Health & Medical

Needle Exchanges Are Targeted by Eco-Rooted Lawsuits. A New California Law Will Stop That.

SANTA CRUZ, Calif. — For greater than 30 years, public well being officers and nonprofits in California have supplied clear hypodermic needles to individuals who use them to inject medication.

For almost that complete time, opponents have accused the free needle applications of selling drug use and homelessness.

But lately, opponents have deployed a novel technique to shut them down: utilizing environmental rules to sue over needle waste. They argue that contaminated needles pollute parks and waterways — and their lawsuits have succeeded throughout the state.

A invoice signed Monday by Democratic Gov. Gavin Newsom will thwart that tactic.

Environmental challenges have already pressured free needle applications in Orange County, Chico and Eureka to shut or modify their operations.

The new legislation comes at a essential second for a program in Santa Cruz. A ultimate court docket ruling that would decide the destiny of this system is predicted inside days, and it’s not clear how the legislation will have an effect on the choose’s choice.

“We’re within the midst of an opioid disaster,” mentioned Assembly member Joaquin Arambula (D-Fresno), a doctor who wrote the invoice Newsom signed, AB 1344. “We want all of the instruments that we now have obtainable for us to handle this disaster head-on.”

Clients of a free needle program in Santa Cruz, California, show what they picked up on a current Sunday, together with clear syringes and an overdose-reversal drug. “For folks to eliminate this program is loopy to me,” the girl in leopard-print sneakers mentioned. “Do they need needles all around the floor?” (Rachel Bluth / KHN)

Despite the legislative victory, lawsuits to problem needle applications on different grounds are nonetheless attainable, and native ordinances banning needle exchanges have flourished throughout California.

Under the brand new legislation, which takes impact Jan. 1, opponents of free needle applications will now not be capable of sue over violations of the California Environmental Quality Act, generally known as CEQA.

CEQA requires tasks that want approval from a public company or obtain public funding to be assessed for his or her potential environmental impacts. This requirement applies to main development tasks, like reservoirs and freeway overpasses, and localized ones resembling reasonably priced housing. CEQA is enforced by lawsuits and has been invoked through the years to cease or sluggish unpopular proposals, like homeless shelters.

California permits licensed physicians to present clear needles to sufferers with out authorization. Free needle applications run by native governments or neighborhood teams have to be authorized by the state, a county or metropolis.

These applications, which permit folks to eliminate used “rigs” and get new ones, try to cut back the unfold of HIV and hepatitis C, which might unfold amongst drug customers who share needles, and reduce infections amongst customers. Some are true “exchanges” that require folks to show in a used needle to get a brand new one. Others permit folks to take what they want with out returning them.

In the previous few years, opponents have began specializing in the applications’ environmental impacts as a result of some needles find yourself on the bottom or in creeks and rivers.

The Harm Reduction Coalition of Santa Cruz County arms out about 5,000 sharps containers per yr, which individuals use to soundly eliminate syringes. The program was sued by teams that allege it contributes to the county’s needle litter drawback.(Rachel Bluth / KHN)

Walt McNeill, a lawyer in Nevada City, California, challenged nonprofit-run needle applications in Chico, Eureka and Santa Cruz on behalf of native officers, former legislation enforcement officers and neighborhood teams.

McNeill mentioned his shoppers aren’t against needle applications usually, simply ones they consider are run irresponsibly. “You don’t know the place the needles are going, and no manner of recovering needles successfully,” he mentioned.

The development in environmental challenges started a number of years in the past when the one needle program in Orange County shut down following a CEQA lawsuit. In 2020, a program created to handle needle air pollution in Chico closed after it settled a CEQA lawsuit, then later reopened on a smaller scale below a doctor’s authority. Also in 2020, Eureka officers wouldn’t reauthorize a needle program after McNeill challenged it on environmental grounds.

Last yr, McNeill sued certainly one of two free needle applications in Santa Cruz County. Run by the Harm Reduction Coalition of Santa Cruz County, it operates out of a van and serves as much as 75 folks every Sunday on the identical avenue nook in an industrial a part of city. The grievance alleged this system “unfold tens of 1000’s of used and unused hypodermic needle ‘litter’” all through the neighborhood and has led to “environmental degradation of the creeks, streams, rivers and seashores.”

A superior court docket choose in Sacramento is predicted at hand down her ruling quickly. McNeill mentioned he’s assured the choose will aspect along with his shoppers regardless of the brand new legislation due to different flaws in this system. If she disagrees, he mentioned, he might file one other swimsuit on different grounds.

“No matter the way you slice it, this system can be deauthorized,” he mentioned.

But Denise Elerick, founding father of the coalition, mentioned she believes her program will survive. She mentioned arguments about needle litter masks anti-homeless sentiment.

“They say it’s concerning the atmosphere nevertheless it’s not. They need folks to die and disappear,” she mentioned.

Decades of analysis reveals that needle giveaways aren’t a significant supply of air pollution, and that individuals who get needles from an alternate usually tend to eliminate them correctly than those that don’t.

A 2019 research by Santa Cruz County’s Health Services Agency discovered that for each 10 needles that ended up on the bottom or in a river, 1,000 made it right into a sharps container, used to gather used needles, or an official disposal level. The report concluded that lowering needle litter would require extra syringe applications and disposal websites, not fewer.

The Santa Cruz program, which started in 2018, offers out as many syringes as folks request.

In addition to providing 9 sizes of syringes, this system offers out sharps containers, ranging in capability from 1 / 4 gallon to eight gallons, which might be returned, picked up or left at disposal kiosks round city.

On one Sunday in August, 56 folks stopped by the van and 51 sharps containers had been distributed. The coalition wouldn’t disclose what number of needles it sometimes offers away.

The shoppers additionally gathered provides to guard them from staph infections, covid and different risks: condoms, hand sanitizer, masks, alcohol pads, drug-testing strips to ferret out fentanyl, and drugs to reverse overdoses. The program even provided clear pipes to encourage that medication be smoked — relatively than injected — and cut back the unfold of covid from sharing pipes.

Many who line up every week stay in close by parks and alongside creeks which are the main target of opponents’ environmental considerations. They mentioned they’ve a vested curiosity in conserving the atmosphere clear.

“Just as a result of we’re drug addicts doesn’t imply we don’t deal with ourselves,” mentioned one lady, 35. (In order to watch how this system works, KHN agreed to not identify the folks procuring provides.) “Yeah, I stay in a tent, however my tent is clear. I attempt to deal with different folks and I deal with myself.”

Volunteers arrange tables weekly on a Santa Cruz avenue nook at hand out needles and different provides, resembling condoms and face masks. An on-site caseworker helps join folks with medical and social providers.(Rachel Bluth / KHN)

The new legislation comes too late for applications like Chico’s, as a result of the town has since handed an ordinance banning syringe exchanges. Similar bans have been adopted in Anaheim, Oroville, Butte County, Yuba City and elsewhere previously few years.

Ryan Coonerty, a Santa Cruz County supervisor, mentioned the county possible received’t undertake a ban, although he’s disenchanted by Newsom’s choice. He believes the nonprofit needle program in Santa Cruz contributes to needle air pollution greater than the county-run program, which requires folks to show in used needles to get recent ones.

“We will proceed to wrestle with needle litter and, sadly, not get any assist from the state to cease needles from going into the ocean, parks and seashores,” he mentioned.

But the Centers for Disease Control and Prevention and different public well being companies say one-for-one applications restrict the methods folks can safely eliminate sharps, forcing them to hold onto their needles till the subsequent needle alternate. That’s not sensible, in line with the individuals who lined as much as get needles from the Santa Cruz program.

“Lots of us are homeless,” mentioned one 40-year-old lady, “and we will solely keep someplace for therefore lengthy.”

This story was produced by KHN, which publishes California Healthline, an editorially unbiased service of the California Health Care Foundation.

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