For seven years, San Diego harm reduction activists running needle exchange programs faced harassment and possible arrest for their efforts as conservative city and county governments blocked repeated efforts to regularize the program. Now, in a stunning about-face, the San Diego city council has taken the first step toward the creation of San Diego's first officially-sanctioned needle exchange program.
The only significant opposition came from the police and the San Diego Union-Tribune, which editorialized against "social nihilism."
Needle exchange programs have been found to be effective in reducing the spread of AIDS, hepatitis, and other blood-borne diseases among injecting drug users.
The city council's Public Safety and Neighborhood Services Committee on Wednesday okayed a proposal from the Alliance Healthcare Foundation for a program whose details would be worked out by a task force including law enforcement and community representatives.
The program would be privately financed and would be tied to some sort of treatment or counseling for participants, Alliance spokeswoman Stephanie Casenza told the San Diego Union Tribune.
The next step, says Dr. Ian Trowbridge, a cancer biologist at the Salk Institute who has long been involved with the issue in San Diego, is for the city council to declare a medical emergency, which, under California law, would allow the city to institute such a program. Trowbridge told DRCNet he expects the council to act at either its October 2nd or October 16th meeting.
For Brent Whittaker, a member of the San Diego Clean Needle Exchange, the city's action is welcome but overdue.
"Currently, we are at the mercy of the officers on the street," Whittaker told DRCNet. "Street officers will write citations, and then we have to deal with the District Attorneys, but they generally go for deferred prosecution," said Whittaker.
Whittaker told DRCNet he had been cited in 1994, but the case was never heard. Instead, he said, it disappeared.
Needle exchange program participants who have drug records or who are currently using face tougher sanctions, though, said Whittaker. "DAs continue to try to prosecute these people."
"One woman who is an active drug user as well as an outreach worker was prosecuted last week," Whittaker continued, "and she had to promise that she wouldn't do any more outreach. But she hasn't stopped participating, she's willing to take the risk."
Dr. Trowbridge pointed to several factors to explain the turnaround. First, he said, was the change in state law allowing municipalities to declare medical emergencies and then initiate needle exchange programs.
Second, Trowbridge told DRCNet, the Harm Reduction Support Group and Alliance Healthcare Foundation created a carefully crafted campaign to heighten public awareness of the need for needle exchange programs.
Whittaker concurred. The campaign "has had a significant impact on pushing the need for needle exchange programs onto the political agenda," he said.
Alliance even arranged for outside experts to address the council and rebut distorted claims about needle exchange programs that appeared in the Union-Tribune's editorial opposing the program.
Also, said Trowbridge, some members of the council merited acclaim for their efforts to pass the program. "Valerie Stallings worked behind the scenes to set up meetings between us and the police and really helped tone down the opposition," said Trowbridge.
Another council member, Byron Wear, wrote an op-ed in the Union-Tribune supporting the proposed program.
Also, said Trowbridge, "It's the hepatitis C. This is a more 'respectable' disease than AIDS. This is a very conservative county, and people weren't willing to act when AIDS was the main threat."
Trowbridge added, "I'm a cancer biologist and there are many cancers we can't cure. The problems associated with injection drug use are one human condition where we know what to do."