In an update to the El Dorado County Board of Supervisors Oct. 11 the Sierra Harm Reduction Coalition reported giving out 99,000 syringes and receiving 108,000 in 2021 as part of its syringe exchange program.

That collection rate is 108.8%, according to Director Tom Ewing. The return rate for this year is around 95%. 

“We are seeing a reduction in syringes on the West Slope and I whole-heartedly believe it is due to the actions of Sierra Harm Reduction Coalition,” Ewing said.

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The coalition gained 416 new clients last calendar year, noted Ewing. Fourty-eight percent of those were housed while 52% were unhoused. 

In 2021 Sierra Harm Reduction Coalition also gave out 1,335 doses of naloxone to clients and reported 309 reversals of opioid overdoses. Some 2,328 fentanyl tests were distributed, of which 915 identified fentanyl, showing the presence of the deadly substance trending upward in the county. 

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“It started rising in May of last year, then peaked in December with a 53% positive rate,” Ewing told supervisors.

Ewing cofounded the coalition in 2019, a California Department of Public Health-authorized coalition, which provides a number of services countywide to residents who suffer from addiction.

These services range from syringe exchange, in which the goal is to reduce the number of spreadable diseases such as HIV and Hepatitis C, with an ultimate goal of educating substance abusers on the consequences of their usage and providing them with options to end their addictions. 

The coalition is required to provide a report to the county of its actions and the results of those actions. The county does not operate the coalition. 

Ewing’s presentation last week left the entire dais of supervisors concerned a coalition like Sierra Harm Reduction only makes matters worse in relation to drug use.

“For alot of us it is difficult because we are still seeing a lot of harm until you get to the point of recovery,” District 5 Supervisor Sue Novasel said. “I’m worried the two or three years it takes to get people to trust you to get there is … how many are dead by then?” 

Ewing emphasized to the board the coalition’s goals is twofold — to build trusting relationships with clients and eventually ease them off their addictions as well as stop the spread of blood-borne diseases. 

“You are changing a social structure of drug users,” Ewing explained. “You are changing an individual but you are also changing the community of drug users and their mindset on drugs.”

Supervisors remained unconvinced. 

“The problem is when you are giving this stuff out, your crackpipes, your tinfoil, you are enabling these people to still do drugs as far as I’m concerned,” District 2 Supervisor George Turnboo told Ewing.

The board further questioned county Public Health Officer Dr. Nancy Williams on the positive effects of the coalition. 

Williams responded that it is difficult to obtain information regarding emergency room visits related to opioid overdose and what happens to clients afterward but acknowledged the state’s overall increase in fentanyl users.

“We believe that SHRC’s efforts are probably decreasing that now but its pretty hard to tell when they are fighting an steep uphill battle,” Williams said. 

Williams reported 113.9 per 100,000 people in the county were living with an HIV infection in 2020, a decrease from 2019 and 2018 figures. Data from 2021 further showed 117.7 people living with HIV per 100,000.

In 2018 Hepatitis C cases numbered 79 per 100,000, an increase from 57 in 2016 and 66 in 2014. 

While Hepatitis C numbers increased (data was only available as recent as 2018), supervisors noted relatively “stable” numbers in infection rates and further questioned the need for Sierra Harm Reduction Coalition. 

“It’s a challenge because we are a relatively small county so those numbers are going to reflect that,” Williams told the board. 

She noted case increases are related to drug use. 

“Those are the kinds of cases we would like to see go down,” Williams said, adding, “Because it can take a long time for people to get diagnosed with Hepatitis, it could be many years before we see a change in that. If drug use goes up in the meantime, even if SHRC is making good progress, they may not be able to keep up.” 

A follow-up presentation will be heard by the board to provide information on how SHRC operates with its purpose of reducing blood-born pathogen incidences and other harms associated with drug use in El Dorado County. 

The board motioned to gather more data on diseases in the county to determine how the efforts of Sierra Harm Reduction Coalition affect local case rates.