CJ Tobe understands why some people are opposed to syringe-service (aka needle-exchange) programs for drug-users—because he used to be one of those people.
But personal experience—as well as good-old-fashioned scientific data—changed Tobe’s mind, and today, he’s overseeing DAP Health’s just-announced Harm Reduction Program. The syringe-service program received state authorization to operate in Palm Springs on Jan. 10, becoming the second such program in Riverside County to get the state’s OK.
“We have a mobile clinic that will go around the city of Palm Springs 24 hours a week,” said Tobe, DAP Health’s director of community health and sexual wellness. (Full disclosure: Tobe is a friend of mine, and I am personally a supporter of DAP Health.) “Participants will be bringing in their used drug equipment, including their syringes or their points, and giving them to us to properly dispose.”
Tobe noted that giving people fresh syringes—and other items they need to inject as safely as possible—has been proven to be one of the most effective tools in reducing new HIV and hepatitis C cases. However, the program’s goals go well beyond just syringe service.
“It’s not just, ‘You give us your used equipment, and we give you new equipment,’” Tobe said. “It’s, ‘Well, what else do you need help with today? Do you need housing? Do you need to talk to a housing case manager? Do you need food? What about medical care? When was the last time you had your blood sugar or blood pressure checked? Do you see a primary-care doctor?’ We can help enroll them into insurance. We can then connect them to any kind of medical or social-support services, internally at DAP or through any of our community partners. We may have a person that says they actually want to stop (using) right then and there, and they want to be in a recovery or treatment center. We will immediately contact one of our partners and get them enrolled into one of those treatment centers.”
DAP Health’s Harm Reduction Program will also include the distribution of Narcan/naloxone, which can save the life of someone who is overdosing on opioids; and the distribution of fentanyl test strips, so drugs can be tested to decrease the likelihood of overdoses. Finally, DAP Health has set up a phone number (760-992-0453) and email address (HarmReduction@DAPHealth.org) which members of the community can use to report findings of used syringes or other drug paraphernalia.
The effectiveness of harm-reduction programs is proven science. According to the Centers for Disease Control and Prevention, “Nearly 30 years of research has shown that comprehensive (syringe-service programs, or SSPs) are safe, effective and cost-saving, do not increase illegal drug use or crime, and play an important role in reducing the transmission of viral hepatitis, HIV and other infections. Research shows that new users of SSPs are five times more likely to enter drug treatment and about three times more likely to stop using drugs than those who don’t use the programs. SSPs that provide naloxone also help decrease opioid overdose deaths. SSPs protect the public and first responders by facilitating the safe disposal of used needles and syringes.”
Science aside, Tobe said he was only convinced about the effectiveness of these programs thanks to personal experience.
“I can see how the perception would be that, ‘Oh, if you’re giving somebody drug equipment, then you’re enabling people to use drugs,’” Tobe said. “In 2014, when I ended up running a syringe-service program in Colorado, my perception was people who use drugs are only those who do not have roofs over their heads—people without jobs, etc.
“Then, one day, a nurse walks in, in scrubs, after work, to access this program. She disclosed to me that she was injected with heroin at the age of 12 by her uncle. So were her siblings, and she’s been addicted to heroin for 20-plus years, but she still made it through nursing school. She told me … she feels horrible using drugs before she comes into work and on her lunch break, and being high while caring for patients. Over six months, we were able to work together. We met twice a week, and we were able to reduce her use to only using at night (after work), so she was never putting her patients at risk. Harm reduction looks different for every single person accessing this program.”
“It’s not just, ‘You give us your used equipment, and we give you new equipment.’ It’s, ‘Well, what else do you need help with today? Do you need housing? Do you need to talk to a housing case manager? Do you need food? What about medical care?’”
CJ Tobe, DAP Health’s director of community health and sexual wellness
DAP’s Harm Reduction Program has even received a thumbs-up from Palm Springs Police Chief Andy Mills.
“It’s important to remember the dynamics that go into a program like this,” Mills said, according to a press release. “That’s what excites me. Not only is DAP Health looking at helping people, but genuinely helping people so they are not destructive to themselves or our community.”
The program is being launched at a time when it’s definitely needed—and in a place where it’s definitely needed. Tobe said HIV cases have risen throughout the region during the pandemic, and Palm Springs is well-known as a place to come to “party and play” for gay men. He also said that the 92262 zip code has experienced a 300 percent higher overdose death rate than the state as a whole during the pandemic.
Tobe said this sort of work is personal for him, based on what he went through after receiving an AIDS diagnosis in 2010 as a young gay man in Ohio.
“I was completely uneducated on HIV—and comfortably being a gay man,” Tobe said. “I ended up going through three years of mental-health therapy, where I was suicidal. One day, I woke up and decided, ‘You know what? I’m not happy here in Ohio, and I’m going to move to Palm Springs.’ So I moved to Palm Springs. I spent about four to six weeks where I was couch-surfing, and spending some nights at Ruth Hardy Park. So I’ve seen this community struggle as a gay man, with the party-and-play community, and with people who don’t have roofs over their heads.”
DAP Health’s Harm Reduction Program is currently authorized only in Palm Springs’ zip codes. Tobe said he hopes the program, or others like it, can be soon expanded throughout the Coachella Valley.
“The more programs we have to support people who are going through their addiction journey, the better they’re going to live their lives,” Tobe said. “It’s going to improve health outcomes.”