Injecting Hope: Harm Reduction Alternatives to the War on Drugs
Orange drawstring bags hang off the wooden chairs inside the Human Health Service lecture hall at Santa Monica College (SMC). Students slowly shuffle in and sit spread around while the smell of pizza lingers in the air.
Robert Villanueva, a faculty intern at SMC and 36 years sober, shared his experience with addiction. “It’s a progressive illness, it starts with a drink or the hit of a joint of marijuana,” he said. Now a 12-step advocate and sponsor, Villanueva helps others with their sobriety.
The Institute for Public Strategies (IPS) hosted a discussion and documentary screening on May 15 at SMC to explore adopting a public-health approach towards drug addiction instead of relying on the criminal justice system.
After screening ABC 7’s Injecting Hope, IPS representatives gave overdose reversal training using Narcan, an opioid overdose reversal spray. Narcan is inserted into the nose and administered; call 911 after every Narcan use.
According to the Recover LA website, maintained by the Los Angeles County Department of Public Health’s Substance Abuse Prevention and Control (SAPC) bureau, “an estimated 1,482,000 Los Angeles County residents struggle with Substance Use Disorder.” Amid this crisis, community organizers and public health organizations have searched for alternative strategies besides the criminal justice system.
IPS, a San Diego-based public health organization, came to SMC to get students' perspectives on the implementation of a safe injection site, after screening ABC7’s documentary Injecting Hope.
Injecting Hope explores Canada’s public health approach towards managing its drug crisis: supervised injection facilities (SIFs), community engagement and increased access to treatment and resources. In 2003, Vancouver, British Columbia, experienced a heroin epidemic, resulting in the development of SIFs.
“It’s probably the most extreme example of a harm reduction program possible, acknowledging that people are still going to use drugs,” Ryan Factora, a prevention specialist, said during the presentation.
InSite, a Canadian SIF, offers sterile drug-use supplies, supervised consumption with an overdose response team, on-site health care and OnSite, withdrawal management and recovery support. According to a presentation from the British Columbia Centre on Substance Use, the overdose mortality declined by 35% in the area around InSite, and frequent users were more likely to seek treatment.
Despite the studies, Governor Gavin Newsom vetoed Senate Bill 57 in 2022, which would have allowed supervised injection sites in California.
According to a letter released from the Governor’s Office, Newsom vetoed SB57 due to concerns “about the operations of safe injection sites without strong, engaged local leadership and well-documented, vetted, and thoughtful operational and sustainability plans.”
Concerns over increased and prevalent drug use have been a hurdle for public health organizations attempting to promote a public health approach.
“The overwhelming stigma against drug use affects it through a variety of spheres, like social stigma and not wanting to talk about it,” Factora said. “There is still the stigma amongst decision makers, lawmakers or folks in regulatory health agencies.”
In an emailed statement to the Corsair, Captain Kevin Kilgore from the SMC Police Department said, “A primary roadblock officers face is the stigma surrounding addiction, which can discourage individuals from seeking help. Additionally, limited resources for treatment and prevention programs often hinder comprehensive community responses.”
The Los Angeles Central Office of Alcoholics Anonymous holds over 1,000 meetings weekly, with times and locations on their website. Find Recovery is a website for people interested in Narcotics Anonymous.
The Recover LA website says, “95% of people who need treatment don’t seek it, 4% did not seek treatment but thought they should get it and 1% sought treatment.”
Los Angeles County has “over 80 contracted SUD treatment providers in over 350 locations,” according to a 2021 SAPC presentation.
Historically, rehabilitation has been left in the hands of the criminal justice system. Prevention came in the form of a tough-on-crime approach and fear-based messaging.
“It’s a moral failing. A decision they chose to make. That’s been the fear-based rhetoric that has been happening, historically, in drug use prevention programs,” Factora said. “The question is, has that approach worked, has fear-based messaging and incarceration worked — no.”
According to a fact sheet from the Public Policy Institute of California, the California prison system is 117.6% over its design capacity. The Supreme Court has set a legal cap at 137.5%. Currently, nine jails are over the legal threshold.
IPS advocates for a public health approach as an alternative to the punitive method. The public health approach “takes into account the social determinants of health when addressing substance use, with a particular focus on the harms of substance use, as opposed to the act of using itself,” according to the IPS presentation.
Social determinants of health are how environment affects health risks and quality of life, according to the Office of Disease Prevention and Health Promotion.
“You don’t get much sleep outside unless you want your things stolen,” Jacob E. said, a homeless man at MacArthur Park, who didn’t provide a last name for privacy reasons. “It’s like starting all over again — every single time.”
According to an SAPC Data Brief, for every dollar spent, the government would save $4 to $7 by investing in SUD treatment, $3.81 to $5.60 by investing in Screening, Brief Intervention, and Referral to Treatment (SBIRT), and $7.40 to $36 by investing in prevention.
Harm prevention and reduction are cost-effective and have also assisted with the plateauing mortality rate amongst people experiencing homelessness.
In a 2025 news release from the Los Angeles County Department of Public Health (LACDPH), the county said, “While the mortality rate remained high, at 3,326 deaths per 100,000 people, 2023 marked the second consecutive year of a plateau in the homeless mortality rate, which previously saw a devastating increase of 56% from 2019 to 2021.”
The news release later said, “The distribution of naloxone, an opioid overdose reversal medication, increased threefold from 2021 to 2023. This effort and other harm reduction, overdose prevention, mental health and substance abuse treatment services likely contributed to the leveling of the overdose mortality rate in 2023.”
Mortality rates are plateauing, but drug potency is increasing. New variants of fentanyl are emerging in the county, according to Factora during the presentation. Appearance doesn’t dictate purity, so testing a drug's contents before use is best practice.
In an emailed statement to the Corsair, Kilgore said, “Common indicators of laced drugs include: unusual potency or effects stronger than expected, different appearance or texture, and unexpected reactions such as extreme dizziness, unconsciousness, respiratory difficulties, or severe anxiety.”
The SAPC’s Syringe Services Programs “provide access to naloxone, safer injection and smoking supplies, and education,” according to the SAPC’s Recover LA webpage.
The Syringe Services Programs run throughout LA with multiple on-site and mobile locations. All pertinent information can be found on the SAPC’s webpage.
The Venice Family Clinic serves the Santa Monica area “up to three hours a week, where people who may benefit from harm reduction services are located,” according to a statement from the LACDPH.
The SAPC also operates seven Connect to Opportunities for Recovery and Engagement (CORE) centers. CORE centers contain information and resources about drug prevention, SUD and free or low-cost treatment services.
“Addiction is a three-fold illness: mind, body and spirit,” Villanueva said. “It’s going to take a certain effort on behalf of the students who haven’t just witnessed, but experienced drug addiction, to come forward and create an opioid prevention club and Narcotics Anonymous meetings on campus, call it a grassroots student effort.”
Students looking to get involved can attend training and lectures on campus or carry Narcan. SMC distributes Narcan and fentanyl test strips at the Student Health Services Center for free, mandated by the Campus Opioid Safety Act.
There are multiple ways to help or receive help, but awareness is only the first step.