How federal funding restrictions could impact harm reduction in San Diego

S1: Welcome in San Diego. It's Jade Hindman on today's show. Drug assistance programs are losing federal funding. We'll talk about the impact here in San Diego. This is KPBS Midday Edition. Connecting our communities through conversation. A new executive order limits how federal funding can be spent by programs that assist people who use drugs. KPBS health reporter Heidi DeMarco says outreach workers believe the change could increase preventable overdoses. Here's that story.

S2: On a recent Wednesday afternoon , alcohol and drug counselor Paulette Mendoza and her teammates are getting ready to meet their patients. They lit up their van with backpacks and boxes full of supplies and head out to.

S3: Like , a 99 cent store where a lot of people that we know are gathered.

S2: Mendoza is part of San Diego's first Street health program. Father Joe's Villages started it in 2019.

S3: A big part of my job is going to be the harm reduction , the amount of time that I spend out in the streets , planting the seeds , talking to my friends. How are you ? Okay.

S4: Let's go.

S3: You want some ? We have snacks , water , and then harm reduction. Kids.

S2: Every day they treat health issues affecting unhoused people , from wounds to substance abuse and severe mental illness. Since 2020 , Father Joe says they have served more than 3000 people.

S3: Deaths are down and people are. People are making it , and there's a lot of things that contribute to that. But probably the biggest one has to be the Narcan , because it's a game changer.

S2: In order to get Narcan into the hands of their patients , Mendoza says the kits include certain tools to help start conversations and build trust with people who use drugs.

S5: You know , we have foil. We have straws. A lot of people on fentanyl here. We also have the the Tourniquet.

S3: And Texas region. Sorry for fentanyl and.

S2: Federal grants can still pay for naloxone and fentanyl test strips , but a new executive order directs the Substance Abuse and Mental Health Services Administration , or SAMHSa , to stop paying for things like syringes and pipes , saying they facilitate illegal drug use.

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S3: He kind of looked like the rest of these guys when I met him. I mean , he didn't look good. It was like. Like you're in the making , but , like , it works if we're out there.

S2: Today , Rivera is a year into recovery. He just completed a peer support specialist certificate. He says cutting funding for programs like Mendoza's could mean more people don't get a second chance like he did.

S6: I was down bad when I when I met her , like I didn't have a stable place to rest my head. I actually overdosed on a fentanyl on accident and flatlined. They gave me Narcan at the hospital and brought me back.

S7: Yeah , I used to come right across the street.

S2: At their second stop. Mendoza runs into Anjelica Preciado , who is also in recovery.

S8: I was on drugs , alcohol , stealing from stores , hanging out with gang members. I did prostitution.

S2: Today she's two years sober , and she and Mendoza lean on each other in recovery meetings.

S3: Well , she has two years , and I had one , so it was great. It was really cool. But we're at the same meeting now. It's like a movie night meeting. Yeah , we were crying. It was all good. It was crazy.

S2: Even after saving lives with Narcan herself. But Acevedo struggles with the idea of giving out harm reduction supplies.

S8: Like I said , I don't want to sound like a hater or anything like that. I just think that people are giving too many options to people that are addicts. You're giving them a way out.

S2: Research shows harm reduction , including distributing syringes , doesn't fuel increased drug use. It reduces disease risk and connects people to treatment in San Diego County. Overdoses decreased by more than 250 between 2023 and 2024.

S9: And I believe that is a direct correlation to the harm reduction interventions that were being provided in the community.

S2: Jenny Wilkins manages Father Joe's Street health program. She says her team has already distributed 2500 doses of naloxone this year.

S9: Moving funding away from harm reduction interventions is going to absolutely increase the amount of preventable overdose deaths.

S3: Do you know where Father Joe's ? Um.

S10: I know , yeah.

S2: Back on the street , Mendoza says she knows what's at stake.

S3: I think there's a stigma that , um , either people on drugs are not worth it , but they are. You're fighting against the solution. We found something that works.

S2: By the end of the day , the team handed out 30 kits , offered detox referrals , and made connections. Mendoza says every kid , every conversation is a seed that can lead people to treatment , but without all their tools , she says that chance for change could vanish.

S1: That was KPBS health reporter Heidi DeMarco. She joins me now to talk about the piece , which really took us into the lives of those who would be impacted by this executive order.

S2: And since harm reduction has become like the center of this national debate , I wanted to look into what that means here on the ground in San Diego. You know , for the outreach workers that use these tools every day and for the people whose lives are directly impacted by it.

S1: We'll talk more about this latest executive order.

S2: So some supplies like syringes , smoking pipes or sterile water can no longer be purchased with federal grants.

S1:

S2: You know , when you talk to these outreach workers , they tell you that the most effective tools are the ones that the federal funding will not , will no longer cover. So like the sterile syringes and the safer smoking kits with without , those people are more likely to share supplies , which raises the risk of HIV and hepatitis C in the community. So it's not just about disease prevention. These are the tools that folks say , you know , are starting conversations when they're out in the street. So someone might not be ready for treatment the first time they meet them , but it creates a relationship that can lead to recovery. Hmm.

S1: Hmm. Well , you know , in in the piece you talked to San Diegans in recovery.

S2: But then I met Bakari by spending the day out with the street health team. So for me as a health reporter , I'm always trying to humanize these stories because , you know , policy debates can feel distant , abstract. But when you hear from people directly and how it's impacting them , you can see what's at stake , and you can see how these services can mean the difference between recovery or relapse.

S1: And the story you also talk about the effectiveness of harm reduction , but also the mixed feelings people still have about that. Talk more about it. What are some stigmas or misconceptions that continue to exist around harm reduction ? Yes.

S2: So the data shows that harm reduction saves lives. So overdose deaths are down nationwide as well as here in San Diego County. And outreach workers credited to tools like naloxone. But like you said , there is still a stigma. You know , some people feel that handing out supplies like syringes or pipes just enables drug use. For example , Father Joe's is a Catholic based organization , so they don't hand out needles or pipes , but they partner with an organization that does because they understand that those are the supplies that kind of open the door for these conversations that will eventually connect people to treatment. So there's a real tension between what the evidence shows works and what people feel about it on a personal or moral level.

S1: As you just mentioned , overdose deaths are declining in San Diego. In fact , they dropped by 21% in 2024. But that number is still high at 945 deaths.

S2: So they're trying to expand that continuum of care. Because overdose is rarely just about drugs. It's tied to homelessness , trauma and untreated mental illness.

S1:

S2: Um , both of the folks that I spoke with , you know , they said it wasn't just about one program that changed everything. It was about someone meeting them where they were , you know , whether it was handing them supplies or talking to them without judgment. So , like Paulette said , you know , those interactions planted the seeds that eventually led them to treatment.

S1: You know , as we work on these stories , oftentimes there's so much that gets left on the cutting floor. Is there anything that didn't make it into the story ? Yes.

S2: The resiliency of Bakari and Angelica. Their stories , you know , of recovery , how they're still. This is still an everyday thing. They're both doing so well. I wish I could have , you know , talked more about it , but they were very impressive , you know , in terms of like where they were just a year or two ago to where they are now and how this has changed them and how they want to give back now. So they're both looking into working in places like Father Joe's to help other people in their situation.

S1: That's excellent.

S2: So we know Congress recently passed the cuts. You know , that can mean tens of thousands of people could lose healthcare coverage for substance use treatment. So experts say that could be devastating because even if harm reduction connects someone to care if they lose insurance , access to that treatment might not be there. So this will just be another hurdle for people who are trying to recover.

S1: I have been speaking with KPBS health reporter Heidi DeMarco. You can read the full story at KPBS. Heidi , thank you so much.

S2: Thank you.

S1: That's our show for today. I'm your host , Jade Hindman. Thanks for tuning in to Midday Edition. Be sure to have a great day on purpose , everyone.