Editor’s Note: This post originally appeared on The Fix, a Pacific Standard partner site.
Santa Cruz, a popular beachfront vacation spot on California’s central coast with an outsized reputation for great surfing and progressive politics, has a drug problem. But the problem goes deeper than the drugs themselves.
In January, the city council forced the closure of a syringe exchange that had provided IV-drug users with clean works for more than 20 years. A rising wave of public outrage at used syringes and metal “cookers” littering local parks, playgrounds, and beaches triggered the shutdown—the flashpoint in a contentious debate that has been unfolding in Santa Cruz for nearly a year.
“This needle exchange episode has been as much a question of perception as reality,” said Steve Pleich, a local lawyer who wrote the grant that first got the exchange—operated by the grass-roots group Street Outreach Supporters (SOS)—up and running.
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At the heart of that question are two competing narratives over the causes of, and solutions to, a perceived deterioration in Santa Cruz’s safety and serenity.
The excess of used needles was more than a public health problem, however. Ever since the ‘60s, this city 80 miles south of San Francisco has been a counter-cultural haven amid the redwoods, attracting alternative lifestyle types, including anti-war army veterans and other activists, who put down roots. Students come for its prestigious University of California campus, and drug users for its tolerant policies and policing. Santa Cruz was a pioneer in legalizing medical marijuana.
But angry residents say that Surf City’s quality of life his being spoiled by the influx of the state’s heroin addicts and homeless people. Many have mental illness as well as addictions. The community of 62,000 residents has five times the national average of homeless people. And according to the local police department, 40 percent of all the calls they receive relate to homeless people involved in break-ins, robberies, and general public nuisances.
“These hard-core addicts have to support their habit, and they are not doing it by panhandling,” said Santa Cruz’s deputy police chief Rick Martinez at a city council meeting in March. “They are doing it by committing crime.” Advocates for the homeless argue that only a small segment of this population is linked to the alleged crimes.
Over the past 18 months, five murders, including those of a local businesswoman downtown at noon (allegedly by a mentally ill homeless man) and two policemen (allegedly by a mentally ill veteran) moved many residents to fury. The SOS needle exchange became the focus of that fury.
One case of an accidental needle prick—a boy playing on the beach—has been reported, according to the Santa Cruz Sentinel. Although risk of HIV infection is virtually nil once the virus is exposed to air, the hepatitis C virus can remain active for up to four days. Either way, the medical care is arduous, including a month of anti-HIV drugs as post-exposure prevention (PEP); no PEP exists for hepatitis C.
But stray syringes are the exception for a program with a long track record of effectively combating HIV and hepatitis C, which are transmitted by sharing contaminated needles, supporters say. The SOS van distributed, on average, 10,000 clean needles a month, reportedly disposing of hundreds of thousands a year. Needle users make up 12 percent of new HIV cases in the county, compared with 20 percent statewide, said Giang Nguyen, director of the county’s Health Services Agency (HSA).
Ironically, the local man largely responsible for igniting the debate over the needle exchange is a vocal supporter of it. “I am 100 percent for needle exchange,” T.J. Magallanes told Santa Cruz Patch. “But I feel that if we make needles available, we need to make rehab available. We have not been treating addiction as a medical condition. It’s being treated as a crime. As long as it’s being treated as a crime, we’re not going to solve the problem.”
Magallanes founded a group called the Clean Team in December, in response to what he saw as an epidemic of trash filling public waterways and the city’s unwillingness to tackle the problem. “I was appalled,” Magallanes said. “I was like, ‘If our city is too scared or too lazy to take care of this obvious public health and safety issue, I’m gonna do it myself.’”
Magallanes, a contractor by trade, and several friends donned HAZMAT suits and rappelled down cliffs at a local beach for their first clean-up operation. In one day they removed three and half tons of garbage. The Clean Team quickly attracted hundreds of residents for larger public clean-ups. After finding several hundred used needles during the clean-ups, Magallanes spearheaded the issue.
“I was appalled. I was like, ‘If our city is too scared or too lazy to take care of this obvious public health and safety issue, I’m gonna do it myself.’”
“When I spoke [at the city council meeting] I brought a big handful of needles and set them down on the podium before I started to talk,” Magallanes said. “I think that’s where the needle debate started to shake up in Santa Cruz.”
Take Back Santa Cruz (TBSC), founded in 2009 and dedicated to fighting crime, added its voice to a chorus of concerned citizens calling for a shutdown of the SOS needle exchange. After a series of additional city council meetings about the issue, the city engineered the shutdown of the mobile needle-exchange van from a parking lot a short walk from downtown.
That left Street Outreach Supporters with one exchange, at the HSA building. SOS continued to operate it until May 1, when HSA took over amid demands from the public for increased oversight.
“It seemed like [the closure of the SOS exchange] was very abrupt,” said Dr. Lisa Hernandez, who became HSA’s county health officer in charge of the needle exchange less than a week after the shutdown. “There wasn’t much notification.”
While the full effects of the changes aren’t yet apparent, she said, the outcome has been mixed. “I think the intravenous drug user community is facing more scrutiny and increased negative sentiment from the community,” Hernandez said in an interview in mid-May. “They may be feeling a bit more on the fringe of society than they already felt.”
At the same time, she said, county public health workers have been able to extend the hours of the syringe swap, doubling SOS’s two-hour weekday to four hours. HSA has also continued the home delivery service, in addition to setting up two sharp boxes, safe drop-off spots for used needles.
Still, Pleich said that the adverse consequences of the change in location are hard to overstate. Compared to SOS’s former location, in a parking lot a short walk from downtown Santa Cruz, the HSA’s exchange is about two and a half miles away. Three weeks after the closure, HSA director Giang Nguyen reported a 38 percent decrease in the number of exchange users.
Pleich worries that until another exchange is opened in Santa Cruz’s urban core, the needle exchange program will never be as effective as it once was. “I think when we look at the stats in 2014, you’re going to find less needles being exchanged, more needle litter in the community and more transmission of HIV and hepatitis C,” he said. “Health care costs will skyrocket.”
Alex Kral, the head of San Francisco’s Urban Health Program and an HIV/drug epidemiologist at the University of California-San Francisco, agrees. “The key is location, location, location, Kral told the Santa Cruz Sentinel. “You can’t have it in a building far away. That won’t work.”
However, Hernandez said that in recent weeks signs have begun to improve. While official HSA stats will not be released until the end of the summer, she estimates that the HSA exchange is now reaching as many participants as the former SOS exchange. “I think now that HSA is running things citizens are feeling more secure and intravenous drug users are beginning to feel more acclimated,” she said.
The public ruckus that forced the initial closure took SOS by surprise, Pleich said. The organization was caught flat-footed, neglecting—or refusing—adequately to address the uproar. “There was a lack of communication with the neighborhood groups,” said Pleich. “[SOS] could’ve gone to the Clean Team when they first came to the city council shaking a bottle of needles and showed them how they operate. I think that would’ve placated a lot of their concerns.”
SOS did not respond to The Fix’s repeated requests for comment.
Street Outreach Supporters’ failure to address the many complaints, Pleich said, is of a piece with its habit of operating unilaterally. SOS originated as a group of volunteers who helped the Santa Cruz AIDS Project (SCAP) to operate a needle exchange in the heart of downtown Santa Cruz in the early ‘90s, when the HIV epidemic was at its peak but distributing clean needles to addicts was illegal. The exchange had always remained unregulated by city officials—an arrangement that many critics say resulted in a lack of accountability.
Facing statewide budget cuts for social welfare programs in California in 2009 as a result of the recession, SCAP discontinued its HIV Resource Center, which had housed its needle exchange. “SCAP just dropped it,” Pleich said. “So [SOS] really stepped up. They created a fully effective service in a very short period of time.”
Ultimately, SOS’s engrained go-it-alone attitude may have been its undoing. “SOS knows everything there is to know about how to run a needle exchange,” Pleich said. “But they understand nothing about the politics of needle exchange. And the politics is what killed them in Santa Cruz.”
Over the past year those politics have undergone a seismic shift, said Robert Norse, a locally famous critic of the city council and Take Back Santa Cruz. “Why did it become such a big issue? Because there are people who are willing to megaphone it,” Norse said. “If the city council had responded quickly and effectively, with more sharps containers and city-funded clean-ups, things might’ve been different.”
Take Back Santa Cruz did not respond to The Fix’s requests for comment.
After a few clean-ups, Magallanes said, the Clean Team took on a life of its own. While homeless people took part in some of the first efforts, before long what was found on those clean-ups was increasingly used to point a finger of blame at the homeless. “People were talking about poisoning the homeless, lighting their RVs on fire, beating them up at night,” Magallanes told Santa Cruz Patch. “Never underestimate the stupidity of people in a group.”
Magallanes said his advocacy about rehabilitation programs and the decriminalization of drugs was ignored as the group’s hostility toward drug users and the homeless increased. “Everything started getting super-weird. I began getting threatening messages on Facebook,” he said. “I was appalled, really saddened. I saw where it was going.”
The outcome of this pitched battle remains to be seen. Many of the same Santa Cruz residents who advocated strongly for closing the SOS exchange have also pushed for hiring more police and cutting funding for homeless services in the city. They have also launched a campaign to force increased surveillance and security checks of the homeless.
These moves trouble Deputy Police Chief Martinez. “It’s pretty obvious we are not going to be able to arrest—or legislate—the problem away,” he said.
Take Back Santa Cruz is meeting more pushback. A petition with 1,200 signatures, including those of the city’s top public health non-profits, was recently publicized, urging an end to the “scapegoating” of the homeless.
Magallanes remains optimistic that the closure of the needle exchange will not foreshadow further cuts to rehabilitation and treatment services in the city. “I hope Santa Cruz can be a leader in treating addiction as a medical condition and not a crime,” he said, “because the whole entire country is suffering from the same problems.”
Leadership may have to wait until the opponents of needle exchange see the results of their action. “If you have no exchange program in Santa Cruz, you will have way more needles on your beaches and in your parks,” the San Francisco Urban Health Program’s Kral told the Santa Cruz Sentinel. “That data is as clear as the day is long.”
Still, a crackdown on the addicted and the homeless could encourage many of them to leave town. Moving on will not solve their problems, of course. But for Santa Cruz, they will be somebody else’s problem.
