Hazardous Needles Pose Difficult Problems for Local Governments

Santa Cruz, California, is a picturesque, laid-back seaside city south of San Francisco known for its boardwalk, pier and ocean views.  

But like so many other places around the United States, there can be serious problems lurking slightly out of view. Officials in Santa Cruz have been struggling with many of the complex, interwoven issues related to homelessness, including risks posed by the needles some people use to inject illegal drugs.

In a handful of cases in Santa Cruz, people have been accidentally stuck with discarded needles.

Mark Dettle, the city’s public works director, told Route Fifty that while he applauds needle exchange efforts by Santa Cruz County, improperly discarded needles—of which, around 12,000 have been found over a four-year period, according to local news reports—lead to a public health emergency and a strain on municipal resources.

Dettle stressed that while all final decisions ultimately rest with policymakers, a focus on giving addicts a safe and supervised space to inject, and therefore ensuring safe disposal of “sharps,” could go a long toward easing the crisis.

“If it’s a medical condition, [safe-injection facilities] may be a better way to treat the medical condition than how we’re treating it now,” Dettle said in a phone interview. “If it eliminates this public health hazard, maybe it’s something to consider.”

The city has an online portal where citizens can report the locations of discarded needles, including public parks and on private property, Dettle said.

Ultimately, Dettle said he knows that cities like Santa Cruz aren’t alone in searching for new strategies to combat rampant drug use and improper disposal of needles.

“. . . [I]t’s not unique to Santa Cruz,” Dettle said. “It’s in cities and counties all around the world.”

For the first half of this year in Eugene, Oregon, the municipal government removed 2,200 hypodermic needles from unauthorized homeless campsites, which creates hazards for cleanup crews.

Santa Cruz County has one of the highest homeless populations in the country for a jurisdiction of its size, the Santa Cruz Sentinel wrote last year. And that’s despite a massive 44.5 percent drop.

Dettle said that he’s not aware of any conversations with local stakeholders regarding creating facilities that can both monitor use and, according to some studies, help with alleviating addiction by connecting marginalized populations with public health resources.

Some local governments around the United States, however, are closely looking at that methodology.

Over the last decade, a number of municipalities around North America and in Europe have piloted programs that offer safe injection facilities (SIFs). In many ways, the idea isn’t dissimilar from a major plotline presented in 2004 in the third season of HBO’s award-winning series The Wire.

Fed up with the Baltimore Police Department’s ability to curb drug dealing and use, fictional police commander Howard “Bunny” Colvin devised a strategy to move all such activities to designated, vacant areas—called “Hamsterdam”—in the hopes of improving public life.

“There’s never been a paper bag for drugs,” Colvin said in the series, comparing the idea to drinking alcohol in public by concealing the bottle.

While Colvin’s tactic eventually drew the ire of police superiors and politicians despite showing some of the public health advantages, flash forward just barely a decade and the idea is quickly becoming part of the mainstream within American drug policy.

While the tactic presented in The Wire may have purely been a law enforcement reaction, the real life examples are largely viewed as reacting to public health policy concerns, albeit with hopes for a similar outcome.

Cities such as Ithaca, New York, have expressed interest in combatting the ongoing crisis by providing addicts supervised injection sites, The New York Times reported in March.

Perhaps the most noteworthy example, however, has come out of Seattle, where the city’s mayor and other local leaders have publicly supported SIFs as a means of curbing addiction and dealing with a major public health policy issue.

Mayor Ed Murray has pushed for pilot projects that create facilities allowing supervised, and perceived-as-safe, injection sites for addicts. The Seattle mayor wrote about his October visit to the Insite Supervised Injection Site in Vancouver, British Columbia.

“Visiting Insite was eye-opening, and it reinforced our need to do what the science tells us to do when it comes to addressing the national crisis of addiction,” Murray wrote. “That means more work on the state and federal level to fund programs and support legislation that truly helps combat addiction, and it means ensuring our public health infrastructure is built in a way that quickly and adequately responds to those experiencing substance abuse disorders.”

Open since 2003, Insite is operated by Vancouver’s regional health authority and makes for North America’s first supervised injection site.

Insite touts success with both reducing overdose fatalities and providing an environment where injection drug users can seek safe spaces off of the street.

“It’s hard for, especially for street people and junkies, to find somebody who will be sympathetic and not be judged by just the fact that you’re doing drugs,” an unnamed 56-year old Insite patient said in its 2009 report.

A 2015 report by the European Monitoring Centre for Drugs and Drug Addiction backs up some of the findings from Insite. The more recent study also showed that supervised injection facilities around Europe reported success in getting access to marginalized drug users and helping get them to safer, more hygienic sites for their use.

Murray and King County Executive Dow Constantine have pledged to support supervised injection facilities in the greater Seattle area.

Likewise, law enforcement officials in Seattle have supported the tactic, saying that the war on drugs has ultimately failed in combatting addiction, according to a September post from neighborhood news blog Capitol Hill Seattle.

Whether the Hamsterdam trend hits the Santa Cruz area anytime soon remains unclear. As Dettle notes, ultimately any such decision rests with policymakers, citizens and other stakeholders. But the public works director told Route Fifty that his ultimate goal is to find a solution that protects citizens from improperly discarded needles and generally improve public health.

“The problem . . . is, if someone is using an illegal drug they may not be cognizant of how they dispose of that needle,” Dettle said. “That’s the dilemma my staff is left with, to go clean up and pick up and protect residents. . . . [I’m] wondering if any other agency or county had come across a way to deal with this issue because I know we’re not alone.”