After hours of discussion and hearing from dozens of community members during a meeting on Tuesday night, Eureka City Council unanimously adopted a resolution allowing for mobile syringe exchange programs (SEPs) to operate within city limits during the COVID-19 pandemic.
The decision, which follows the council’s recent vote to temporarily ban SEPs entirely, amends the city’s local emergency declaration related to the pandemic to temporarily allow for mobile-only exchange, until the council can rewrite and adopt a more permanent syringe ordinance.
Although the Humboldt County Department of Health and Human Services (DHHS) — not subject to city jurisdiction — has continued to operate a SEP in Eureka, City Manager Miles Slattery said that the program is strained. “While they have increased to three days and have seen a lot more people, they don’t feel that they’re meeting the need,” Slattery said, citing a conversation he had with Public Health Director Michelle Stephens.
In addition to requiring that SEPs only operate on a mobile basis, the resolution requires that SEPs adhere to a strict one-for-one needle exchange per visit — meaning participants can only receive one new needle for every used one handed in.
Many members of the community, including medical and public health professionals and representative from the Humboldt Center Area for Harm Reduction (HACHR) — urged the council to not approve the resolution, saying that it is too restrictive and not in the best interest of those who use syringe services, especially during a pandemic.
Alessandra Ross, an injection drug use specialist from the state Office of AIDS, said that requiring a one-for-one exchange would not reduce needle litter and would increase the risk of disease through needle-sharing and reuse. “The evidence for this is really solid and there is consensus within the public health, medical and scientific community that one-for-one is not effective as litter prevention and it’s certainly dangerous as disease prevention,” she said to the council.
HACHR Executive Director Lasara Firefox Allen also voiced concern over several of the proposed restrictions, including not allowing credit accrual — meaning when someone brings in old needles, the organization operating the exchange will keep track of the number turned in and the participant is able to receive new ones during a different visit. So if someone brings in, say, 200 needles, they can take 10 new ones and have a 190 credit. Allen said that this is a crucial component of syringe exchange because it encourages people to clean up others’ syringes, while allowing participants to carry fewer syringes on them at a time.
After a long and somewhat convoluted discussion, the council ultimately decided to allow syringe credit, but with a cap of 100 syringes — meaning that, regardless of the number of syringes a person returns to the exchange, the cannot have an accrued credit of more than 100 syringes.
The resolution requires that any organization wishing to operate a mobile SEP submit a detailed operations plan for review and approval by the city council at a public meeting. Though HACHR is currently the only organization — other than the county DHHS — that operates a syringe exchange locally, Slattery said that there was potential interest from another organization.
In a statement sent out this afternoon HACHR said that although it “categorically opposes the restrictive measures taken by city council,” the nonprofit still plans to apply to operate a mobile exchange, and that it “will do whatever it takes to get services — even if they are compromised from a public health perspective — to our population.”
You can read the full press release from HACHR below:
On 1/5/21, against the advice and request of many specialists including doctors, representatives from California Department of Public Health (CDPH), harm reductionists, and concerned citizens from all sides of the issue, Eureka City Council voted into effect a vastly restrictive emergency resolution amendment governing SEP operations within the city limits. HACHR opposed this amendment not only on our own behalf, but also on the behalf of any future non-profit SEPs who may wish to operate in the City of Eureka. We are further concerned about the precedent set by the actions taken by city council, many of which are a solid overreach, and all of which toss the science of harm reduction to the side.
HACHR categorically opposes the steps taken which limit access to syringe services; a practice which is dangerous at any time, but is even more dangerous in the midst of the global COVID-19 pandemic which —according the CDC— is bringing to bear new clusters of HIV infection across the US. Current recommendations designed by the CDC and the CDPH Office of AIDS to address these spikes include reduced restrictions, and reduced barriers to access.
The city manager crafted, and Eureka City Council voted in, an amendment that stands in stark opposition to these recommendations.
According to the Vulnerability Assessment released by CDPH in November of 2020, Humboldt is in the highest risk categories for HIV and Hepatitis C infection spikes. This amendment restricts the distribution of syringes to a strict 1:1 protocol, as opposed to the needs-based methodologies supported and recommended by the CDC and CDPH. Further, the amendment caps the credit system for syringes brought in at 100, a number that was chosen arbitrarily, punishes participant’s positive behavior, and will likely result in a decrease in HACHR program participants performing voluntary cleanup duties.
While HACHR has always practiced a 1:1 exchange, it has been done so voluntarily and in direct response to community concerns. We recognize that a needs-based exchange model is what is recommended by public health officials and harm reduction specialists. HACHR also has a well-established credit system that encourages our participants to bring in additional discarded syringes they find along with ones used for personal use and get credit for future needs. This credit system is a 1:1 system, and one which works for our population to incentivise voluntary syringe cleanup in our community.
The new requirement created by the city council is even more restrictive than a 1:1 protocol, working in direct contradiction to the recommendations of public health officials. The amendment puts a cap of 100 needles for credit, meaning that if a participant brings in 150 used needles, for example, and can only carry away 20 that day, the remaining credit that would normally be 130 would instead be 100. This is damaging for all participants — especially folks who live in more remote locations and may come in only rarely. Some participants bring in a large volume all at once and do not want to get the whole number back in one visit.
The credit system as designed by HACHR is a logical and fair way to participate in a 1:1 exchange protocol without penalizing participants for the desired behavior of conducting voluntary syringe litter cleanup. There are currently 187 people in HACHR’s credit system that will unfairly lose the majority of their accrued credit in the past year due to these dangerous and restrictive measures, further damaging already fragile relationships which have been eroded by past measures taken by city council.
Amidst varied requirements including spatial considerations and written permission for use of any site for mobile SEP services, the amendment also requires that each SEP make a proposal to be considered for emergency operation and bring it to a publicly noticed city council meeting. You can rest assured that there will be more five-hour council meetings in our collective future.
While HACHR categorically opposes the restrictive measures taken by city council we will still apply to operate under these draconian measures within the city, because we will do whatever it takes to get services —even if they are compromised from a public health perspective— to our population