Journal of Student Research 2019

Journal of Student Research 120 opioids as the de facto pain management option.

A Case Study of California’s Syringe Exchange Programs on Illicit Opioid Use

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To explore the effect cannabis liberation may have on the opioid epidemic, a case study of California will be used. The selection of the state of California is intentional due to the long democratic history of California’s cannabis laws and data surrounding illicit opioid treatment methods. Both substances have detailed reports and public information available on the California Department of Public Health website. Medical marijuana has been legal in California since The Compassionate Use Act of 1996, and in 2016 the state legalized recreational marijuana (Compassionate Use Act, 2011). However, California is not immune to the opioid epidemic. The California Department of Public Health states, “Heroin is the one exception to the statewide leveling trend among opioid related deaths. Heroin deaths have continued to increase steadily by 67% since 2006 (with a 2014 rate of 1.4 per 100,000) and account for the growing share of total opioid related deaths” (“Statewide Opioid,” 2019). Largely, heroin depends on needle injection. In the 1980’s Syringe Exchange Programs (SEPs) were institutionalized throughout California, providing a resource for current injection users to obtain clean syringes to decrease HIV transmissions and opioid deaths. Currently, California has 39 Syringe Exchange Programs under the North American Syringe Exchange Network (NASEN) (“Syringe Exchanges,” n.d.). They also decrease HIV from opioid usage. Two charts reflecting this correlation between Syringe Exchange Program facilities (figure 1) and concentration of opioid

deaths (figure 2) support that these can be resources for local communities to prevent illicit opioid deaths. Supporting this correlation is a study done by the leading researcher on Syringe Exchange Programs, Ricky N. Bluthenthal, and his colleauges, who states that; “Clients of unlimited needs-based distribution and unlimited one-for-one plus [multiple syringes] exchange had a higher prevalence of adequate syringe coverage compared to clients of more restrictive syringe dispensation models” (Bluthenthal et al., 2007, p. 643). In other words, sterile syringes provided by a Syringe Exchange Program in return for used syringes decrease the spread of HIV among users. However, this will not effect opioid related deaths, which may be why California is still struggling with its opioid crisis. According to a study published in the journal Addiction by Shane Darke and Michael Farrell heroin deaths are correlated with use over time, specifically when use occurs in a community setting (Darke & Farrell, 2014). Facilities currently only deal with immediate needs of users given their resources (syringes) but addressing holistic aspects of users—like the setting of their use or decreasing opioid injection itself—could decrease spending and increase health in patrons. By providing additional resources—like medical marijuana for Figure 2: California Death, Total Population, 2016, All Opioid Overdose: Age Adjusted Rate/100k Residents (CA Opioid Overdose Surveillance Dashboard)

Figure 1: Counties with Syringe Exchange Program: dark green (CA Department of AIDS)

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