSBW doesn't alter the facts, it just exacerbates fears and sets up more money to be showered on the SCPD in the futile Drug War.

Those concerned about crime and health consequences from drug addiction might want to consider the disproportionate amount of funds going into futile "Reefer Madness" motivated police enforcement, court costs, and prison expansion.
A salute to the Sin Barras protesters who raised their voices as they raised that issue today.

I repost the letter sent to me by former Santa Cruz needle exchange volunteer Penelope Jernberg. I encourage folks to read it. If you have valid contrary evidence, please post it as well.

http://www.indybay.org/newsitems/2013/02/12/18731886.php?show_comments=1#18732354
by Razer Ray
egocopjoinsthescpd.jpg
..and keep in mind you KNOW I live with this around me.

Give an addict more, and they'll just use more.

That's the modus of an addict Robert... besides 'energy suck on' the counterculture (which is known by anyone whose ever been around counterculture since the word was coined and before. The tendency to be humanely tolerant of addicts by 'hippies' and other street people is well-used by the city in it's 'make-it-ugly-so-we-can-make-more-stupid-laws' anti-homeless campaigns... ticket blitzes on known alcoholics to gerrymander their crime stats another example), and you could give each one of them as many needles as they'd like... It STILL wouldn't be enough.

Much more that 1-1 is simply enabling. No doubt about it, NO MATTER the ostensible 'benefits', and I cannot approve.
by RazerRay
I read with some concern at another site that someone on Lower Ocean found "A bag of syringes" in their driveway... With all the surveillance cameras around that batch of paranoid freakazoids I'd figure the police had identified the felonious perp leaving biomedical waste on people's doorsteps around town like little contaminated 'stork droppings'.

Just sayin'... Show me the perp.

ANYONE with a little determination can produce a 'bag of syringes'. I want to see the surveillance footage of the individual who left it.

Or better yet... almost all people incarcerated have had DNA samples done by the jail or prison, and intravenous illegal drug users typically are incarcerated on a regular basis, so let's play 'match the needle to the medical waste generator'.
by Steve Pleich
Thank you RR for lending the voice of experience to this discussion. Too often, we forget that those of us who have not been there think they know more than they really do.
by Robert Norse
Much as I appreciate the voices and work of Steve Pleich and RazorRay, what they write does not constitute any evidence that broader needle distribution enables addiction, increases improper needle disposal, or has caused addicts to "flock to Santa Cruz" as reactionary fearmongers have claimed.

If anyone has any hard evidence, please post it.

Steve's position seems to me a form of political accommodation that is unwise.

To politically accommodate the voices of fear flies in the face of the evidence as it's been presented to me, is bad public policy and also shows political cowardice. Aspiring politicians are tempted to do so but it's a temptation I would urge them to resist--a form of packing with those in power. One can delude oneself that one can't really speak the truth about the issues because it's "the wrong time", "wouldn't be politically effective", and would be an "unrealistic" approach" lest your simple sane statements be drowned out in the current hysteria.

It facilitates a police state agenda that is not only repressive but futile even on its own terms.

Perhaps it shouldn't upset me since it's so common, but it still pisses me off big time when I see it happening.

My criticism here shouldn't be construed as disparaging other positions taken by either Steve or RazorRay.

by Writing on the wall
One can demand proof , but it's an irrelevant demand at this poin. Many in the communityelieve that the needle exchange program, having failed to show that they collect needles as aggressively as they hand them out, is responsible for the quantity of needles being found on the street.

So while one might wish to demand proof of that, it's a demand that is being ignored. The reality is that rules have already been changed and tightened, distribution will be more closely monitored, and collection will become more accountable. And then we'll watch and we'll see.

Pontificating here isn't going to stop the real changes that are already in effect. IMO, the reality is that most are supportive of a needle exchange program IF that program has beneficial results for the addicts and no negative repercussions for the general populace. But now the community believes that the needle program is having negative repercussions for the general populace, and it's demanding change. And the change is here. We'll see soon enough the results and who was right.

Either the quantities will go down, and the side that blamed the needle exchange for shoddy practice will be shown right. Or the quantities will go up/remain the same, and those such as Steve will be proven right.
by Razer Ray
800_more_fun_than_tagging_mrk.jpg
[Image Caption: "Here's wishing everyone, especially the Global Youth Movement, a loooong hot summer"]

...get a job with the poverty pimps or some other codependent leech organization and do something even less useful than running your mouth about something you have absolutely no experience with.

Your 'statistics' and 'studies' are just about as valid as the SCPD's crime statistics... Because they are generated with an agenda and methodology that doesn't give a flying fuck about the well-being of addicts but simply frames the 'necessity' of funding the 'poverty pimps' authoritarian 'drug programs', and upper 5 figure social workers who are equally as callow and shallow in regard to solutions.

Giving away syringes like candy canes is also callow, shallow, and about as useful as any other poverty pimp's ideas regarding 'solutions', with the sociological mayhem to match.

It's really really simple Robert. If there are more needles in circulation with easy access, no matter WHAT your cherry picked studies say, the statistically UNWEIGHTED PROBABILITY IS there WILL be more syringes 'laying about'.
by Razer Ray
manarchy.jpg
"Even if one where to talk about the drugs in our community, if you just talk about drugs and not talk about the enemy, you make no analysis at all. If you haven’t brought in the question of who brings the drugs in, why the drugs are brought in, for what purpose they are brought in, you will never understand the problem at all." —Kwame Ture (Stokely Carmichael)

The poverty pimps ARE the enemy of the drug addict and anyone trying to truly help the addict towards recovery as well, no matter HOW benign they seem. They are vampires sucking the blood of the addicts for their paychecks.

I could analyse all three items of interest Ture recites right now in relation to Santa Cruz' totally socioeconomically fucked up society but I'll pass on it because one doesn't learn the lessons until they've done their own thinking on the topic.

H/t: http://disciplesofmalcolm.tumblr.com/post/47636068396

Youtube with full 3 hour lecture "No Revolution Without Organization" at Brooklyn's Slave University: http://www.youtube.com/watch?v=DQKlor9x_LM
by Paul
Of course the 'Authorities' will access the information; the object of needle exchange should remain anonymous, as it's objective is to prevent the spread of dangerous illnesses such as aids, not to document drug users.
But I have a message for drug users, intravenous or otherwise: if drugs were good for you, the CIA would not be involved as the world's premier trafficker.
Think about it. Watch 'The Mena Connection' and 'Meet Me At Mena' (though the latter is hard to find).
Read 'Cocaine Politics' by Peter Dale Scott; watch 'Cathy O'Brien + Granada Forum'; and read her and Mark Phillip's books.
by Robert Norse
RazorRay Writes: "It's really really simple Robert. If there are more needles in circulation with easy access, no matter WHAT your cherry picked studies say, the statistically UNWEIGHTED PROBABILITY IS there WILL be more syringes 'laying about'" No: if there's needle education combined with needle exchange, isn't it the experience of needle exchanges that there are less needles laying about than if addicts when to buy them from pharmacies 30-at-a-time and then dump then? I don't have stats either, but it sounds like "simple" prejudice rather than "the voice of experience" to me. With all due respect.

Again: "Much as I appreciate the voices and work of Steve Pleich and RazorRay, what they write does not constitute any evidence that broader needle distribution enables addiction, increases improper needle disposal, or has caused addicts to "flock to Santa Cruz" as reactionary fearmongers have claimed.

If anyone has any hard evidence, please post it."

Still waiting. Particularly from Steve, who delights in denouncing for the "errors" of Needle Exchange, but has declined to come out with obvious, if unpopular, truths, in strong public statements, but seems to prefer to pander to the "politically possible" on this issue.
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