Needle replacement is targeted by eco-rooted lawsuits.  A new California law will stop that.

SANTA CRUZ, California – For more than 30 years, California public health officials and nonprofits have provided clean needles to people who use drugs to inject drugs.

Almost all of the time, opponents accused the free needle programs of promoting drug use and homelessness.

But recently, opponents have come up with a new strategy to shut them down: use environmental laws to sue waste of needles. They argue that contaminated needles pollute parks and waterways – and their lawsuits are successful across the state.

A bill signed by Democratic Governor Gavin Newsom on Monday will thwart these tactics.

Environmental challenges have already forced free needle programs in Orange County, Chico and Eureka to close or change operations.

The new law comes at a critical time for a program in Santa Cruz. A final court ruling that could determine the fate of the program is expected within days, and it is not clear how the law will affect the judge’s decision.

“We are in the middle of an opioid crisis,” said Joaquin Arambula (D-Fresno), a member of the Congregation, a doctor who drafted the Bill, signed by Newsom, AB 1344, said this crisis head-on. “

Customers of a free needle program in Santa Cruz, Calif., Show what they brought with them last Sunday, including clean syringes and a drug to reverse the overdose. “It’s crazy to me that people are getting rid of this program,” said the woman in leopard print sneakers. “Do you want needles all over the floor?” (Rachel Bluth / KHN)

Despite the legislature’s victory, lawsuits challenging needle programs for other reasons are still possible, and local regulations banning needle exchanges have flourished across California.

Under the new law, which goes into effect January 1, opponents of free needle programs can no longer sue for violations of the California Environmental Quality Act, known as CEQA.

CEQA requires that projects that require approval from an authority or receive public funding are examined for their possible environmental impact. This requirement applies to large construction projects such as reservoirs and motorway flyovers as well as to local construction projects such as affordable housing. CEQA is enforced through lawsuits and has been used over the years to stop or slow down unpopular proposals like homeless shelters.

California allows licensed physicians to administer clean needles to patients without authorization. Free needle programs run by local governments or community groups must be approved by the state, county, or city.

These programs, which enable people to dispose of used “rigs” and purchase new ones, seek to reduce the spread of HIV and hepatitis C, which can spread among drug users who share needles, and reduce infections among users. Some are real “exchanges” where people have to give up a used needle in order to get a new one. Others allow people to take what they need without giving it back.

In recent years, opponents have focused on the environmental impact of the programs because some needles end up on the ground or in streams and rivers.

The Santa Cruz County’s Harm Reduction Coalition distributes approximately 5,000 sharp objects annually that people use to safely dispose of syringes. The program has been sued by groups claiming it contributes to the county’s needle litter problem.(Rachel Bluth / KHN)

Walt McNeill, a Nevada City, California attorney, has challenged nonprofit needle programs in Chico, Eureka, and Santa Cruz on behalf of local officials, former law enforcement officers, and community groups.

McNeill said his clients are not against needle programs in general, only those they believe are being operated irresponsibly. “They have no idea where the needles are going and no way of effectively retrieving needles,” he said.

The trend towards environmental issues began a few years ago when Orange County’s only needle program was shut down following a CEQA lawsuit. In 2020, a needle pollution control program in Chico was closed after a CEQA lawsuit was settled and later reopened on a smaller scale under medical supervision. Even in 2020, Eureka officials would not re-authorize a needle program after McNeill challenged it on environmental concerns.

Last year, McNeill sued one of two free needle programs in Santa Cruz County. Operated by the Santa Cruz County’s Harm Reduction Coalition, it operates by van and serves up to 75 people every Sunday on the same street corner in an industrial district of the city. The complaint alleged that the program had spread “tens of thousands of used and unused needle waste” across the community and caused “environmental degradation of streams, creeks, rivers and beaches”.

A Sacramento Supreme Court judge is expected to deliver her verdict soon. McNeill said he was confident that despite the new law, the judge would stand on his clients’ side because of other flaws in the program. If she disagrees, he can file another lawsuit for other reasons.

“No matter how you cut it, the program will be disabled,” he said.

However, Denise Elerick, founder of the coalition, said she believes her program will survive. She made arguments about anti-homeless sentiment.

“They say it’s about the environment, but it’s not. They want people to die and disappear, ”she said.

“We’re a bit pushy with containers for sharp objects,” said Dani Drysdale, syringe services coordinator for the Harm Reduction Coalition of Santa Cruz County. From August 2020 to July this year, the coalition conducted 194 cleanups in the community to collect used needles. (Rachel Bluth / KHN)

Overdose Reversal Kits are distributed with the free needle program. The pointed, pocket-sized container contains two syringes and two vials of naloxone, a drug that can stop opioid overdoses. (Rachel Bluth / KHN)

Decades of research show that gifts of needles are not a major source of pollution and that people who get needles from a purse are more likely to dispose of them properly than those who don’t.

A 2019 study by the Santa Cruz County’s Health Services Agency found that out of 10 needles that landed on the ground or in a river, 1,000 ended up in a sharp object container for used needle collection or an official disposal site served. The report concluded that reducing needle waste would require more syringe programs and disposal points, not fewer.

The Santa Cruz program, launched in 2018, gives out as many syringes as people ask for.

In addition to nine sizes of syringes, the program offers containers for sharp objects ranging from a quarter-gallon to 8-gallon capacity that can be returned, picked up, or dropped off at kiosks across town.

The needle program on Sunday evening in Santa Cruz is “demand-oriented”, which means that customers do not have to hand in used needles to get clean needles. (Rachel Bluth / KHN)

People come to the needle program on Sunday evening for clean syringes, but also for food, medical care, and a sense of community. The program faced an environmental challenge related to needle litter. (Rachel Bluth / KHN)

On a Sunday in August, 56 people stopped the van and 51 containers of sharp objects were distributed. The coalition didn’t want to reveal how many needles it usually gives away.

Customers also gathered supplies to protect them from staph infections, Covid, and other hazards: condoms, hand sanitizer, masks, alcohol swabs, drug test strips to detect fentanyl, and medication to reverse overdoses. The program even offered clean pipes to encourage people to smoke drugs – instead of injecting them – and to reduce the spread of Covid from pipe-sharing.

Many who line up each week live in nearby parks and along streams that are the focus of opponents’ environmental concerns. They said they had a personal interest in keeping the environment clean.

“Just because we’re addicted to drugs doesn’t mean we don’t take care of ourselves,” said a 35-year-old woman. (To see how the program works, KHN has agreed not to name the people who procure supplies.) “Yes, I live in a tent, but my tent is clean. I try to take care of others and I take care of myself. “

Volunteers set up tables on a street corner in Santa Cruz weekly to hand out needles and other supplies like condoms and face masks. A local clerk helps connect people to medical and social services.(Rachel Bluth / KHN)

The new law comes too late for programs like Chico’s, as the city has now passed an ordinance prohibiting the exchange of syringes. Similar bans have been enacted in Anaheim, Oroville, Butte County, Yuba City, and elsewhere in recent years.

Ryan Coonerty, a supervisor for the Santa Cruz district, said the district is unlikely to issue a ban, although he is disappointed with Newsom’s decision. He believes the Santa Cruz nonprofit needle program is contributing more to needle pollution than the county-run program that requires people to hand in used needles in order to get new ones.

“We will continue to struggle with needle waste and unfortunately we will not get any help from the state to prevent needles from getting into the sea, parks and beaches,” he said.

But the Centers for Disease Control and Prevention and other health officials say one-on-one programs limit the ability to safely dispose of sharp objects, forcing them to hang on to their needles until the next needle change. That’s not realistic, say the people queuing up to get needles from the Santa Cruz program.

“Many of us are homeless,” said a 40-year-old woman, “and we can only stay somewhere that long.”

This story was produced by KHN, an editor of California Healthline, an editorially independent service of the California Health Care Foundation.

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