Back in 2012, the activist, artist, and educator Dont Rhine stopped by a needle exchange run by Clean Needles Now (CNN) for the first time in sixteen years. From an RV parked smack-dab in Hollywood, the outreach team handed fresh injection equipment to anyone who asked, while safely disposing of used works. Rhine, one of the exchange’s earliest members, recalled the visit in the Spring 2013 issue of X-TRA. His essay marked 20 years of Clean Needles Now, chronicling the organization’s early days as a guerilla outpost of AIDS Coalition to Unleash Power (ACT UP) and its establishment of a Warhol Factory–esque storefront, a haven for its Hollywood community. Throughout the text, Rhine foregrounds the art and artistry of the organization, outlining the political potential of art and direct action in tandem.

This year, Clean Needles Now—since renamed Community Health Project Los Angeles (CHPLA)—celebrates its 30th anniversary. Weathering the ongoing COVID-19 pandemic and opioid epidemic, while calibrating to the oft-changing attitudes towards harm reduction at local, state, and federal levels, the organization has changed radically in the past decade. Artist and writer Juliana Halpert asked Rhine, as well as artist and outreach worker Nick Angelo, to discuss CHPLA’s continuous efforts as a burgeoning nonprofit and committed social practice. The following is an edited transcript of their conversation.

Nick Angelo, Wednesdays, Stericycle Day, 2022. Oil on linen, 36 x 48 in. Courtesy of the artist.

JULIANA HALPERT: Could I begin by asking each of you to explain the nature of your past and present involvement with Community Health Project Los Angeles?

NICK ANGELO: I’ve been with CHPLA for four years. I started as a volunteer. Before I joined, a lot of my friends were on the other side of the table, and I knew it as the only official organization that is accepting of drug use and actually helps users stay healthy. I was enthralled by that idea. As someone who used opiates, I felt completely rejected by every other facet of society. During graduate school up at CalArts, I was feeling a bit alienated from the city. A close friend had been a volunteer with CHPLA for a long time, and helped me get involved. I quickly fell in love with the organization and the work. I joined the staff when I graduated.

I’ve worked in treatment before, but this feels more honest to me. I can finally meet people where they’re at, not trying to drop any knowledge on them or change them. Our directive is to help them not die or contract diseases.

DONT RHINE: It starts a bit earlier for me. I was an activist in ACT UP here in LA. I joined in late 1991. Starting in June 1992, we did the needle exchange every week, at MacArthur Park, in Hollywood, and in West Hollywood.

In 1987, ACT UP chapters—beginning in New York and later that year in Los Angeles—formed out of a shared sense that the movement couldn’t properly address the AIDS crisis if the only thing we were doing was providing services. Using direct action, we had to target the state, the healthcare system, the pharmaceutical companies, the media, religious institutions, and so on, all of which had a hand in creating the crisis. Needle exchange programs that emerged out of ACT UP chapters represented something of a return to the earlier phase of AIDS activism in which community members organized the services not provided by the state. In Los Angeles, the needle exchange quickly became a huge drain on ACT UP’s resources. And it became a contradiction to run a large direct service operation within a protest organization. Consequently, the two organizations split and I stayed with the needle exchange for a few more years. By 1996, the organization was a full-fledged health service provider with nonprofit status, so at that point, I left. I didn’t reconnect until 2012, partly out of nostalgia, partly out of solidarity.

Cookers, lube, condoms, miscellaneous safe sex supplies in the storage room, May 2020. Photo: Nick Angelo.

JH: What’s your relationship to CHPLA now?

DR: That’s an interesting question. I’d like to see my role as a more pedagogical one, not really as a staff member. The projects I’ve done over the past ten years have been popular-education projects.

NA: Can I chime in here? Dont visited CHPLA a few weeks after I had joined the staff. He gave a presentation on the political history of needle exchange and harm reduction. I knew very little about these things at the time, and that presentation made me fall in love with the work. It showed me how much bigger it could be than simply giving supplies to people.

JH: Bigger in what ways?

NA: He taught me that the exchange could be used as a vehicle to build power among its participants, as an organizing engine. To empower the disempowered. Drug users are often severely subjugated by other service providers, by the city, by NIMBYs, by the police, any authority. When I was using, I felt so alienated, essentially rejected by the state. My friends that died had felt rejected by the state. They had no idea where to go to have any sort of outlet—they didn’t even know one existed.

JH: Dont, your piece for X-TRA was published ten years ago. How has the organization changed since then?

DR: That article was important for a couple of reasons. It was an excuse for me to reconnect with CHPLA after being disconnected for almost 16 years. It also was my way of resolving some demons. One thing about the AIDS crisis: a lot of the people who died are always with you. There were so many of them, and consequently, it’s hard to navigate the city without feeling like you’re surrounded by ghosts. I can’t spend time in Silver Lake, it’s much too difficult for me to even go there. I think that people who have lost loved ones to the opioid epidemic feel similarly. Writing that piece was partially to speak to those ghosts.

2012 was a significant turning point for CHPLA. That year was the dawn of Obamacare. One of the conditions of Obamacare was a complete, fundamental reorganization of community health services across the country. There was a sweeping change in how nonprofits access federal funds. An organization has to meet a set of criteria, and to demonstrate “capacity.” That’s a word you’ll hear all the time in the nonprofit sector. If you can’t demonstrate capacity, you can’t justify your funding, or your existence.

Community Health Worker Brian packing clean supply bags for outreach, May 2020. Photo: Nick Angelo.

NA: Federal grants and funding have deliverables. They want to see data. Organizations have to meet certain data quotas, and become beholden to these requirements. Many of them, including CHPLA, want to help participants gain control over their own lives. But to meet these quotas, we run the risk of just becoming a straight-up service provider. The politics deteriorate.

DR: Organizations also have to compete over resources, i.e. the people that they serve. They’ll poach participants from each other, they’ll fight over them. This was all accelerated with Obamacare. The only way any community health organization could survive was to merge with a larger one or to find a way to scale up. That was a huge discussion at CHPLA.

Under the organization’s forward-thinking director at the time, Shoshanna Scholar, we chose to diversify the services that we provide, which is partially why we changed CHPLA’s name from Clean Needles Now. We couldn’t just be a needle exchange anymore. In the abstract, that’s a good thing. Our community members are not just people who need clean needles. They need a lot of things. Unfortunately, which services we can and do provide aren’t necessarily dictated by the community members and their actual needs.

Crack kit supplies (brillo, rubber ends, and vitamin C for breakdown), May 2020. Photo: Nick Angelo.

You ask people what they need from harm reduction, and they will tell you one thing: they need housing. They need dignified housing. Not carceral housing. It doesn’t matter if you’re in LA, Vancouver, Philadelphia, New York—you ask a community member what they need and they will tell you it’s housing. Unfortunately, all CHPLA can do is provide referrals, which throws people into a meat grinder of housing bureaucracy. And these programs are totally abusive to people who use drugs.

NA: We don’t even provide referrals anymore. The waiting lists at the Los Angeles Homeless Services Authority (LAHSA) are just too long.

JH: How did CHPLA manage to scale up and expand its services?

DR: A book could be written on that. Basically, CHPLA started to develop relationships with the city and county. We added programs: there was funding to help ensure community members showed up for medical appointments. We added a case worker who can connect people with other services, creating a referral system that doesn’t necessarily go through the cops.

All of this comes with a devil’s bargain. What ends up happening with any nonprofit—even art ones—is that the more money you get from the state, the more they ask of you. Your responsibility is now to manage scarcity and the expectations of the state. That’s your number one job.

JH: What does that mean—to manage scarcity? What scarcity are you referring to?

DR: To tell people who are unhoused, as the representative of a city- or county-funded program, that there isn’t enough housing. “I don’t know if I can work with you today. We don’t have enough staff. We don’t have enough supplies.” These are not programs of abundance. We’re a bunch of punk rockers who are being asked to manage and dispense the scarcity of the state.

Community Health Worker Mr. James in the van during Hollywood exchange, May 2020. Photo: Nick Angelo.

NA: I can’t tell you how many times I’ve had to tell someone that I can’t help them. The main disappointment is not that I can’t get them what they’re looking for—it’s that this arrangement creates a barrier between me and them, and it limits the relationship that we can foster. If they don’t trust me, I’m not going to be able to organize with them in any way. Trust is the foundation of organizing.

JH: Do either of you see any way out of this devil’s bargain? Is there any sort of pipe dream, utopian model of how a community health organization could flourish?

NA: I don’t know if I can fathom anything that would function autonomously from the state. Without their money, we’d get crushed by other nonprofit service providers. It’s no different than corporate competition in many ways.

DR: I think what we’re talking about needs to be named. Because if we can name it, we can look at what’s driving it. I think what we’re describing is a crisis in harm reduction. It’s not a new crisis: the women’s movement experienced it, the gay movement experienced it. The AIDS movement—I could go on. But it’s the moment when the state recognizes that it could use you.

In President Biden’s State of the Union address in March 2022, he said, “We need to fund harm reduction.” In the same breath, he said that this country needs to accelerate the war on drugs, and then he advocated for increasing the militarization of the border. That’s a fundamental contradiction.

Clean injection supplies (cookers, cotton, alcohol swabs, tourniquets, and sterile water) before being packed for distribution, May 2020. Photo: Nick Angelo.

Community Health Worker Liv during outreach, Echo Park, May 2020. Photo: Nick Angelo.

Here in LA, the city and country government are dominated by the interests of real estate. And to real estate, the unhoused are the great nightmare. But they’re also potentially a tremendous political force. There is sheer terror that the unhoused are going to get organized. It’s no accident that harm reduction—which has historically empowered people on the street—is being brought under the wing of the state. But after Biden’s speech, everyone in harm reduction is saying, “Hallelujah! We’ve won!”

NA: Yeah, hallelujah. But this is also because no one has any idea what to do about the opioid epidemic. Overdoses continue to skyrocket, so the state has ordained harm reduction as the sector that is going to clean up the mess.

DR: So, to answer your question, I think we need to understand the potential for the unhoused, drug users, sex workers—can we just say the poor—to organize and form a militant block in our society. We’re talking about people that we know! We’re with those people every fucking day. We have an intimate relationship with them. They’re us! The possibility that we could be agents and be in the service of the organizing of that political force is real.

It’s not probably going to happen in the context of organizations that are now completely swamped with demands by local, state, and federal governments. But that doesn’t mean that the relationships between those of us who are out on the streets every day couldn’t be the basis of something. Something that isn’t just focused on safe supplies, but is interested in giving power to poor people. That’s the harm reduction movement that Nick and I want to be a part of.

Full sharps containers being picked up for disposal, May 2020. Photo: Nick Angelo.

JH: Dont, in your X-TRA piece, you cited the powerful roles that artists played in the ACT UP movement: from crafting iconic imagery and a “communications-based aesthetic,” to articulating rage in public, to blurring the lines between protest and performance, demonstration and drag. A certain artistry seemed vital.

You also mentioned the aesthetic of Clean Needles Now’s old storefront, Harm Reduction Central (HRC), as being “not the preciousness of a gallery, but the union of art with the functionalism of a social service.” HRC closed its doors over twenty years ago, and CHPLA is a few generations apart from its ACT UP origins. What function can—or do—art and artists serve within harm reduction now?

DR: At Harm Reduction Central, the dominant aesthetic strategy was to normalize needle exchange. We drove our big Ford Bronco, emblazoned with our logo and “Clean Needles Now,” around the city, so that people would go, “Oh, I guess that’s legal now!” Mind you, it still wasn’t.

We’re in a really different moment now. When the state is happy to appropriate harm reduction, our goal isn’t to normalize it—that would be the wrong aesthetic strategy.

Until we have the moment to seize on a militant strategy, there’s only going to be despair. With ACT UP, the thing that turned people’s affective register around was joining the movement. Before that, all we had was our sense of victimization: “We’re all going to die.” ACT UP gave people a sense of their collective power, and the belief that they could disrupt a system and change the entire narrative.

I think this is where, as artists, we have to understand what we could actually participate in; we could participate in creating those political and narrative possibilities. But as long as we’re out there chasing the tail of the galleries, we’re not actually working with people on the streets and following their lead. As a result, artists will just remain part of the problem.

Boxes of clean needles in storage, May 2020. Photo: Nick Angelo.

NA: I think it’s difficult to function within the established art world and receive grants for social practice projects, while actually partaking in any sort of direct action. I’m unsure whether social practice can be anything truly revelatory unless you’re organizing among individuals who have lived experience in whatever subject you’re looking at. That type of social practice is not visible enough, in my opinion.

JH: I want to call attention to your use of the word “visible,” particularly because so much “socially engaged” contemporary art is centered around the politics of representation. Being seen. Visibility and recognition are vital, but who do we want to be seen by? There’s some amorphous gaze here, and I fear that, within art, at least, it belongs to institutions—a perceived establishment.

DR: Given where we are historically, in terms of late capitalism and the harm being done to people and planet, art is in a massive identity crisis right now. But so is nearly every institution. You could talk to people who are doing social work, health work, criminal justice work—everyone is like, what the fuck are we doing? Social practice potentially puts us right in the middle of that contradiction. I suppose social practice could create space for people to admit that it doesn’t make any sense, but where would that take us? If we’re not collectivizing people, and if we’re not building a form of social practice that’s about expanding the political capacity of the poor and working class, then what are we even working towards? And why? It makes no sense. x

Dont Rhine is a Los Angeles–based artist, organizer, and popular educator. He is a member of the international sound art collective, Ultra-red, which he co-founded in 1994. Following decades of exhibitions, performances, record releases, and publications, in 2023 Ultra-red will release the first issue of their own journal through the publisher Rab-Rab Press in Helsinki. Since 2015, he has been a founding organizer of the L.A. Tenants Union.

Nick Angelo is a Los Angeles–based artist. He holds a BA in Urban Studies from the Eugene Lang College for Liberal Arts at the New School in New York City, and an MFA in Photography and Media from the California Institute of the Arts. Recent exhibitions include Reality Becomes A Playground at Sebastian Gladstone, Los Angeles (2022); Bread and Circuses at F, Houston (2020); and The Conspiracy of Art: Part II at Chateau Shatto, Los Angeles (2019). He has been a full time Community Health Worker with Community Health Project Los Angeles (formerly Clean Needles Now) since 2019.

Juliana Halpert is a Los Angeles–based artist and writer. Her writing has been published in Artforum, Frieze, Art in America, Aperture, and X-TRA, among others. She received her MFA from ArtCenter College of Design in 2020.