By: Marcus J. Hopkins, Blogger
Last week, HEAL Blog covered San Francisco’s multi-pronged approach to dealing with public health among People Who Inject Drugs (PWIDs) and health concerns related to Injection Drug Use (IDU). This week, we’ll visit the southern part of the state – Orange County.
For those unfamiliar with Orange County, either from the salacious Bravo “reality” series involving housewives, or from Disneyland, the OC is virtually the opposite of all things San Francisco. Long considered a Conservative bastion for the rich and ridiculous, Orange County is home to some of the most ludicrous local regulations and laws – regulating that street lights be turned off by 10 PM to avoid “light pollution;” regulating the length of grass and the design of doors on houses; one town attempted to ban flip-flops. The county has long been the butt of jokes, and deservedly so.
It should, then, come as no surprise, then, that Orange County recently shut down the county’s only Syringe Services Program (SSP) in Santa Ana in January 2018 by denying it a permit (Graham, 2018). This move came after a massive Hepatitis A (HAV) outbreak spanning the southern California coast from San Diego to Los Angeles (between which Orange County lies) primarily within homeless and PWID communities in 2016-2017. At the time, Orange County officials failed to follow the leads of San Diego, Santa Cruz, and Los Angeles Counties in declaring a public health emergency, deciding instead to continue with their protocol of vaccinating and educating their homeless population…which many cities within the county have criminalized (Vo, 2017). Not only did they fail to recognize that the HAV outbreak in surrounding counties could spread to them, they failed to enact any of the proactive sanitation recommendations put forth by the California Health and Human Services that were instituted in San Diego County.
Following this regressive trend, a permit request that would allow the establishment of a mobile SSP in Costa Mesa’s Westside is currently attempting to raise botoxed eyebrows. The justification used by Santa Ana to January permit denial was an “increased number of discarded syringes in the area.” Costa Mesa officials called the proposed mobile SSP a “magnet for drug users” (Fry, 2018).
…because there are no drug users originating from Orange County…
The proposed mobile SSP would serve four Orange County cities – Santa Ana, Anaheim, Orange, and Costa Mesa. These cities were chosen because the Orange County Health Care Agency depicted them as being hotspots for HIV and drug overdoses (Brazil, 2018). Anaheim had the highest number of opioid-related overdose deaths between 2011-2015, followed by Huntington Beach, Santa Ana, Costa Mesa, and Orange. Santa Ana has the highest rate of HIV cases, while Costa Mesa and Orange also have high rates.
As for Hepatitis C (HCV) and Hepatitis B (HBV), California, as a whole, has relatively low rates of both – 0.2 and 0.3, respectively. Moreover, the state consistently runs behind on issuing annual reports and epidemiological profiles – the most recent HCV report was issued in 2016, and counts only Chronic HCV cases, which is counter to how the Centers for Disease Control and Prevention (CDC) accounts for HCV counts and rates in the U.S. (they count Acute HCV cases, as Chronic HCV is a long-term disease that is hard to track and may take years to develop). When states account for Chronic HCV cases in their reporting, rather than Acute infections, the data tends to skew toward patients within the Birth Cohort – Baby Boomers born between 1945-1965. This inevitably will wind up excluding PWID and homeless populations, as they are less likely to be screening for HCV, and data from virtually every state in the U.S. indicate that PWID who contract HCV trend younger – 15-45.
The justification in Costa Mesa for denying permits to the Orange County Needle Exchange Program – that it will attract drug users to their fair cities – is ludicrous on several fronts, not the least of which is the simple issue of distance. Anyone who’s ever lived in southern California can tell you that it will likely take you an hour or more to get somewhere during the daytime, and that’s if you’re driving. The suggestion that a mobile SSP will somehow draw PWID from neighboring counties – from Los Angeles, San Bernardino, San Diego, or Riverside, all of which are wellout of walking distance – is just ridiculous.
If the Real Housewives of Orange County taught us anything, it’s that keeping up appearances in Orange County is more highly regarded than adequately addressing serious issues. Orange County, rather than being proactive and attempting to directly confront HIV, HBV, and HCV, are instead trying to maintain the façade of a Pleasantville-esque paradise, where the homeless are invisible and drug users mustbe coming from othercounties. It’s a shortsighted approach, destined to produce lackluster results.
- Brazil, B. (2018, April 19). Orange County’s needle exchange awaits state approval for mobile service. Los Angeles, CA: Los Angeles Times: Social: Daily Pilot: News. Retrieved from: http://www.latimes.com/socal/daily-pilot/news/tn-wknd-et-needle-exchange-update-20180419-story.html
- Fry, H. (2018, May 02). Costa Mesa officials call proposal for mobile needle exchange a potential ‘magnet for drug users’. Los Angeles, CA: Los Angeles Times: Social: Daily Pilot: New. Retrieved from: http://www.latimes.com/socal/daily-pilot/news/tn-dpt-me-needle-exchange-20180502-story.html
- Graham, J. (2018, February 01). Orange County’s only needle exchange shuts down; advocates fear increased HIV transmission. Anaheim, CA: Digital First Media: Southern California News Group: The Orange County Register. Retrieved from: https://www.ocregister.com/2018/02/01/orange-countys-only-needle-exchange-shuts-down-advocates-fear-increased-hiv-transmission/
- Vo, T. (2017, September 21). Amid Hepatitis A Outbreaks, Orange County Focuses on Vaccination. Santa Ana, CA: Institute for Nonprofit News: Voice of OC. Retrieved from: https://voiceofoc.org/2017/09/amid-hepatitis-a-outbreaks-orange-county-focuses-on-vaccination/
Disclaimer: HEAL Blogs do not necessarily reflect the views of the Community Access National Network (CANN), but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about Hepatitis-related issues and updates. Please note that the content of some of the HEAL Blogs might be graphic due to the nature of the issues being addressed in it.