The Board of Supervisors recently heard heated concerns from residents about hazardous waste, such as syringes, being found in parks, beaches, etc. What is the Board doing to respond to these complaints?
First, some background on this issue is important. By 1995, the Centers for Disease Control reported that nearly three-fourths of all new HIV infections were linked to injection drug use, transmitted by sharing contaminated syringes. That same year, only seven California counties had a higher prevalence rate of HIV/AIDS than Santa Cruz, and an increasing number of these cases stemmed from injection drug use. At that time, our Health Services Agency reported that the percentage of AIDS cases not attributable to male/male sex had more than doubled from a mean of 12 percent in the years 1983-1990 to a mean of 27 percent in 1991-1993, and that 43 percent of female AIDS cases in the county were injection drug users.
In an effort to help curb the spread of disease, the Santa Cruz Needle Exchange Project was developed and soon partnered with the Santa Cruz AIDS Project (SCAP). Today in Santa Cruz County, as a result of an effective needle exchange program operating for more than 25 years, injection drug users make up only 12.5 percent of the HIV cases compared to the statewide average of 20 percent. The efficacy of syringe exchange programs is well documented and supported by research carried out by the American Medical Association, the National Institute of Health, the Journal of Public Health, and others.
In 2009, SCAP’s budget for education and prevention programs was cut by more than $300,000 by the state, and the agency was no longer able to support the needle exchange program. In an effort to maintain this critical prevention program, community volunteers organized themselves and raised their own funds to continue this vital service.
Under the leadership of our new Public Health Officer, the county is currently working to provide comprehensive oversight of the program. A new advisory board has been created and includes public health professionals, law enforcement, community-based organizations, pharmacists, and the state Office of AIDS. We will be establishing new sites for needle exchange at county Health Department buildings in both Watsonville and Santa Cruz. Additional sites will be identified to ensure access, and the program will be run by county health staff with additional support from community volunteers. New disposal kiosks will also be installed in various locations to provide places where needles can be safely discarded.
It is also important to include pharmacies in any strategy addressing safe disposal of needles. SB 41, which went into effect in 2012, permits pharmacists to sell up to 30 syringes without a prescription. Pharmacies are also required to provide written information or verbal counseling to customers on how to access drug treatment, access testing and treatment for HIV and HEP C, and safely dispose of sharps waste. Unfortunately, many pharmacies are not fulfilling their responsibilities. County Health Services has been working with pharmacies to distribute free sharps disposal containers, and while some have been willing to work with the county, others have chosen not to participate.
Research shows that syringe exchange programs do not increase drug use and in fact contribute to helping connect people to treatment. The history of the fight against AIDS has always involved working with marginalized communities and developing strategies that promote effective public health. It has been proven that communicable diseases do not stay within their original host communities but spread into the general population. We must maintain our vigilance against the spread of HIV and other blood-borne disease among the injection drug using community. Preventing the spread of disease and ensuring the safety of our community will only be achieved through a combination of a well-supported needle exchange program, providing safe disposal of used syringes, and expanding drug treatment availability. I will continue to work together with county staff and our community to improve public health and safety.