L.A. programs that help drug users await fate during Trump era

Samson Tafolo’s final count read 119.

For 45 minutes, he had tugged a wagon packed with mini water bottles, hemp cigarettes and miscellaneous hygiene products around Skid Row, handing out the supplies and keeping a tally of everyone he served on his usual route.

Tafolo and other leaders at the Sidewalk Project, a harm reduction nonprofit headquartered a few blocks down, make their rounds several times a week. The counting, he said, has become a high-stakes part of the job, since the numbers are reported in grant applications.

With the shifting political climate, their funding is suddenly in jeopardy.

Community ambassador Samson Tafolo, with the Sidewalk Project, shows how many homeless and needy have been helped during one morning’s outreach efforts on L.A.’s Skid Row.

(Genaro Molina/Los Angeles Times)

The Sidewalk Project is one of several groups that provide resources to homeless people, including some supplies specifically geared toward drug users, such as sterile syringes. While credited by advocates with saving lives during the opioid epidemic, the programs remain controversial, with critics arguing they fuel addiction.

Leaders of similar organizations across the state are worried that recent pledges by the Trump administration to trim federal spending and reduce redundancy in government agencies will have far-reaching ramifications for their work.

“It’s just a scare,” Tafolo said of the uncertain future under Trump. “It keeps us on our toes.”

Federal health officials said Friday that cuts to HIV prevention efforts, a key component of many harm reduction programs, are already in motion.

“It’s definitely a different level of threat than normal,” said Elly Jalayer, director of harm reduction at Bienestar Human Services, which offers HIV testing and treatment as well as syringe exchange.

Jalayer said the L.A. County Department of Health has been vocal about its continued support for harm reduction programs, but federal funding streams are more precarious.

In San Francisco, Mayor Daniel Lurie has pledged to restructure the city’s homelessness services and take a critical look at the efficacy of city-funded nonprofits, including ones that offer supplies to drug users.

“The days of just handing things out, and no accountability — those are over,” Lurie said at a news conference.

Clive Jackson, right, receives a hug from the Sidewalk Project’s Samson Tafolo.

(Genaro Molina/Los Angeles Times)

Last year, the Sidewalk Project was passed over for a grant because of questions about its syringe service program, said Soma Snakeoil, the nonprofit’s co-founder and executive director. In 2023, the program administered more than 267,000 sterile syringes and collected more than 53,000 syringes from the Skid Row and MacArthur Park areas, according to an impact analysis by a third-party research firm.

“When you’re consistently performing in a way that shows that you’re successful, you would imagine that you would be refunded,” Snakeoil said. “But they said that they are moving in a different direction.”

Members of the Sidewalk Project dispose of a needle they found on the street while giving out water, hygiene bags, CBD Gummies and other harm reduction supplies on Skid Row.

(Genaro Molina/Los Angeles Times)

That shift tends to mean more emphasis on treatment and less on harm reduction, Snakeoil said. She and others warned that scaling back syringe programs could have serious public health consequences.

Federal officials told the Wall Street Journal earlier this month that the Department of Health and Human Services is considering moving the Center for Disease Control’s Division of HIV Prevention under a different agency — or eliminating the division altogether.

Either move would set back decades of progress and be “devastating for our efforts to end the HIV epidemic,” said Timothy Zembek, harm reduction program manager at Being Alive L.A., an HIV services nonprofit.

Local officials are bracing for sweeping cuts to research and prevention efforts in the event of the CDC’s ceased involvement.

Cheryl Barrit, executive director of the L.A. County Commission on HIV, said that her fellow commissioners — 33% of whom live with HIV — are nervous.

“There’s a deep sense of anxiety and worry about what the current situation in the near future holds for their lives,” Barrit said.

Programs that offer clean syringes to intravenous drug users have been shown to prevent the spread of hepatitis and other blood-borne pathogens. But Barrit said it seems decisions at the federal level are now being made “with what appears to be a lack of analysis and with lack of community input and lack of partnership with stakeholders who are experts in the field.”

Th Department of Health and Human Services did not reply to requests from The Times.

The sense of disconnect between what government leaders believe will improve public health outcomes and what local communities actually need is what landed Snakeoil and her Sidewalk Project co-founder Stacey Dee in their line of work.

Soma Snakeoil, executive director and co-founder of the Sidewalk Project, sits inside her facility in Skid Row in downtown Los Angeles.

(Genaro Molina/Los Angeles Times)

The group was initially founded as an arts and music program, Snakeoil said. It only morphed into a harm reduction organization, she continued, once she and Dee realized “we were the right people to be doing that work because of our lived experience with drug use.”

That lived experience is also shared by much of Sidewalk’s staff.

One of the main knocks on harm reduction is that it enables and encourages illicit drug use. But some Sidewalk staffers who have turned their lives around said they wished they had access to services like theirs when they were on the street.

Crushow Herring, who heads Sidewalk’s Community Ambassador Program, used to sell drugs and live on Skid Row. He stopped dealing in 2006 when his son was born and has since painted a mural at his old selling spot.

When Herring made the neighborhood rounds with his team one Wednesday in late March, he stopped at every block to greet old friends passing by.

“We’re like lighthouses,” he said. “When you’re treading water, you need a lighthouse.”

Crushow Herring, right, gives out a hygiene bag to a man on Skid Row in downtown Los Angeles.

(Genaro Molina/Los Angeles Times)

As Herring doled out supplies, he directed new recipients to Sidewalk’s drop-in site on Stanford Avenue — a renovated garage space where unhoused community members can eat, rest and shop a free stock of the overdose reversal drug naloxone, clean syringes and sharps containers and other first-aid and hygiene supplies.

There, Sidewalk regular Michelle Ortiz was loading up on juice, oatmeal and underwear.

Ortiz, who is HIV-positive, has lived on Skid Row for more than a decade, she said. In that time, she was assaulted and even gave birth on the street.

Last year, Sidewalk helped Ortiz move into the Weingart residential tower, she said. She still uses drugs occasionally — “I’m not gonna lie to you” — but less than she used to, and she now takes medication for HIV.

Without Sidewalk, Ortiz said, “I wouldn’t be here — it would’ve been different.”

Despite testimonial from people such as Ortiz, the tide seems to be shifting against harm reduction. Last year’s passage of ballot initiative Prop 36 enacted harsher penalties for some drug offenses, and now the Trump administration is poised to enact sweeping changes.

Snakeoil noted that nearly “every single aspect of our work on the list of banned terms,” citing the hundreds of terms that the Trump administration has reportedly instructed federal employees to avoid.

Some nonprofits are scrambling to change their organizational language to secure federal funding, Snakeoil said, while others are fleeing to the private sector.

For Snakeoil, “it’s hard to see the way forward to sustainability” — especially when Trump and California officials are fueling public interest in tough-on-crime tactics.

“A lot of people have already lost patience,” said Sebastian Perez, state affairs specialist at APLA Health & Wellness, a nonprofit focused on preventing overdoses and diseases such as HIV.

As indicated by Prop 36’s passing, Perez said, “I think the public is more willing to be punitive right now.”

But drug policy researchers have long-argued being tough on drug users is not an evidence-based approach.

Peter Davidson, a professor at UC San Diego who has studied the efficacy of so-called overdose prevention sites, where drugs are used under the supervision of harm reduction workers and medical professionals, said the current system sets people up for failure.

“We give them criminal records, so it’s hard for them to have legitimate jobs and be part of the legitimate economy, and with all the instability that comes with that, we make it hard for them to get housing,” Davidson said. “Then we expect them to somehow successfully quit using drugs.”

Meanwhile, research indicates those who use syringe exchange programs are more likely to enter treatment, he said.

And those on Skid Row continue to worry they’ll lose some of the only good they see being done in their neighborhood.

“I’m afraid Trump wants to shut down all this,” resident Alvaro Rodriguez said while in line for Sidewalk supplies.

As he walked away, Rodriguez clutched a pair of worn composition books — in them, business plans to get himself and his neighbors off the street.

The Sidewalk Project’s Crushow Herring receives a hug from a friend while doing outreach work on Skid Row.

(Genaro Molina/Los Angeles Times)