San Francisco preparing to open first U.S. safe injection sites

Mar 09 2018

San Francisco preparing to open first U.S. safe injection sites

San Francisco city officials hope to open what would be the United States’ first legal safe injection sites for opiate addicts, with two planned for a July opening, at the start of the city’s fiscal year. The San Francisco Department of Public Health unanimously endorsed a task force’s recommendation to open the supervised sites.

The facilities provide a safe space where people can consume previously obtained drugs, such as heroin and fentanyl, under the supervision of trained staff with the first aid Brisbane courses ready to respond in case of an overdose or other medical emergency. They also provide counseling and referrals to other social and health services.

Although some contend the safe injection facilities would encourage drug use, San Francisco Mayor Mark Farrell told a San Francisco Chronicle editorial board meeting he is in favor of trying what he acknowledges would be an imperfect solution. “I understand the misgivings around it and some of the rhetoric from people who don’t support it,” Farrell said last week. “But we absolutely need to give it a try.”

Barbara Garcia, director of San Francisco’s Department of Public Health, told the Chronicle she has been looking into possible locations for the facilities. She is also working with six to eight nonprofits that already operate needle exchanges and offer other drug addiction services; two of them will be selected to offer safe injection on-site.

After officials can evaluate how the first two sites are working, a third and fourth could be opened, she said. Opening the injection facilities will not require the approval of the Board of Supervisors or other officials, according to Garcia.

Garcia said initial funding for the facilities will come from private entities, which she did not identify. Doing so will help shield the city from liability, under state and federal law. The safe injection sites will initially be privately funded, though Garcia wouldn’t say where the money’s coming from. She said that will help the city avoid liability, since intravenous drug use is against state and federal law.

San Francisco has an estimated 22,000 intravenous drug users, many of whom openly inject drugs in parks, plazas and other public locations. Public health officials estimate that 85 percent of the city’s intravenous drug users would use safe injection sites and that the city could save $3.5 million a year in medical costs.

Garcia said recent public opinion polls in the city have indicated growing support for the idea.

For the first time this year, the San Francisco Chamber of Commerce’s annual Dignity Health CityBeat Poll included a question about safe injection sites. It asked respondents whether they support or oppose “drop-in facilities called safe injection sites where intravenous drug users could use their drugs, off the street, and in a place where medical and social services are available.”

In the January poll, 67 percent of respondents said they support the proposal — 45 percent strongly and 22 percent somewhat. Twenty-seven percent opposed it, and 6 percent were undecided. The poll showed support for the sites regardless of age or home ownership.
State Sen. Scott Wiener has been trying to muster enough votes to change the state law so that those involved in operating injection sites or using them aren’t subject to arrest and prosecution. The bill passed in the state Assembly last year but was two votes short in the Senate.

If the bill does pass and is signed by the governor, it wouldn’t take effect until 2019. But Weiner told the Chronicle he would like to see the sites open “as quickly as possible.”

“I’m fully supportive of the city moving forward, just like we did with needle exchange before it was technically legal,” Wiener said. “We need to do everything in our power to keep people healthy, to get people off the streets so they’re injecting in a safe space indoors instead of on people’s doorsteps or in public parks, and to make sure we can intervene quickly if they overdose.”