This article first appeared in the Ukiah Daily Journal
A conversation with MACVHN executive director Joanna Olson
The principles of harm reduction form the foundation for MCAVHN- Mendocino County Care and Prevention Network. Like most harm-reduction agencies, the non-profit was birthed from grass-roots community activism- the response to the AIDS crisis that resulted in the formation of MCAVHN in the 1980’s.
Harm reduction incorporates strategies that reflect the community where these principles are being implemented. It is not a “one size fits all” program. It changes and modifies as the community’s needs change.
“MCAVHN was formed to address the AIDS crisis. Today, our harm reduction-based organization now embraces a multitude of issues- the diagnosis and treatment of Hepatitis B and C, the provision of safe equipment to those who use substances, the provision of drug testing kits, distribution of overdose prevention medications, prevention education, counseling, housing support services, medically-assisted treatment for opioid use disorders and lots of community outreach,” says MCAVHN executive director Joanna Olson.
Just as a person is far more than their substance use, harm reduction represents a constellation of policies, practices, and principles, with the goal of minimizing the negative impacts associated with substance use and improving quality of life.
“The goal of harm reduction is simple- to keep people alive. We do so by helping people achieve positive change- no matter how small or how long it takes. MCAVHN provides safe alternatives, education, and support- tailored to the individual and provided without judgment.”
Harm reduction is an international movement, actively practiced in 93 countries. 95 countries offer their citizens “opioid agonist” treatments, such as the use of buprenorphine or suboxone, and 112 countries have codified harm reduction in their legislative policies. Conversely, only 36 countries continue to retain the death penalty for drug offenses.
In the past, people who used drugs and alcohol had one option to address their disorder: total abstinence. There was a limited understanding of the why and how people turn to substances. Today’s experts in harm reduction understand that, along with challenges concurrent with addiction, substance users are highly likely to be criminalized, marginalized, racially profiled and/or stigmatized by society.
Probably the most controversial tenet of harm reduction is the acceptance that both licit and illicit substance use are part of life. The mission of agencies like MCAVHN is the minimization of harm, as opposed to the decades-old, failed models that demanded abstinence to qualify for services.
“Abstinence is still a tool in our toolbox, but in the modern world of harm reduction, it is one of many. We can’t ‘save’ anyone from addiction. Thousands of parents, siblings, spouses and friends in our community understand this. We recognize the incredibly complex factors that lead someone to use substances, and help people minimize the harm they are incurring. We welcome them into a community that can assist them with teasing apart the complex threads that contribute to their substance use.”
Some people need support getting into rehab. Others need counseling. Some avail themselves of the confidential guidance of Dr. Ace Barash’s program, which helps people manage, mitigate or even cease the use of many substances. Some people are looking for AA or 12 Step programs. Others- perhaps the most visible clients that MCAVHN serves need a roof over their head or a bottle of water.
“People come to us because of our culture of acceptance. For some, substance use is a shameful activity- a secret kept from family, their faith community, or even their physician. When they come here, they can investigate pathways to a healthier, safer life. The choice of how, when, or if they choose to walk that path is up to them.”
MCAVHN is one of the county’s primary treatment centers for people who have been diagnosed with Hepatitis C. “Since the retirement of Dr. Matossian, there are very few options for people needing treatment for Hep C. We receive referrals from Indian Health and Consolidated Tribal Health, from local clinics, from Adventist Health Clearlake, and from physicians. People walk into our office regularly, asking to be tested.”
“Housed individuals make up the majority of patients who are carrying, being diagnosed, and being treated for Hep C.” Mendocino County has seen a decrease in Hep C since 2014, which Dr. Barash directly equates to the agency’s successful syringe exchange program. “We provide over 50% of all the HCV-positive testing to the County of Mendocino, which tracks these statistics,” he explains.
Despite years of data proving the efficacy of syringe exchange programs, they continue to be an area of community concern.
“Sharing needles statistically increases the likelihood of blood-borne infections like HIV and Hepatitis. We began our exchange program in the 1980’s, with the concept that people could confidentially exchange used needles for new ones.” The CDC lauds exchanges as a method to increase access to harm reduction services while reducing infectious diseases and other complications related to IV drug use, noting that 30 years of research shows syringe exchange programs are “safe, effective, and cost-saving. They do not increase illegal drug use or crime.”
According to a paper published by the National Institute of Health entitled, Harm Reduction Services to Prevent and Treat Infectious Diseases in People Who Use Drugs, America’s “war on drugs” culture created a misconception that substance use disorders were the equivalent of “a moral failing,” and concerns that syringe exchanges would lead to drug use initiation. Evidence confirms that the provision of syringes, along with education around safe injection techniques, reduces infectious complications associated with IV drug use.
Olson emphasizes, “MCAVHN is one of several providers of syringes in our community. Our syringes are provided to people from all walks of life- a cross-section of our population, including many people who are both housed and employed. Locally and globally, syringe exchange programs result in improved community outcomes.”
In the period between 4/01/2025 and 3/31/2026, MCAVHN dispensed 96,663 syringes. Of those, 82,608 were returned to the facility, an 85% return rate- significantly higher than the state average of 71%. In March, that return rate increased to 134%.
“We are aware that community members go to the river and other areas to clean up encampments. Though we honor people’s efforts to keep our waterways and rural areas free of hazardous materials, please have the landowner call us to retrieve syringes. We do not venture onto private property without the express permission of landowners. Please allow us to do this work so that no one is harmed in the process.”
Other statistics describe the story of MCAVHN’s community impact. During the same time period stated above, 1,392 people received MCAVHN services. 106 Hep C tests and 105 HIV tests were administered.
The Medication Assisted Treatment, or MAT clinic, overseen by clinic director Dr. Ace Barash, serves people choosing to use medications to help address their opioid use disorder. Patients are treated by clinic staff and local physicians as part of Adventist Health Ukiah’s Family Residency Program. The clinic provides medications like buprenorphine, which replaces opiates and often helps people reduce or cease their dependency on them. 110 people were served by the MAT clinic during the above time period.
Narcan and Naloxone are available at MCAVHN to the public and any agency, business, or organization that wishes to have the medication available in case of an opioid overdose. The medications attach to the same brain receptors as opioids like heroin, OxyContin, and fentanyl- reversing an overdose. In the time period above, 331 individuals received 2,332 doses of Narcan and 1,077 doses of Naloxone. 66 community agencies received 2,841 doses of Narcan and 86 doses of Naloxone. 3,927 personal hygiene kits were handed out, and 3,088 wound care kits were distributed.
“Mendocino County had the unfortunate status of being #1 in the state for the number of opioid overdoses. Since we began distributing Narcan countywide, we’re now #10. Our team provides education to rural fire departments, clinics, pantries, community members, and other community-based organizations. We attend tribal events and always set up a table providing Narcan and educational materials. We are always willing to provide Narcan training to any group or organization.” October is MCAVHN’s biggest distribution month of the year. “Last year we handed out 1,200 doses of Narcan at Pumpkinfest.”
“One of the most important things we do is provide outreach to the most outlying regions in Mendocino County. We provide food pantries in Laytonville, Willits, the Coast, and Anderson Valley with wound care kits, hygiene kits, and Narcan.”
Over the past several years, Olson and her harm reduction colleagues nationwide have observed an uptick in negative activity directed toward their agencies. “I believe over the past year or so, hate has become normalized. The targets of people’s hate are those who are the most marginalized- the unhoused, people with mental health issues, people with substance use issues, and the LGBTQ community. We have worked tirelessly to maintain excellent relationships with our neighbors, to educate and support local and county law enforcement, and to work closely with our agency partners- the City, the County, and our colleagues in the nonprofit sector. We invite everyone to visit us- to ask questions and learn what we do. Our doors are always open.”
Olson is honored that MCAVHN was recently notified it is one of three nominees for the annual 100 Women Strong campaign, which, if selected, would provide an infusion of much-needed financial support. “Funding for agencies such as ours has been severely curtailed. We compete head-to-head with large, urban clinics that are battling for the same funding. We’re honored that 100 Women Strong has recognized the work we do, and we’re looking forward to the event.”
When asked what fuels her after four years as director, Olson says, “Teamwork. Every single staff person is committed to our mission and vision. They have the passion and compassion to do this work, and the full support of our board. Our team continually strives to do more and improve services. They build the skills to overcome challenges and do it all without judgment. We continue to educate everyone we come in contact with- with care, kindness, and concern as our North Star.”
