People who use drugs in Chico, California have faced opposition in obtaining sterile harm reduction supplies. Following residents’ complaints about a syringe service program operating in a park, officials have considered a measure to shut it down.

Butte County, where Chico is located, has a drug-involved death rate 2.5 times higher than the state average, according to the public health office. It is also ranked 15th among California counties for its rate of new hepatitis C infections. The syringe exchange in Chico was the first to open in the county, after receiving authorization from state public health authorities in October 2019.

But on February 18, the city council discussed an ordinance to ban the Northern Valley Harm Reduction Coalition (NVHRC) program, which operates out of Humboldt Park. Every Sunday morning, NVHRC gives out free sterile syringes, fentanyl test strips, first aid supplies and other items. But the council ultimately voted to request a report from NVHRC within 30 days on their progress with syringe disposal. Other council members and residents also spoke in strong support of the program.

On February 16, a local resident, Roxanne Eldridge, had posted a video on Facebook in which she says that the program gave a 16-year old girl 30 syringes and other supplies. Eldridge has previously posted other videos, including one in which she says she was given 100 syringes without being asked any questions.

“I wanted to see if they would ask [the girl’s] age, she looks young, she’s beautiful, and doesn’t look like she uses,” Eldridge told local KRCR News. “I know there’s many faces of addiction but I wanted to see if they would question her or ask if she’s okay. But they didn’t hesitate to give her the needles. They only asked her if the 30 needles were enough to get her through her next fix.” Though California state law describes how a resident may legally possess syringes for injecting drug use, there is no explicit restriction against individuals under age 18 from obtaining syringes.*

Eldridge isn’t the first local resident to criticize the program, and officials including the City Manager Mark Orme and City Councilman Sean Morgan have argued against the program since before it opened in November 2019. They have claimed that the it ‘encourages’ illegal drug use and has led to increased public syringe litter.

Councilman Morgan was unequivocal when asked by Filter what the city could do to reduce syringe litter: “Stop the program.”

When asked whether shutting down the program might have negative health consequences, he told Filter: “Health consequences to drug addicts or to 99 percent of the rest of us? No, there is no crisis, other than users of the program are already strung-out drug users.”

NVHRC told KRCR News that it provides services and supplies to anyone, “align[ed] with best practices,” without asking for identifying information. The group pointed out that it also runs a phone line for residents to call and report syringe litter. The program is staffed by volunteers, who both distribute supplies and work to clean up discarded syringes in the neighborhood. Because of that, it doesn’t have the staff to immediately respond to requests when they come in but also takes voicemails.

There are also constructive ways for the city to address syringe litter without shutting down the program. It could encourage local businesses, libraries, parks and other public spaces to install syringe disposal containers, for example. The syringe exchange itself is making an effort to do this, by giving out portable sharps containers.

Residents’ and officials’ claim that a syringe exchange encourages drug use is refuted by the evidence. “Nearly 30 years of research has shown that comprehensive syringe service providers (SSPs) are safe, effective, and cost-saving, do not increase illegal drug use or crime, and play an important role in reducing the transmission of viral hepatitis, HIV and other infections,” states the Centers for Disease Control and Prevention (CDC).

The CDC further states that people who use syringe programs are five times more likely to enter drug treatment and three times more likely to stop using drugs compared with people who don’t use these programs. In other words, syringe exchanges help reduce overall drug use.

Eldridge also claimed that the syringe exchange contributes to deaths. “They know people are getting these syringes and kits to do drugs,” she said. “They are aiding in helping people kill themselves. What if that was my last needle and it came from them?”

In fact, syringe exchanges prevent deaths. They give out naloxone, the opioid overdose antidote. They also give out fentanyl test strips, which are an easy way for people to check their drugs for the potent synthetic opioid.

And of course, syringe exchanges reduce transmission of blood-borne diseases by providing sterile syringes and advising against sharing. They further give out condoms and other safer sex supplies to reduce the spread of sexually transmitted diseases.

Through her recent videos, Eldridge argued that the syringe exchange gives out too many free syringes. “The value of the needle goes down when you give out hundreds at a time. There’s no need to hold on to one for the next time,” she said.

But programs are doing exactly the right thing by giving out lots of syringes. Syringe tips quickly degrade with repeated use, so re-using a syringe risks causing damage to your skin. “A 2001 California study of syringe services programs found that clients were less likely to reuse syringes at programs where they were provided syringes on an as-needed basis, rather than one-for-one,” states the Comer Family Foundation. “Limiting the availability of syringes has been shown to be a risk factor for sharing needles.”

One hundred syringes might seem excessive to people who don’t inject, but for a person who injects three times a day that is roughly one month’s supply. Supplies like band aids and alcohol swabs additionally help prevent abscesses and infections.

NIMBY-ism against harm reduction programs like that seen in Chico is sadly widespread. Filter has reported, for example, on alarming HIV outbreaks in West Virginia, where cities and counties have moved to shut down syringe exchanges, and the state government is even considering a total ban. The same towns that have shut down or restricted syringe access are also seeing rising rates of HIV and hepatitis C.

Image of harm reduction supplies offered by Northern Valley Harm Reduction Coalition via Facebook.

*Update February 20, 2020: An earlier version of this article incorrectly suggested that the City Council was planning to ban the syringe exchange, and suggested it is illegal under CA state law for minors to possess syringes. The article has been edited to clarify these points.