San Francisco Launches First-in-Nation Program to Combat Heroin Use

SAN FRANCISCO (CN) – San Francisco on Thursday became the first city in the nation to adopt a promising new treatment for heroin addiction that city officials say could save lives and cut down on drug use on the streets.

Interim Mayor Mark Farrell introduced a new program to combat heroin use among San Francisco’s homeless population in front of the city’s Civic Center Navigation Center on Thursday.

The city will spend $6 million over two years to hire 10 clinicians to work with homeless patients and prescribe an opioid addiction treatment called Buprenorphine. Health professionals say the once-daily pill has reduced overdose deaths and is more effective than other drugs in suppressing heroin cravings when combined with counseling and other treatments.

“This investment will ultimately help save lives and improve conditions on the streets of San Francisco,” interim Mayor Mark Farrell said at a press conference Thursday.

Farrell announced the new treatment in front of the Civic Center Navigation Center on 12th Street, one of four city centers providing temporary shelter and services to the homeless.

An estimated 22,500 San Franciscans actively use injection drugs, and half of those report using heroin, according to the city’s Department of Public Health.

The city started a Buprenorphine pilot program in 2016 under former Mayor Ed Lee and saw promising results among 200 homeless patients enrolled in it.

The $6 million investment will allow the city to provide Buprenorphine and other services to at least 250 new homeless patients. A team of clinicians will go to tent camps, parks, injection sites and other locations to offer same-day prescription Buprenorphine and other treatments and services.

“Homeless people who use drugs are especially vulnerable and our health system is adapting by going directly to them,” San Francisco Health Director Barbara Garcia said.

Unlike methadone, which is also used to treat heroin addiction, doctors can prescribe Buprenorphine for patients to take home without restrictions. Methadone must be administered at a licensed clinic and can only be prescribed to patients who are deemed stable enough to take the drug home.

Approved by the FDA as an opioid  addiction treatment in 2002, Buprenorphine is “chemically unique” in that it banishes cravings and blocks the effect of other opioids,Dr. Andrew Saxon of the University of Washington School of Medicine in Seattle said in a phone interview.

“There is a ceiling effect on how much it can change how your cells operate,” Saxon said. “Because of the ceiling effect, it’s impossible to overdose on Buprenorphine no matter how much you take.”

It also offers immediate relief to someone who wants to stop using heroin, which allows an addicted person to forgo scheduling an appointment at a methadone clinic, Dr. Joshua Sharfstein of Johns Hopkins University Bloomberg School of Public Health in Baltimore said by phone.

“If you tell someone here is your appointment for Monday, they might use drugs five or six times before Monday,” Sharfstein said. “They might not go to treatment.”

Sharfstein said when he used to work as health commissioner for the city of Baltimore, the city expanded access to Buprenorphine and saw a steep decline in heroin deaths.

Dr. Barry Zevin, a medical doctor who treats homeless patients in San Francisco, said being able to prescribe Buprenorphine has completely changed his attitude toward heroin users.

“Earlier in my career, I never felt like I had something to offer,” Zevin said. “Now, to be honest, my favorite patient is someone who is using heroin, who I’m able to say, ‘I actually have effective treatment.'”

Christopher Ruffino, a former patient of Zevin, said he tried everything he could to kick his 28-year heroin habit, but nothing worked. He met Dr. Zevin on a rainy morning three and a half years ago and was prescribed Buprenorphine. Ruffino says it changed his life. He has stopped using heroin and now works as a substance abuse counselor in the East Bay.

“I have everything back that I lost,” Ruffino said. “I owe my life to Dr. Zevin and Buprenorphine.”

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