Needle and Syringe Programme Shutdown in California’s Orange County

The contents of a sterile needle kit. (Source: Wikimedia)

A Californian court has shut down one of the US state’s major needle and syringe programmes (NSPs), in a dangerous move that will contribute to increased drug harms.

The programme in the southern California region of Orange County was closed following a preliminary injunction on 27 November by the Superior Court of the State of California. The NSP had been running for two years, and organisers had hoped to expand the programme to neighbouring areas. The court’s injunction on the NSP cited increased drug litter in the surrounding area, which could expose the public to health harms.

An NSP is an essential harm reduction service that provides people with sterile injecting equipment, information for safer injection, a place to dispose of used needles safely, and counselling for people who want help in reducing their drug use or mitigating risks. NSPs are recognised by the World Health Organisation as being effective in reducing the spread of blood-borne diseases, such as HIV and Hepatitis C.

The Orange County Needle Exchange Programme denounced the court’s decision on Twitter:

“During this unprecedented opioid epidemic, counties across the country are collaborating with their local syringe exchanges to combat the problem. Rather than following their lead, Orange County officials have chosen to shut their only syringe exchange down.”

Furthermore Mahan Naeim, a member of the NSP’s steering committee, also criticised the court’s decision:

"It's a very disappointing ruling, needle exchange programs are not a radical idea. They exist in cities throughout the country."

Other harm reduction measures have been blocked in the state lately; California Governor Jerry Brown was rebuked by health experts in September for vetoing legislation that would have permitted San Francisco to open the US’ first legal drug consumption room. Additionally, the Orange County NSP is not the first such programme to be shut down in the US over the past year; similar closures have taken place in West Virginia and Indiana recently.

Such opposition to harm reduction is concerning in the US, particularly amidst the continuous rise of problematic opioid use and opioid-related deaths in the country.

In Orange County specifically, there were over 1.7 million opioid prescriptions dispensed in 2015 (in a county with a total population of 3.1 million). With this trend of overprescribing being followed by a sudden government crackdown on opioid prescriptions, there is an increased likelihood of people turning to injectable opioids – such as heroin – as alternatives.

The need for NSPs is therefore vital.

The Orange County judgment reflects a massive problem in the US: evidence-based harm reduction measures are being regularly abandoned, threatening the lives of countless people at a crucial time for evidence-based health interventions.