Underground Health Care: A Fresno, Calif., Needle-Exchange Program Still Operates After County Supervisors Back Away From Legalizing It

Fresno County supervisors earlier this month voted against legalizing a syringe-exchange program that has been operating underground for 15 years. In 2008, the board publicly supported moving the SEP indoors, potentially providing one-stop mental health and other services, while relocating the SEP's medical clinic to a Fresno drug rehabilitation center.

On a recent Saturday, volunteers rumbled up in a school bus to an isolated cul-de-sac in Fresno to distribute sterile syringes and provide medical care. The line for syringes was long.

"Donations? Anyone have more donations?" asked SEP Director Dallas Blanchard, collecting clients' used syringes in a container. Each Saturday, the SEP exchanges up to 10,000 syringes.

"I have no right to talk to God. But, still, every night I pray that he won't let my children find the needles," said an unemployed carpenter, pouring used needles from a 2-liter soda bottle.

"Dallas, make sure that guy gets a sharps biohazard container," said Dr. Marc Lasher, whose day job is medical director of Aegis methadone clinic. On the bus, Dr. John Zweifler was lancing an abscess on an injection drug user's thigh and draining the angry-looking welt.

A woman Lasher long ago referred for drug rehabilitation, which she credits for keeping her clean for years, came up to the bus. She had used again, just once, she said. But the puncture site on her arm had swollen with a quick-spreading skin infection.

"Let's see what's going on," Lasher said to her. "Let's see how we can help you."

On Gov. Jerry Brown's desk are two syringe-access bills: One would let doctors, pharmacists, and workers of authorized SEPs provide a patient with a limited number of syringes without a prescription. The second would direct the state Department of Public Health to authorize SEPs in the event of a public health risk.

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