Safer drug use spaces will benefit San Francisco, advocates say
Are safe drug consumption spaces coming to San Francisco?
A task force, announced by the City, will help to answer this question by developing a set of recommendations on safe consumption sites in San Francisco. Over the next few months, the task force will convene a group of stakeholders and hold a series of public meets to discuss the feasibility and possibility of creating safe drug consumption sites in the city.
Safe drug consumption sites (also called supervised injection facilities) are hygienic environments where people who use drugs can inject or ingest drugs under the supervision of heath care staff with sterile, clean supplies. They have been in use for decades in numerous countries outside the U.S. to help curb the spread of infectious disease (e.g., HIV, hepatitis C), save people from overdose, reduce public drug use, link people to social services and reduce the amount of injection litter on streets and in public spaces. (A facility in Vancouver, named Insite, has been closely studied and is oftentimes cited as a successful example of one such facility in public health literature.)
Gathering outside of San Francisco City Hall, a group of community members, public health experts, clinicians and people from community organizations showed their support for safe consumption sites at a rally on May 22.
London Breed, president of the San Francisco Board of Supervisors, shared that there are an estimated 22,000 people who inject drugs in San Francisco who could benefit from safe consumption sites.
“We are finally having an open and honest conversation about what’s happening on our streets,” she said. “The fact is that we, as a city, can’t sit back and do nothing. This is a public health crisis, and we need to treat it as such. As a caring city, we have an obligation to do better for those in need.”
Safe consumption sites operate under the guiding principles of harm reduction, providing vital services and resources without requiring that people reduce their use or abstain from drugs or alcohol.
“I believe in the power of acceptance. I believe in the power of telling drug users that they matter—that their lives matter,” said Mike Discepola, director of behavioral health services and the Stonewall Project at San Francisco AIDS Foundation at the rally. “Evidence-based health care services save lives. We see that, we know that. Yet at the same time, it seems like people can’t come to a place where they can really embrace harm reduction in a meaningful way—to accept people exactly how they are with no need to measure up.”
Paul Harkin, program manager for the harm reduction program at GLIDE, described safe consumption sites as “win-win-win.”
“There are over 100 or so safe consumption facilities around the world. They have saved lives, decreased infections, decreased costs to the community and reduced trauma from injecting in public,” he said.
The resistance to safe consumption facilities, he said, likely comes from people who are not well informed about the benefits of safe consumption facilities or the realities about the lives of people who use drugs or the challenges they face. “We have to pursue a humane and evidence-based solution to the problems faced by drugs users. This is the way to go, and the evidence supports it,” he said.
Jorge Vieto, health systems navigator at GLIDE, said that he attended the rally because he has many clients who could use a safer space to consume drugs. “They don’t have places where they’re fully supported in making safer choices. Having a space where people can consume safely would really help people. And there’s a ‘halo effect’ that comes with safer consumption spaces. Not only are people engaging in harm reduction [safer drug use], but they might be more likely to change their relationship to whatever drug they’re doing. That might even include going into treatment.”
Zachary Fernet, chair of the Youth Advisory Board for Larkin Street Youth Services, said safer consumption sites would benefit the young people who receive services at Larkin Street.
“Substance use is definitely a significant barrier for some of the youth experiencing homelessness in San Francisco,” he said. “The more safe we can make it for people on the streets—by providing welcoming environments for them—the more problems we can help solve. As a recovering addict, this is something I strongly believe in.”
Holly Bradford, program coordinator for San Francisco Drug Users Union, shared what she hears from people who visit the needle exchange she runs. “They don’t say, ‘Oh, I want some where to get high so I’m comfortable.’ This is what they say, ‘I don’t want to inject in front of children. I don’t want to have families see me injecting between cars.’ These are the things that people are worried about! I’m worried about [their] health, and [them] overdosing, about skin infections, abscesses, hep[atitis] B, hep[atitis] C and HIV and AIDS. They’re worried about injecting in front of families. Drug users are people, and they care!”
“Safe consumption sites are the next step in a total harm reduction approach,” said Judy Auerbach, professor of medicine at University of California, San Francisco. “They could prevent HIV infections but also save the lives of people who use drugs. They have been shown to reduce overdoses and abscesses and keep needles off the streets. There really isn’t a more appropriate community in the U.S. to have safer consumption sites than San Francisco.”