Promoting a Health Approach to Drugs

Drug overdose is now the leading cause of accidental death in California, as it is in much of the United States. Overdoses are reversible and survivable if the individual gets medical assistance in time.

Health-based approaches to drug use – including harm reduction services and a range of evidence-based drug treatment programs – are more appropriate, effective and fiscally responsible responses than the punitive approach that has long dominated U.S. drug policy.

Drug Policy Alliance (DPA) and our allies are leading the way in California with significant reforms that reduce the harms associated with drug use and help save lives.

Did You Know?
Californians are now able to purchase naloxone directly from a participating local pharmacist, either with cash or in some cases, private insurance.

Learn about pharmacy naloxone access in California.

Supervised Consumption Services

Supervised consumption services (SCS), also called supervised injection facilities or drug consumption rooms, are legally sanctioned health care settings where people can use pre-obtained drugs in a safe, clinical setting. 

SCS are designed to reduce the health and societal problems associated with injection drug use. 

Benefits of Supervised Consumption Services
Extensive research has found that SCS can:

  • Reduce HIV and hepatitis C transmission
  • Prevent overdose deaths
  • Reduce public drug use and syringe litter
  • Increase access to primary medical care and treatment

DPA’s efforts to establish SCS in San Francisco began in 2007 when DPA and the Alliance for Saving Lives held a well-attended symposium on the topic. DPA’s Bay Area staff have led local, state, and national advocacy on the issue.

In 2016, DPA drafted a groundbreaking bill for Assembly member Susan Talamantes Eggman (D- San Joaquin) that would have allowed jurisdictions to permit SCS and would provide legal protections for the staff, volunteers, and participants in such programs. The bill was co-sponsored with Tarzana Treatment Center and Project Inform.

Although the bill failed in the Public Safety Committee, DPA is committed to running the bill again, educating elected officials on the benefits of SCS, building public support, and working with organizations like the San Francisco Drug Users’ Union to make the idea a reality. 

“We need to do everything in our power to keep people healthy, to get people off the streets so they’re injecting in a safe space indoors instead of on people’s doorsteps or in public parks, and to make sure we can intervene quickly if they overdose.” – State Senator Scott Wiener (San Francisco Chronicle, February 6, 2018)

There are currently 92 SCS operating in 62 cities around the world. In July 2021, Rhode Island became the first state in the nation to authorize a two-year pilot program to establish "harm reduction centers" where people can consume pre-obtained substances under the supervision of trained staff. We hope other states will follow Rhode Island’s example.

Get more information about SCS.

Increasing Access to Effective Treatment

DPA works 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). We also 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 its first decade.

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. DPA continues to push for expanded treatment opportunities in California.

Previous Victories

Reversing Opioid Overdose with Naloxone
Since 2001, DPA has fought to increase access to naloxone, a medication that reverses an opioid overdose. It blocks the effects of opioids, such as heroin, methadone, or OxyContin, reviving someone before they stop breathing and die. In June 2016, Governor Jerry Brown signed a budget bill including $3 million for community-based naloxone distribution – the first state funding for naloxone.

Research has shown that getting naloxone into the hands of people who use drugs is the most cost-effective way to prevent overdose deaths. DPA and our partners are continuing to advocate with the state department of public health to ensure that the funds are used as quickly and effectively as possible.

In 2014 our bill allowing pharmacists to furnish naloxone without a prescription authored by Assembly member Richard Bloom (D- Santa Monica) was signed into law. Trained California pharmacists can now dispense naloxone without a prescription. We co-sponsored the bill with the California Pharmacists Association.

This victory built on an earlier 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, as well as previous DPA legislation that created naloxone pilot programs in several counties.

Preventing Overdose Deaths with the 911 Good Samaritan Law
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.

This law 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.

In addition to legislative advocacy, in 2016 DPA led the reemergence of the LA Overdose Task Force (ODTF), an auxiliary group of the Naloxone Access Team for the LA county taskforce, SafeMedLA.  The ODTF meets bi-monthly to discuss the latest news in treatment and overdose prevention in order to take action to reduce preventable deaths.  To find out more about meetings and join the LA Overdose Task Force, email [email protected].

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, our bill, AB 1743,decriminalized syringe possession and expanded non-prescription pharmacy sales of syringes. Californians can now legally access syringes by purchasing them at a participating pharmacy or by visiting an authorized syringe access program.

An earlier key victory was AB 604, authored by Assembly member 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 used syringes. This legislation has been used to create the Orange County Needle Exchange Program.

Get more information on syringe access in California.