On a typical day, locals tend to avoid the intersections of Crocker and 5th Street in downtown Los Angeles. The cross streets are located right in the heart of Skid Row, which has earned a reputation for being home to one of America’s largest and most visible homeless encampments.

For the residents who live there, however, the tents that line the street represent their daily life and a consistent community.

Over the years, city and county leaders, health workers, residents and community organizers have worked towards shifting perceptions of Skid Row’s residents, many of whom are facing a variety of personal and financial hardships.

Now, in the first-of-its-kind, the Skid Row Care Campus has offered the unhoused community a glimpse at stability. Since its opening in April, the campus has offered dozens a place to shower and do laundry, access medical care without judgment or simply rest without being treated as a nuisance.

The campus comes out of the Skid Row Action Plan, a community planning initiative that expands access to interim and permanent housing, health care, harm reduction and other supportive services. The plan, developed by Skid Row community members along with public, private and non-profit organizations, seeks to address systemic racism and disinvestment in Skid Row by supporting a culturally vibrant and thriving community.

According to staff members, the 3.4-acre, community-driven site was envisioned as a lasting refuge. Its architecture is deliberately welcoming, featuring both indoor and outdoor spaces where visitors can charge their phones, listen to music, freshen up or socialize. Thoughtful use of color and design elements reflects the care and intention behind this piece of urban infrastructure.

Run by community organizations and staffed by people from the Skid Row neighborhood, the campus reflects what Skid Row residents have highlighted as the greatest needs in the community.

“It’s based on feedback from the community–so it’s what they want, and it’s tailored to what they’ve asked for,” said Associate Director of Community Initiatives, Aurora Morales.

Morales spoke with CALÓ News during an in-person tour of the facility. She mentioned that the goal is to improve the health and well-being of Skid Row community members and create pathways out of homelessness. Since opening, The Skid Row Care Campus has served approximately 3,000 people per day across all of the programs.

“The Skid Row care campus is so significant for this community because it provides not only opportunities for people to work, [as well as] opportunities for the community members to be safe,” said Morales. Additionally, there are opportunities for individuals to be paid to contribute and work on-site, which Morales says helps boost confidence and morale.

Los Angeles — Inside a bright new building in the heart of Skid Row, homeless people hung out in a canopy-covered courtyard — some waiting to take a shower, do laundry, or get medication for addiction treatment. Others relaxed on shaded grass and charged their phones as an intake line for housing grew more crowded.

The Skid Row Care Campus officially opened this spring with ample offerings for people living on the streets of this historically downtrodden neighborhood. Pop-up fruit stands and tent encampments lined the sidewalks, as well as dealers peddling meth and fentanyl in open-air drug markets. Some people, sick or strung out, were passed out on sidewalks as pedestrians strolled by on a recent afternoon.

For those working toward sobriety, clinicians are on site to offer mental health and addiction treatment. Skid Row’s first methadone clinic is set to open here this year. For those not ready to quit drugs or alcohol, the campus provides clean syringes to more safely shoot up, glass pipes for smoking drugs, naloxone to prevent overdoses, and drug test strips to detect fentanyl contamination, among other supplies.

As many Americans have grown increasingly intolerant of street homelessness, cities and states have returned to tough-on-crime approaches that penalize people for living outside and for substance use disorders. But the Skid Row facility shows Los Angeles County leaders’ embrace of the principle of harm reduction, a range of more lenient strategies that can include helping people more safely use drugs, as they contend with a homeless population estimated around 75,000 — among the largest of any county in the nation. Evidence shows the approach can help individuals enter treatment, gain sobriety, and end their homelessness, while addiction experts and county health officials note it has the added benefit of improving public health.

“We get a really bad rap for this, but this is the safest way to use drugs,” said Darren Willett, director of the Center for Harm Reduction on the new Skid Row Care Campus. “It’s an overdose prevention strategy, and it prevents the spread of infectious disease.”

Despite a decline in overdose deaths, drug and alcohol use continues to be the leading cause of death among homeless people in the county. Living on the streets or in sordid encampments, homeless people saddle the health care system with high costs from uncompensated care, emergency room trips, inpatient hospitalizations, and, for many of them, their deaths. Harm reduction, its advocates say, allows homeless people the opportunity to obtain jobs, taxpayer-subsidized housing, health care, and other social services without being forced to give up drugs. Yet it’s hotly debated.

Politicians around the country, including Gov. Gavin Newsom in California, are reluctant to adopt harm reduction techniques, such as needle exchanges or supervised places to use drugs, in part because they can be seen by the public as condoning illicit behavior. Although Democrats are more supportive than Republicans, a national poll this year found lukewarm support across the political spectrum for such interventions.

Los Angeles is defying President Trump’s agenda as he advocates for forced mental health and addiction treatment for homeless people — and locking up those who refuse. The city has also been the scene of large protests against Mr. Trump’s immigration crackdown, which the president has fought by deploying National Guard troops and Marines.

Mr. Trump’s most detailed remarks on homelessness and substance use disorder came during his campaign, when he attacked people who use drugs as criminals and said that homeless people “have no right to turn every park and sidewalk into a place for them to squat and do drugs.” Health and Human Services Secretary Robert F. Kennedy Jr. reinforced Mr. Trump’s focus on treatment.

“Secretary Kennedy stands with President Trump in prioritizing recovery-focused solutions to address addiction and homelessness,” said agency spokesperson Vianca Rodriguez Feliciano. “HHS remains focused on helping individuals recover, communities heal, and help make our cities clean, safe, and healthy once again.”

A comprehensive report led by Margot Kushel, a professor of medicine at the University of California-San Francisco, this year found that nearly half of California’s homeless population had a complex behavioral health need, defined as regular drug use, heavy drinking, hallucinations, or a recent psychiatric hospitalization.

The chaos of living outside, she said — marked by violence, sexual assault, sleeplessness, and lack of housing and health care — can make it nearly impossible to get sober.

• The 2024 overdose death toll of 2,438 is the lowest since 2019, and a drop from the 3,137 deaths recorded in 2023.
• While fentanyl remained the leading cause of accidental overdose deaths, its share dropped to 52% of all cases, down from 64% in 2023.
• Health officials credited measures including large-scale investments in drug treatment and overdose prevention for a sharp decline in drug overdoses.

Accidental drug overdose and poisoning deaths plunged by 22% in Los Angeles County last year, according to a new report, marking the most substantial single-year decline on record.

The 2024 overdose death toll of 2,438 is the lowest since 2019 and a notable drop from the 3,137 deaths recorded in 2023. The sharpest decline was in fentanyl-related deaths, which fell 37% from 2,001 deaths in 2023 to 1,263 in 2024, according to a report released Wednesday from the L.A. County Public Health Department.

LOS ANGELES — For the first time, California is reporting a decline in overdose deaths tied to synthetic opioids, according to state health data through June 2024. Officials say the drop marks real progress and credit harm reduction programs for playing a critical role.

Los Angeles-native Rebeca Orellana began cooking professionally at 16 — and said the job exposed her early on to drugs and alcohol.

“Cooking for artists and a lot of high-profile clients, you’re kind of surrounded by those substances and alcohol,” she said. “It wasn’t easy for me to stay clean and sober.”

After leaving the food industry, Orellana has now been clean from crack for 19 years, although she still struggles with alcohol.

Today, she leads the Harm Reduction Drop-In Center at HOPICS in South LA. There, she not only prepares meals but also provides harm reduction services — a strategy that meets people where they are, without judgment, to reduce the risks associated with drug use.

Her goal, she said, is to “ultimately make somebody feel vulnerable enough to feel safe to open up and to establish that foundation of hope and trust.”

Orellana and her team also do outreach, handing out fentanyl test strips, clean syringes, wound care supplies — and naloxone, the overdose-reversing medication commonly known as Narcan.

Gov. Gavin Newsom recently announced the state will make Narcan more accessible, cutting the price of twin-packs to $24 — half the retail cost.

LA County said it has distributed more than 400,000 kits of naloxone and 65,000 fentanyl test strips in the last three years. Those efforts have helped reverse more than 30,000 overdoses.

Ian Flagg, program manager in the Harm Reduction Division of the Department of Health Services, noted that harm reduction is often misunderstood — but can be the first step toward recovery.

“Harm reduction not only reduces the transmission of infections through decreasing, decreasing supply sharing, but by providing clean supplies to individuals,” Flagg said. “But we also provide safe structures and supportive structures like this drop-in center we see here where participants can come in, it’s often the first step in the continuum of care to get treatment.”

For Orellana, the work is personal.

“It feels fulfilling that I’m able to help somebody in return with the same kind of harm reduction that helped me get clean,” she said.

It’s a full-circle moment — and a sign of hope — as California builds on this momentum to protect more lives.

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Read the full article with video here: https://spectrumnews1.com/ca/southern-california/news/2025/04/30/opioid-fentanyl-harm-reduction-health?cid=id-app15_m-share_s-web_cmp-app_launch_august2020_c-producer_posts_po-organic

Elena Cruz is a 45-year-old Afro-Boriqua woman and former sex worker who is passionate about working in harm reduction. She recently became one of the first graduates of the newly launched Worker Education & Resource Center (WERC) program, which is playing a critical role in transforming harm reduction services throughout Los Angeles.

Cruz first became involved with the groundbreaking initiative while volunteering with The Sidewalk Project, a street-based harm reduction organization. Now she is continuing that work as a paid employee, thanks, in part, to the professional development she’s received through WERC.

Launched by the L.A. County Department of Health Services (DHS), the WERC program specializes in hands-on training that equips participants to work as harm reduction support specialists or supervisors. The program is made up of approximately 33% Latino participants. The eight to 10- week curriculum offers free, comprehensive instruction on essential topics like safer drug use, engaging unhoused community members, compassionate communication and working within social services.

“I’m gaining confidence through the program,” said Cruz, reflecting on her growth. Since joining The Sidewalk Project, she has taken on the role of managing the front reception area where she helps connect visitors with resources. “Everyone who walks through the door needs something—whether it’s a place to charge their phone, somewhere to sit or even a place to meditate. We provide a lot of things.”

Shoshanna Scholar, the director of the Harm Reduction Division for DHS, spoke to CALÓ News about the critical importance of programs like WERC and city-wide investments in harm reduction initiatives.

Scholar noted that until recently, many organizations that focus on harm reduction were often underfunded and relied heavily on volunteers. Many of these volunteers, like Cruz, had lived experiences that informed their work.

“The piece you can’t substitute is a lived experience,” Scholar states. “We wanted to make sure that we were hiring from the Skid Row community…and recruiting residents who have a long-term relationship connection with the area.”

In recent years, Los Angeles County has intensified its efforts to develop a more comprehensive and inclusive strategy for public health. In 2023, the number of drug-related overdose and poisoning deaths in the county plateaued for the first time in a decade.

A significant portion of the work has been hindered by the stigma surrounding harm reduction initiatives, even in places like California, which is generally considered less conservative. In 2022, Gov. Gavin Newsom vetoed a controversial bill that would have allowed San Francisco, Oakland and Los Angeles to launch trial supervised drug injection sites. Harm reduction advocates and experts argue that the most effective way to tackle this public health issue is to meet individuals where they are.

Soma Snakeoil, the executive director and co-founder of The Sidewalk Project, has been a strong supporter of Cruz throughout her journey in the job readiness program and urges political decision-makers to continue funding initiatives like WERC.

Snakeoil, a veteran in the harm reduction field, has long been a fierce advocate for both sex workers and unhoused community members. She emphasizes that Cruz’s success story is in part possible due to a “complex network of people within LA County who are really trying to do something different.”

Snakeoil asserts that there are many different systems at play, crediting The Sidewall Project, funds from Measure J, the Amity Foundation and DHS. “I hope that [Cruz’s] story is a story that shows why we need to fund all of these programs, because it not only supports the individual, it supports a community of care and is cyclical in giving back.”

Now, as Cruz begins a new chapter as a paid employee, she is excited to continue the work she is so passionate about. With the continuation of the WERC program, the hope is that more graduates with lived experiences will step into roles that support people in need. “Her lived experiences make her so good at her job,” said Snakeoil of Cruz’s expertise.

For graduates like Cruz, the WERC program not only brings the knowledge gained in the program but also a sense of purpose and commitment to their communities.

“I wish I had those services back then, because I would be more confident.” Cruz reflects, “I would be more in tune, like how I am now.”