Promoting a Health Approach to Drugs

Preventing HIV and Hepatitis C by Expanding Access to Sterile Syringes

Sterile syringe access is one of the most effective HIV and hepatitis C prevention tools we have. Sterile syringes help prevent transmission of blood-borne diseases such as HIV and hepatitis C among people who inject drugs, their sexual partners, and their children. There is overwhelming support in the medical and public health community for syringe access, and study after study has shown its benefits.

DPA has led the efforts to increase syringe access for more than 15 years in California. In 2014 we won a major legislative victory that decriminalized syringe possession and expanded pharmacy sales of syringes. Californians can now access syringes by purchasing them at a pharmacy or by visiting an authorized syringe access program.

Our bill, AB 1743, was introduced by Assemblymember Phil Ting (D- San Francisco) and signed into law by Governor Jerry Brown in 2014. As of January 1, 2015, any pharmacy in California may sell an individual syringes without a prescription. The law exempts people from prosecution for carrying syringes that they obtained from a legal source, such as a syringe access program, pharmacy or clinic. It expands and protects our 2011 victory, when SB 41 expanded syringe access by allowing pharmacies throughout the state to sell syringes without a prescription. AB 1743 extended this program through 2021 and lifted the restriction on the amount of syringes.

An earlier key victory was AB 604, authored by Assemblymember Nancy Skinner, which was signed into law in 2011. It enables the California Department of Public Health (CDPH) to authorize health and social service programs to provide syringe exchange services in any location where the department determines that the conditions exist for the high transmission rates of HIV, viral hepatitis or any other potentially deadly or disabling infections that are spread through the sharing of used syringes.

Get more information on syringe access in California.

Preventing Overdose Deaths in California

Drug overdose is now the leading cause of accidental injury-related death in California, as it is in much of the United States.  Many overdoses are reversible and survivable if the individual gets medical assistance in time. DPA continues working with allies as we achieve a number of significant reforms that help save lives.

Learn more about pharmacy naloxone access in California.

On January 1st, 2015 we were proud to see the result of our 2014 workwith Assemblymember Richard Bloom (D- Santa Monica), a bill allowing pharmacists to furnish naloxone without a prescription, signed into law. California pharmacists will soon be permitted to sell naloxone (the antidote to opiate overdose) and provide brief educational training on overdose recognition and response, as well as the safe and effective use of naloxone. We co-sponsored the bill with the California Pharmacists Association. This victory built on a 2013 victory achieved by our allies at the Harm Reduction Coalition that increased layperson access to naloxone by removing some of the legal and liability barriers to broader distribution, which has already led to new naloxone education programs and access to naloxone in counties that previously had none.

One of the most common reasons people cite for not calling 911 when they witness an overdose is fear of police involvement and criminal punishment for themselves or their friends. That’s why DPA took the lead in successfully passing California’s 911 Good Samaritan law, which can help prevent many of these needless overdose deaths by encouraging witnesses of drug overdoses to call 911. It provides limited immunity from arrest and prosecution for low-level drug law violations to individuals under the influence, or in possession of drugs for personal use or drug paraphernalia, if they seek medical attention to save the life of someone experiencing an overdose. The law took effect on January 1, 2013.

Increasing Access to Effective Treatment

Health-based approaches – including harm reduction services and a range of evidence-based drug treatment programs – are more appropriate, effective and fiscally responsible responses to drug use than the punitive approach that currently dominates U.S. drug policy. We work to support health insurance coverage for substance use disorder treatment on par with the coverage of treatments for other chronic conditions; we work to identify federal and state funding sources for community-based treatment (including Byrne Justice Assistance Grants); and we work to eliminate barriers to treatment and recovery, including drug arrest and incarceration practices.

Too many people in California who want treatment for substance use disorders are unable to access it. The combination of increased access to health insurance under the Affordable Care Act (ACA) and the requirement for parity in mental health and substance use treatment under the Mental Health Parity and Addiction Equity Act have the potential to enable more Californians who want treatment to get it, including access to methadone and buprenorphine.

DPA believes that treatment is an effective and compassionate alternative to incarceration for people convicted of drug law violations who also struggle with substance use disorders. In 2000, DPA wrote and spearheaded the campaign to pass Proposition 36, the Substance Abuse and Crime Prevention Act, the state’s landmark treatment-instead-of-incarceration law that has diverted more than 300,000 people from jail and prison and saved the state more than $2.5 billion in just ten years. This program is a significant step toward a health-based approach to drug use, but reform must go farther – so that no one enters the criminal justice system simply for using or possessing drugs, and so that treatment and other health interventions are much more widely available in the community and through the healthcare system. In 2008, DPA supported Proposition 5, which would have significantly expanded treatment opportunities in California, but the measure failed to pass.

Supervised Injection Facilities

Supervised injection facilities (SIFs) are legally sanctioned health care settings where people who use drugs can inject pre-obtained drugs under clinical supervision.  SIFs are designed to reduce the health and societal problems associated with injection drug use.  Extensive research has found that they can reduce HIV and hepatitis C transmission, stop overdose deaths, reduce public drug use, and increase access to primary medical care and treatment. DPA’s efforts to establish a SIF in San Francisco began in 2007, when DPA and the Alliance for Saving Lives held a well-attended symposium on the topic. DPA is committed to educating elected officials on the benefits of SIFs, building public support, and working with organizations like the San Francisco Drug Users’ Union to make the idea a reality in San Francisco. There are currently 92 SIFs operating in 62 cities around the world – but none in the U.S.

Get more information on SIFs.