Safe Injection Sites: Sweeping the Nation, Coming to SF

“Today, you can’t walk from City Hall to Civic Center BART without seeing people shooting up in broad daylight,” Supervisor London Breed said last week. She stood on the front steps of that very city hall, announcing her plans to do something about it.

The President of the Board of Supervisors has launched a Safe Injection Services Task Force to study a radical approach to stemming the surge in drug overdoses: a safe place to inject them. Safe injection sites around the world typically offer medical supervision, clean needles, and access to other social services.

In recent years, opiates have been the deadliest class of drugs among San Francisco residents. The Department of Public Health estimates that at least 100 overdose deaths a year are due to injected drugs.

After Seattle became the first city in the United States to approve a supervised injection site, with similar plans subsequently announced in New York City and Ithaca, San Francisco Mayor Ed Lee dropped his opposition to the idea last year.

While task forces can be symbolic and non-binding, Breed’s efforts form part of a broader regional movement to reframe drug policy as a public health issue. San Francisco’s state Senator Scott Wiener recently coauthored legislation with Assemblymember Susan Eggman authorizing California counties to set up safe injection sites. The latest version of the bill was narrowly approved by the State Assembly’s Public Safety committee.

In Europe, Australia, and North America, there is a growing body of evidence supporting the effectiveness of such services. After Vancouver opened the first safe injection site in the Western hemisphere, the city saw a 35% decrease in drug overdoses in the immediate area, albeit with a much smaller decrease citywide. The World Health Organization has reported that safe injection sites lead to a significant decrease in the spread of HIV. According to the Drug Policy Alliance, there is no evidence linking Safe Injection Facilities to increased crime or drug trafficking.

Still, some researchers urge cautious implementation of these policies, since the data is too new and non-random to be fully reliable. Breed’s statements touched upon such lingering uncertainties while still acknowledging a dire urgency.

“I don’t know if offering a safe place for people to use drugs is the right answer for our city and for helping this vulnerable population,” Breed said in a press release “but I know that our existing efforts simply aren’t working and we need new approaches to treat and care for people with addiction.”

Amid a nationwide opiate crisis, even some conservative lawmakers have been inching away from violently ineffective “War on Drugs” criminalization strategies—a “war” motivated primarily by racial and political animus, according to one former Nixon administration official. Once staunchly opposed, then-Governor of Indiana Mike Pence signed an emergency order in 2015 authorizing needle exchange programs to combat a statewide HIV pandemic. GOP Senate Majority Leader Mitch McConnell had a similar reversal last year as opiate addiction surged in his home state of Kentucky.

Drug reform remains much less likely at the federal level. U.S. Attorney General Jeff Sessions (who, incidentally, now faces ongoing criticism for lying to Congress and failing to disclose foreign correspondences) has called for a return to highly punitive sentencing practices, which immediately drew swift rebuke from New York Attorney General Eric Schneiderman.

The growing number of local drug policy reforms are typically multi-pronged approaches. Following Seattle’s lead, Svante Myrick, mayor of Ithaca, NY, announced his “Ithaca plan,” which also funnels petty drug offenders straight into social services rather than jails.

Accordingly, the 15-member task force consists of public health officials, medical researchers, drug policy advocates, a homeless outreach specialist, and a police officer. Sam Dodge, Deputy Director of Communications for the Department of Homelessness and Supportive Housing, will also serve on the task force.

The San Francisco Safe Injection Site Task Force will meet three times over the next three months before presenting their findings to the Board of Supervisors.

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