Despite voluminous rain clouds looming overhead, a cheerful posse of outreach workers with the Harm Reduction Coalition of San Diego, health care workers from UCSD’s School of Medicine, and other supportive volunteers from On Point, Be Kind, Sidewalk Project, Food Not Bombs, Young People in Recovery, and Imago Dei Clinic posted up Friday morning along the south end of Sports Arena Blvd in the Midway District.

They quickly erected brand new tents to keep their tables of food, water, ponchos, warm clothes, colorful new tee shirts, feminine hygiene products, backpacks and even candy, dry. Volunteers Dr. Ben Han and Lisa Silvestro, FNP, were ready to administer wound care, while representatives from Imago dei Clinic offered Naloxone and overdose prevention training. Throughout the morning, local unsheltered folks, many of them either drug users or who are friends of those who do, wandered through the outreach event, gladly accepting packages of unused syringes and backpacks. Many specifically asked for the Naloxene (Narcan) and made a b-line for that table. Recipients were only asked for the first three letters of their first and last names and a birthdate.

The local Harm Reduction Coalition has been on hyper drive since it was approved for operation in October by the California Department of Public Health office of AIDS, according to the local group’s executive director Tara Stamos-Buesig. They have been doing syringe service outreach three days a week, and Friday’s event was the first such collaboration with other groups. Last week the San Diego County Board of Supervisors voted in favor of developing a needle exchange program, essentially repealing the ban on such programs enacted in 1997. At that meeting, Dr. Christian Ramers of the Family Health Centers of San Diego applauded the vote and reminded the supervisors that one person died of an overdose nearly every day in 2019 (314). He added that not only do syringe exchange programs save lives, prevent the spread of infectious disease like HIV and Hepatitis C, they also save taxpayers millions of dollars in long term care for those patients.

Stamos-Buesig said since their program started they have over 600 people enrolled in their program.To date they have logged 167 overdose reversals. They also have safe smoking supplies which, in the time of COVID reduces the spread of the virus across a population that is traditionally difficult to reach, but who deserve to be safe and healthy. “Our mission is to make sure that people don’t end up with the consequences from drug use, such as hepatitis, HIV, STDs, and really to get rid of the stigma and meet people where they are,” she said, adding that it is equally important to let them know they are loved and that they matter, and support them in finding ways to succeed. “Success isn’t necessarily my idea of success,” Stamos-Buesig said. “It’s the individual’s idea of what they want to achieve.”

It was a similar encounter with a syringe exchange program Stamos-Buesig had when she was on the street with her own addiction, that kept her from getting HIV. All the ‘tough love’ and treatment programs didn’t work for her, she said. But what did work was people saying “Hey I went hiking the other day over at that place. Have you been there? And just having a regular conversation about food or music, the simple things; they reminded me that I matter, and that made me hold on to hope,” she said.

Rooster, one of Friday’s volunteers, has a similar story. She was leaning against the wall outside the local 7-11 one day when the Harm Reduction Coalition’s van rolled up. “At first I thought it was a cop car and I was like ‘wooo shit’!” she said. It turned out that Tara and Rooster had some friends in common. Today, Rooster is able to pay it forward and take clean kits to some of the most vulnerable users who don’t come out in public that often. A proud sixth generation from Oceanside, she isn’t looking to change her own or anyone else’s lifestyle, just to make sure they are safe from the harm caused by sharing needles and leaving open wounds untreated. She sees her volunteer work with the Harm Reduction Coalition as a way of making amends for some of the things she’s done. “If I’m a drug addict in this life, and I want good karma, and I want things to start turning around, the least I can do is do what I’m doing safely,” she said.

Rooster said she hates to get involved when people want her help shooting up, but when she sees them doing things so badly they create wounds, she steps in. “How can I just sit there and watch somebody not be able to get well because their shot will coagulate or end up with endocarditis because they did it wrong? And I know damn well how to do it? I’m like a phlebotomist, it’s crazy.” She said she tries to live by the sentiment of First Corinthians 13, which she has tattooed on her neck. “The greatest things that you’ll receive in life are faith, hope and love,” she said, and the greatest of these is loving.”

At that moment three men came over to the tents, surprised by what was being offered. One man said he’d used Narcan “like 500 times” on the street to save someone from overdosing. He was walking a little ways behind his girlfriend recently when she started screaming. “I headed over there and people were panicking and I grabbed the Narcan and just pfft-pfft, and they survived. I mean I wish everybody who got a rig (syringe) got a pack of these (Naloxene) with it,” he said. “Especially with the whole fentanyl thing. Unfortunately, it’s like 20 times for one person but it’s still somebody who’s alive, right? that’s the important part.”

The guiding principles of the National Harm Reduction Coalition would concur. They advocate for accepting that licit and illicit drug use is part of our social world, and that working to minimize harm is a more effective public health policy than choosing to ignore or condemn drug use. They center a non-judgmental, localized approach to affirming that the very people who use drugs should be the primary agents of reducing the harms of drug use and should participate in sharing information among each other, while also developing support systems that recognize past traumas, racism, social isolation and other triggers for drug use. A $400,000 grant will allow the Harm Reduction Coalition to implement training and develop a staff over the next three years. The syringes, basic health care supplies and packages of Naloxone (Narcan) are funded through the National Association of Syringe Exchange Networks (NASEN).