Needle exchange clinic loses Fresno support. It saves 15 lives a week, staff says
A needle exchange program run by a doctor who says it saves 15 to 20 lives a week lost the support of Fresno County on Tuesday after a vote by the Board of Supervisors.
The board voted, 3-2, to not renew the Whole Person Harm Reduction Program and its two-year pilot needle exchange program, which also provides glass pipes as well as basic health care inside the Department of Public Health office on Fulton Street each Saturday.
The program had been in operation for 25 years inside a trailer at Roeding Park and other locations until the county agreed to provide a free space in the county building in 2023.
The program drew about 130 people every weekend in 2024, according to Dr. Marc Lasher of the San Joaquin Valley Free Medical Clinic and Needle Exchange. He said the offerings of needles and glass pipes draw in the hardest-to-reach addicts, who can receive health care in an attempt to keep them alive until they can turn the corner on their drug habits.
The supervisors asked Lasher how he measures the success of the program.
“Well, one is keeping people alive in a very dangerous situation,” he said. “We’re saving as many lives, maybe even more than all the cardiology suites throughout the Valley.”
The program is meant to be a low barrier clinic, meaning it’s easier for drug users to access health care. He said his clinic hands out naloxine, commonly known as Narcan, and it averages 15 to 20 uses a week. The drug saves the life of a person who is overdosing on fentanyl.
The county’s costs for the program were about $90,000 in 2024, according to Joe Prado, the interim director of the county’s public healthdepartment. That covers the cost of utilities in the building and staff time for janitors, security and other labor.
The doctor and his staff are volunteers. Expenses for the drug paraphernalia and other supplies are paid for through a state grant funded by the Opioid Settlement Fund.
Prado said the program has saved some $6 million primarily by preventing more visits to a local emergency room. Some of the supervisors showed skepticism over that number, saying it didn’t account for expenses related to law enforcement calls.
Two of the supervisors — Nathan Magsig and Garry Bredefeld — said they wouldn’t support the program any longer and questioned the results. Supervisor Buddy Mendes also voted not to renew it.
“There is no mechanism in this destructive program to force or compel the drug addict to get treatment,” Bredefeld said. “In essence, the county is enabling them to continue their drug usage.”
The clinic hands out about 7,800 needles a week, according to the staffers. That’s fewer than the 16,000 to 20,000 that went out before the pilot program.
On average, staffers said, about 1.5 needles went out of the clinic for every needle returned. The drug users are not required to return any needles to get more needles.
Staffers said last year 327 people were enrolled in medically assisted treatment through the clinic, 63 were referred to a primary care doctor and 20 were referred for behavioral health care. The clinic did not track how many of those people went to their referred care providers.
The clinic also helped the Department of Social Services find services for 844 people, according to staffers. But, Lasher said, his clinic does not track how many visitors to the clinic are new or are returning patients.
Tracking and sorting that data would have been the next step if the program were to continue, according to Prado.
The vote on Tuesday means the lease that allows the clinic to operate in a county building ends Aug. 31.
Supervisor Brian Pacheco, who voted to renew the program, said the 15 or 20 people saved by naloxine every week helps to reduce the strain at local emergency rooms. He also said he believed the needle exchange cut down on the number of needles discarded in public while also providing vital health care to the downtrodden.
“They’re preventing needles, in my opinion, going all over. They’re cutting down the dirtiness of the needles,” he said. “So, in my opinion, these are the true public servants.”
As for the needle exchange program, it will continue somewhere else in the city, according to its staffers.
This story was originally published August 19, 2025 at 3:41 PM.
