The History of Harm Reduction in Santa Cruz County

Santa Cruz County has had a long and vibrant history around syringe access dating back to the late 1980’s and early 1990’s, long before it was legal, and long before mounting data proved that clean injection supplies greatly reduces the spread of disease and death.

Accepting that people will inject drugs and providing sterile syringes and other supplies, curbs the spread of preventable diseases, connects users to services and reduces the amount of syringe waste in a community. In the early 1990’s, Santa Cruz County had one of the highest rates of HIV among the injection drug-using community at the time. Volunteers led by Richard Smith who was also knows as “Bleachman” began distributing bleach and condoms. Volunteers met with people who use drugs to ask what they needed, and they expressed a need for clean syringes. Syringe exchange was born. Richard has garnered the support of HIV ( called AIDS at the time) activists, City Council members Mardi Wormhoudt and John Laird. Council members educated law enforcement and asked them ‘to look the other way’ so to speak. Syringes were illegal to possess, purchase or carry. Mardi Wormhoudt held a fundraiser at her house to raise money to buy syringes. Ira Lubell was the Public Health Officer and Betsy McCarthy was Chief of Public Health . They both wrote and signed a letter of support for SCNEP. The first syringe services were mobile and home delivery operating in Santa Cruz, Watsonville, Felton and the 41st area of Capitola. They were called the Santa Cruz Needle Exchange Program (SCNEP) and did street based exchange on Barson Street as well as home visits. As the first Executive Director of the Santa Cruz Needle Exchange Program, (SCNEP) Heather Edney created one of the earliest feminist-run harm reduction agencies in the U.S.

In the mid-'90s, Heather and a dedicated team of volunteers engineered an innovative DIY organization that utilized punk aesthetics, Feminist & Queer theory, cutting-edge harm reduction modalities as well as creating one of the first risk reduction models that included holistic healthcare practices. It was modeled on women’s free clinics, gay men’s sexual health clinics and the early community health initiatives and buyer’s clubs. They also collaborated with the local arts community creating one of Northern California’s most cutting-edge cultural institutions of the period.  

As the fourth authorized syringe exchange program in the United States, SCNEP was groundbreaking in its work with young injection drug users and sex workers. They spearheaded the first Hepatitis A & B vaccination campaign in the State of California, partnering with UCSF on the study of young injection drug users, and participated in pioneering academic studies on drug use, HIV/AIDS and a spectrum of related illnesses. Their revolutionary ideas and programs remain the bedrock of harm reduction today.

Edney and her colleagues created one of the earliest informational zines, titled junkphood which was written by and for young injection drug users. The zines, fliers were responsible for expanding the field of harm reduction through wound care, overdose prevention, and a host of similar modalities. They were also the first syringe exchange program that designed their services specifically for women and were at the vanguard of bringing the voice of feminism into the national harm reduction conversation.

They joined forces with the Santa Cruz AIDS Project and Health Services Agency when the Drop In Center across the street from the Metro Station opened. SCNEP opened a second Drop-In Center in Watsonville called “Casa Bienestar.” Drop in Centers were open 7 days a week and provided services from Boulder Creek to Watsonville. In 1994 Santa Cruz became home to the 4th authorized syringe program in North America.

In 2009 all HIV prevention funding was cut by then Governor Schwarzenegger. The Drop-In Centers where syringe exchanges were run in Santa Cruz and Watsonville closed abruptly. This created pressure and the program moved back to mobile outreach and one small space behind a Laundromat on Barson Street. In 2013 a morphed version of SCNEP, Street Outreach Supporters (SOS), received intense scrutiny from Santa Cruz Police Department and in particular, Deputy Chief Steve Clark and a so called public safety group. The director of SOS was Emily Ager. She was harassed endlessly and county leadership at the time did not openly advocate for her or the program. The criticism was based on syringe litter which has been a dog whistle to stigmatize, vilify and demonize people who use drugs by mobilizing the most conservative voices to close down programs across the country. The perceived increase in litter was not attributed to the burgeoning Opioid crisis, failed housing and shelter policies that was brewing locally and nationally. So called ‘Public Safety’ advocates would ‘go under cover’ and noted that the program was operating closer to an evidence based program as opposed to an outdated unsafe model known as 1:1. In addition SOS raised the ire of conservative Santa Cruz Police Chief Kevin Vogel and Steve Clark when anti police literature was available from an unknown source. This would soon result in city staff sending an enforcement letter to the property owner of the laundromat. Program participants and staff would be arrested. City Council leadership in 2013 time was David Terrazas, Lynn Robinson, Hilary Bryant, Cynthia Mathews, Don Lane and Micah Posner. Lynn Robinson had a poor understanding of harm reduction and raised conserns that syringe service programs were enabling unless people were connected to treatment. What followed was a perfect storm that decimated what was once an internationally renowned program.

This created an urgent need for the county Health Services Agency Program to mobilize and begin operating two fixed locations for syringe services at the two county health clinics on Emeline Avenue in Santa Cruz and Crestview Drive in Watsonville. The county program would partner with Street Outreach Supporters (SOS). SOS would continue mobile outreach to supplement the fixed location clinic model. Mobile delivery would maintain relationships with program participants. Sadly, the all volunteer program ended after the tragic death of Emily Ager, leaving the County Health Services to operate two fixed sites with limited hours of operation and excessive restrictions. In the coming years the Board of Supervisors would continue to issue restrictions moving farther away from an evidence based program that would serve all the county residents who use drugs. The void left by not having mobile outreach would result in poor health outcomes that include one of the highest overdose rates in the state of California for years.

In 2018…. stay tuned. A new program is born.