San Francisco OKs Process to Open Safe-Injection Sites

Syringes are scattered in the remains of a tent city being cleared by city workers along Division Street in San Francisco. (AP Photo/Eric Risberg, File)

SAN FRANCISCO (CN) — San Francisco is one step closer to opening one of the nation’s first safe-injection sites after the Board of Supervisors on Tuesday approved a law that will permit nonprofits to operate facilities where people can inject illegal drugs under medical supervision.

“What we are doing today is not a new or radical idea,” said Supervisor Matt Haney, who represents the city’s Tenderloin neighborhood. “One hundred overdose-prevention sites exist in 65 cities across the world. They have gotten thousands of people into detox services.”

The board unanimously approved the legislation, which was co-sponsored by Haney and Mayor London Breed. The ordinance creates a system for issuing permits to nonprofits that want to operate safe-injection sites in the city.

Despite local approval, legal obstacles could delay the opening of a safe injection site for some time. The Trump administration has opposed such sites, arguing they violate federal law. Approval by state lawmakers could strengthen the city’s position against a legal challenge.

Assembly Bill 362, co-written by State Sen. Scott Wiener of San Francisco, would authorize the city to open a safe-injection site. The Assembly passed the bill last year but it has yet to be approved by the state Senate.

An estimated 24,500 people inject drugs in San Francisco, according to the city’s Public Health Department. Most of those people reside in the city’s Tenderloin, South of Market and Mission neighborhoods.

The city saw a major spike in fatal overdoses last year, reporting 290 deaths involving fentanyl, heroin or a combination of the two. That’s more than double the 134 fentanyl or heroin-involved overdose deaths reported in 2018.

Laura Thomas, director of harm reduction policy at the San Francisco AIDS Foundation, says San Francisco needs a safe injection site to help combat a rising rate of overdose deaths.

“For anyone who has spent much time in San Francisco, the drug use in public and discarded syringes are obvious to everyone here,” Thomas said. “We know that these services can save lives and can improve the health of neighborhoods and communities.”

Approximately 120 safe-injection sites currently operate in 10 countries, including Australia, Canada and Germany, according to the Drug Policy Alliance. Studies show such sites have effectively lowered overdose deaths, ambulance calls and HIV infections.

“What personal experience and evidence shows is these actually encourage people to get treatment and stop using drugs,” Thomas said. “That’s why treatment providers at a local and state level are supporting these programs.”

Still, some groups have argued that safe-injection sites “create a haven for the use of illegal drugs” and “turn a blind eye” to concerns that drove Congress to enact a law prohibiting the operation of facilities where illegal drugs are used.

A 2016 cost-benefit analysis found a 13-booth safe-injection site could save San Francisco $3.5 million per year, mostly by reducing health care costs. Researchers found it would result in 415 fewer hospital stays, 19 fewer hepatitis C cases and 3.3 fewer HIV cases per year. Additionally, the study found the site would save one life every four years and steer 110 people into drug-dependency treatment each year.

A poll conducted last year found broad support for a safe-injection site in San Francisco with 77% of city residents in favor of opening such a facility.

The Trump administration maintains that safe-injection sites violate a provision of the federal Controlled Substances Act known as the crack-house statute that punishes parties who knowingly maintain a place “for the purpose of manufacturing, distributing, or using controlled substances” with up to 20 years in prison.

Last year, the Trump administration sued to block Philadelphia from opening the nation’s first safe-injection site. A federal judge found the law did not apply to facilities “that are components of medical efforts to facilitate drug treatment,” but the ruling was stayed pending appeal.

A potential legal challenge by the federal government is one reason why advocates are pushing for state legislation that would make a safe-injection site legal under California law.

“That puts us in the same situation as marijuana, which is legal under state law but not under federal law as it is in many other states,” Thomas said.

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