SANTA CRUZ -- In the depths of her heroin addiction 20 years ago, Frankie Marie tried to escape the pain in her life.
Abused as a child and troubled in her adult life, she first experimented with heroin in Oregon. She was drawn to the Beach Flats area of Santa Cruz because of its notoriety then for easy access to drugs.
"I didn't care if I lived or died. I basically ran amok when I was out there," Marie said of that time. Heroin, she said, "takes away every fiber of pain. It makes you feel like no one will ever hurt you -- like you're strong."
She found secluded spots to shoot up with others. They tossed their needles where they pleased.
"We were too scared of coming out of the woodwork to get rid of them. They were dropped along the side of the road or the side of a building."
Grappling with poverty and frequent trouble with Santa Cruz police, Marie said even in her darkest days she never shared needles.
"I knew I could go to the needle exchange and get them for free," she said. That may have saved her from diseases such as HIV and hepatitis -- and she was thankful for it.
In the wake of hundreds of discarded syringes found on beaches, trails and waterways in Santa Cruz County in recent months, community leaders and community members want answers about where the needles are coming from and solutions for better disposal.
Street Outreach Supporters, a needle exchange that uses a Santa Cruz County-provided van, doles out about 10,000 clean needles and other equipment to injection drug users each month. The group typically serves about 350 visits per month at its exchanges, which run three times a week and they deliver.
Based on a global public health practice, the idea is to offer clean needles and related equipment to prevent the potential spread of disease among injection drug users.
The group collects several thousand dirty needles from its participants. The problem, police and others say, is that the metal cookers and syringes given out by the exchange have turned up on beaches, trails and other places -- putting residents in danger.
The cookers, in particular, clearly come from the exchange, police said.
"They're dumping them in the community with no accountability," said Santa Cruz Deputy Police Chief Steve Clark. "And they're expecting the community and police to deal with it."
This month, members of the needle exchange, police and Santa Cruz County health officials met privately twice to try to find common ground.
Friday, Santa Cruz city staff released a report that offered some recommendations for the city's Public Safety Committee to consider at a public meeting on Tuesday. More county oversight of the needle exchange, potential new drop boxes for needles and a new citizen task force were among the suggestions.
Emily Ager, a longtime volunteer at the Street Outreach Supporters needle exchange, said her group wants to be part of the solution.
"No one wants to see that," Ager said of stray needles. "We don't like it either. I think that the main thing to understand is that it's a complex issue. It's not as easy as wiping out a demographic or eliminating a certain type of drug."
RISK OF INFECTION
Finding a discarded syringe can be a jolting experience, especially at beaches where people often go barefoot.
Santa Cruz County Health officials said the biggest risk is that the stray needle might carry hepatitis C or HIV if a person is pricked accidentally. However, both diseases require blood-to-blood contact for a person to be infected, said Leslie Goodfriend, county senior health services manager.
Even if someone is stuck by a needle, there is only a 2 percent chance that the person will be infected with either disease, according to the Centers for Disease Control and Prevention.
Santa Cruz County health officials do not track "needle sticks," perhaps because they are uncommon, Goodfriend said.
There have been from 9 to 28 new reported cases of HIV in the county since 2008, according to health records. It's unclear how many of those were traced to injection drug use.
Reported hepatitis C cases in the county dropped from 531 cases in 2008 to 245 cases in 2012 -- although staff time has diminished to collect that data, Goodfriend noted.
While the risk of infection might be low, the number of syringes discovered in Santa Cruz has risen recently.
During Santa Cruz police sweeps of more than 200 homeless camps during the summer of 2012, officers and parks workers found 358 syringes, according to city records.
On Jan. 12, more than 30 syringes were found at a volunteer cleanup near East Cliff Drive and Hiawatha Avenue in Santa Cruz. Several also have been found at Natural Bridges State Beach.
A group that cleans the San Lorenzo River levee has found more than 38 syringes since it started in 2010.
Santa Cruz police want people who find syringes to call 911 so an officer can retrieve it. They must be collected in a Sharps container or glass bottle in part to protect garbage workers.
Representatives of Street Outreach Supporters said there are a few reasons why drug users ditch syringes.
Sometimes meth and heroin users spot a police officer and discard them to avoid a drug paraphernalia offense, users told needle exchange volunteers. Others lose their needles and other belongings as a consequence of homelessness and drug use.
"It's difficult to be really specific about this. You can't say 'It's the meth users and the crazy people.' Yeah, but it's also people who are totally sane but nervous about the police."
Despite the increase in found needles, many injection drug users in Santa Cruz put them in Sharps containers and give the back to the exchange.
Some drug users who participate in the exchange said they do it because they too don't like to see syringes strewn in public places. The Sentinel agreed not to name them because they fear criminal prosecution for drug related offenses.
"I put them in a bio (biohazard Sharps container) and give them back to the needle exchange lady," said a woman who participates in the needle exchange and lives in Watsonville.
"Like everyone else, I have tossed them out when I was scared of being caught with them by the cops," she said.
Another man in his 40s said he brought dirty needles to the exchange even when he was homeless.
"Even when I didn't have a bio, I would collect dirties from other people I knew who didn't go to the needle exchange sites. I have hep C so I'm really careful about my own supplies, and as long as people recap their dirties, I don't mind taking them to exchange," he said. "We're not all careless."
Besides Sharps containers, there are also public drop boxes for syringes. There were drop boxes in public restrooms the Santa Cruz Municipal Wharf, San Lorenzo Park and other places a few years ago. Those often were so full that they needed to be emptied two to three times a week, Street Outreach representatives said.
The boxes now are gone because they were vandalized or ripped off the wall -- apparently during drug users' attempts to get dirty needles, said Scott Collins, assistant to the Santa Cruz city manager. The last two drop boxes in the county are in the men's and women's restrooms at the Santa Cruz and Watsonville Metro Bus stations. The boxes are often full.
Until September 2009, the Santa Cruz AIDS Project ran a drop-in center on Front Street that included a needle exchange. It also provided free HIV testing, counseling and prevention workshops, and helped people find food, housing, employment and legal services.
Although its leaders lauded the project, some Santa Cruz police said it enabled drug use.
State and federal funding dried up, and the group decided to close the center. When the drop-in center closed, volunteers from Street Outreach Supporters continued the needle exchange in the parking lot of a laundromat near Barson and Bixby streets in Santa Cruz that had been a meeting place since the 1980s.
In 2009, Street Outreach leaders secured help from the county and use of a white Ford E-350 van for a mobile needle exchange if they also agreed to do HIV testing. It has a table, bench and chair in the back so people can speak privately. The van is still used -- as well as by other groups -- and the group uses its own minivan.
Street Outreach now receives grants from the Comer Foundation, the Syringe Access Fund, the North American Syringe Exchange Network, the State Office of AIDS, and from County Public Health, according to its website at www.shootclean.org.
Street Outreach typically meets participants on Tuesday and Friday nights in a laundromat parking lot at Barson and Bixby streets. Sundays, the exchange site is outside the Santa Cruz County Health Services Agency on Emeline Avenue.
Santa Cruz County health officials said they have helped reduce the spread of disease among injection drug users.
HOW IT WORKS
In a recent Friday night in early January, the exchange was run from a volunteer's minivan parked in a laundromat parking lot on Barson Street.
Lights from the laundromat cast on the dark lot and the van, which had paper "Exchange" signs on its windows. Two volunteers sat in the van with the door open waiting for participants.
The same night a Sentinel photographer and reporter argued with a volunteer about taking pictures of the needle exchange, a member of Take Back Santa Cruz also visited it -- also to gather information.
Drug users often bring in their "points," or needles, in Sharps containers, pencil cases or other boxes, needle exchange volunteers said. A volunteer looks inside and estimates the number of syringes and other equipment, Ager said.
Volunteers typically asks the participant what he or she needs. The idea is to provide clean equipment -- beyond a syringe -- to prevent the spread of disease.
They offer a metal "cooker" for drugs, a syringe, cotton balls, a vinyl tourniquet, a small bottle of bleach and distilled water. They don't typically hand out an entire kit.
Because heroin is often sold in solid form, the user has to mix it with water and cook it before it can be drawn into a syringe. Ager said the Street Outreach exchange policy has moved from "one for one" to "one for one plus" -- meaning that a user can get up to 30 more clean needles than the number they bring.
When volunteers meet participants each week, they often develop relationships and mutual trust. Volunteers offer them resources to kick drugs if they're ready. Lately they've been talking to them about proper syringe disposal.
Essentially, Street Outreach can be a force of change because it has access to people who don't want to deal with police or drug rehab groups.
"They don't have to lie to us," Ager said. "And most of the time, drug users -- to get what they need -- they do kind of have to lie a lot to people. We try very hard to make it unnecessary."
Street Outreach doesn't track how many participants have gone on to rehabilitation, in part because it's often a process of several years.
"It's easy to say (drug use) is unhealthy and it's dangerous and it's wrong and it's selfish. You know, to some extent all of that is true," Ager said "But it's also always going to be more complex than that in an individual situation. That doesn't mean it's an insurmountable thing. People get clean all the time."
Dr. Ira Lubell, the interim Santa Cruz County public health director, added that "a clean needle has proven to be a good public health measure."
The irony, then, is the proliferation of discarded needles that could endanger residents who don't use drugs.
"You might be trying to prevent the spread of disease, but you're also exposing the risk of disease to the rest of the community," said Clark.
At a packed Santa Cruz City Council Public Safety Committee meeting in December, residents talked about some potential ways to solve problems with stray syringes at beaches, parks, waterways and paths.
Some of the ideas include more disposable Sharps containers, more public drop boxes for syringes and more retractable needles -- although retractable needles appear impractical for drug users.
Friday, Santa Cruz city staff released a report with recommendations for dealing with drug waste.
Among the suggestions were more oversight of the needle exchange, more Sharps drop boxes in public places and a citizen task force to offer more recommendations to the City Council.
Santa Cruz surf instructor Dylan Greiner is one of many residents trying to find answers to the problem. He essentially started the push against stray needles in November when he posted a YouTube video about drug waste he cleaned up around Cowell Beach.
"We've been finding (syringes) continuously all over the place for a while now and it's worse than it's ever been," Greiner said earlier this month. Even if new Sharps drop boxes were installed at public restrooms at Cowell's, he doubted that drug users would fill them with their dirty needles.
Greiner said, "I'd love whoever's leaving them all over the place to prove me wrong."
Follow Sentinel reporter Stephen Baxter on Twitter at Twitter.com/sbaxter_sc
At a glance
Syringes in Santa Cruz
NEEDLE DISTRIBUTION: At least 10,000 clean needles are distributed by Street Outreach Supporters each month. About 30 people attend a typical two-hour needle exchange, which takes place three times per week.
NEEDLE DISPOSAL: It's unclear how many dirty syringes and other drug waste Street Outreach collects each month, but it typically takes in several thousand in the equivalent of four 55-gallon drums.
EXCHANGE POLICY: The group's needle exchange policy is 'one-for-one plus.' That means they can give an injection drug user up to 30 clean needles beyond the dirty number the person submits -- depending on the person's need and others he or she might be supplying.
FUNDING: Street Outreach now receives grants from the Comer Foundation, the Syringe Access Fund, the North American Syringe Exchange Network, the State Office of AIDS and from County Public Health, according to its website at www.shootclean.org.
COST: The cost of a typical syringe at a pharmacy is 24 cents. State law allows up to 30 syringes can be sold to adults without a prescription at a typical drug store.
SOURCE: Sentinel reporting
IF YOU GO
PUBLIC SAFETY MEETING
WHAT: The Santa Cruz City Council's Public Safety Committee will discuss drug waste such as syringes and strategies to address the problem. City staff is expected to make recommendations for potential new policies at a public meeting.
WHEN: 6 p.m. Tuesday
WHERE: Santa Cruz City Council Chamber, 809 Center St.