Should the city of San Francisco provide safe spaces where injection drug users can shoot up? Today, on the steps of City Hall, a new task force was launched to answer that question.
Used needles and people shooting up are increasingly common sights on city streets. Both are signs of the growing epidemic of people addicted to prescription opioid painkillers and heroin.
Safe injection sites are medically-supervised facilities that do not provide drugs, but reduce the health risks and public nuisance drug use. It’s a method of harm reduction that focuses on reducing the negative effects of addiction by treating it not as a law enforcement issue, but as a public health problem.
San Francisco could save $3.5 million a year, mostly in reduced medical costs, if it provided a 13-booth facility similar to one in Vancouver, Canada, according to an estimate in the Journal of Drug Issues.
According to the Department of Public Health, there are an estimated 22,500 injection drug users in the city. Members of this population are more likely to contract HIV, hepatitis C, and skin infections, which are costly to treat. There are also around 100 overdose deaths each year in San Francisco.
The 15-member task force
will deliver a report in three months on how safe consumption services might offer
solutions to drug use in San Francisco.
For supporters gathered at City Hall, when San Francisco launched one of the first needle exchange programs in the nation, it reflected the city’s compassionate values and a willingness to try a controversial harm reduction methodology.
But as the opioid epidemic intensifies, they believe that the city needs to go further, a step they say is long overdue.
“The reason we’re here is because our friends are dead,” said Holly Bradford of the San Francisco Drug Users’ Union, which provides needle exchange and other harm reduction services.
“Our family members have passed on streets, in bathrooms, in alleys,” she said, before leading those gathered in a moment of silence.
“It will allow people to shoot up where they don’t have to rush," said Jason Norelli, a health systems navigator at the GLIDE Foundation. "They’ll get access to clean equipment and prevent overdose.”
“You can eventually get them linked to residential drug treatment," he said, "so they can stop shooting up and doing the crime necessary to support a daily habit that costs hundreds and hundreds of dollars a day.”
The first safe injection sites started in the Netherlands in the 1970s. Today, more than 100 exist around the world.
The first safe injection site in North America opened in Vancouver In 2003. There, overdose deaths declined and the city’s HIV infection rate fell while it continued to rise in other Canadian cities. Needle litter and violence went down, too, according to The New York Times.
At today’s press conference, many supporters of safe injection sites shared stories of pain and loss—but a sense of hope and excitement was evident.
"This is the San Francisco I heard about back in the day," said Bradford, "where they actually stepped up to the plate and did something around public health."
Before any safe injection sites can be piloted, state law needs to change. One bill under consideration is Assembly Bill 186, which would "authorize the operation of supervised injection services programs for adults."
It has the support of San Francisco’s delegation in Sacramento, including Assemblymembers Phil Ting and David Chiu, and State Senator Scott Wiener, who co-authored the legislation.
Here in San Francisco, District 5 Supervisor London Breed championed the task force with legislation co-sponsored by Supervisors Jeff Sheehy, Hillary Ronen, and Jane Kim.
After years of opposing the idea, Mayor Ed Lee recently has said he’s open to the idea, although he's not on the task force himself. “He looks forward to the group's report and recommendations,” said Nancy Sarieh, a spokesperson for the mayor.
However, challenges may come at the federal level. Earlier this month, Attorney General Jeff Sessions ordered federal prosecutors to start seeking the toughest penalties possible for low-level drug crimes, a radical change in direction from Obama-era policies that intended to reduce mass incarceration while dialing down the unsuccessful “war on drugs.”