Major Safe Consumption Site Bill Bumped to 2020

The news comes a mere week after San Francisco saw a sharp uptick in fatal overdoses.

An example of a “chill-out room” where users can relax for a while after using drugs at a safe injection site simulation at Glide Memorial Church’s Freedom Hall , Aug. 29, 2018. (Kevin N. Hume)

A controversial but life-saving bill to create a safe space for people to use drugs has been bumped to next year. Assembly Bill 362 would allow San Francisco to launch a six-year pilot program for a safe consumption site. Legal in Canada, Australia, the Netherlands and Germany, the sites offer a protected space and clean supplies for people to use drugs in the company of trained medical staff. It’s a tried-and-true method for connecting drug users to care, and could have a big impact on the number of fatal overdoses the United States sees each year — which saw 72,000 drug-related deaths last year alone.

California, Oregon, and Pennsylvania are so far leading the charge in establishing such centers, but it’s an uphill battle. Last year the bill managed to get through both the California Assembly and Senate in Sacramento before it was killed by then-Governor Jerry Brown.

While AB 362 cleared the Assembly this year, the Senate’s response has been discouraging. In the past few weeks, the bill was referred to three committees for review, putting it through an unusual amount of scrutiny. Concerned that it was being slowed down, Assemblywoman Susan Eggman and state Senator Scott Wiener — who co-authored the bill — decided to put it on hold until next year so more alliances could be built.

It’s politics as usual, but drug policy reform advocates and frontline workers are concerned about the impact of further delays in opening the sites. More than a hundred people die in San Francisco each year from drug overdoses. Earlier this month a particularly strong batch of fentanyl made the rounds, and 10 people were killed in a span of just seven days. Many more were discovered overdosing on the streets and saved by members of the community. 

This is not unusual. As we’ve mentioned before, drug users in San Francisco are incredibly adept at saving lives. There were 1,658 overdose reversals performed last year by members of the community (not police or paramedics), and each time the street drug supply shifts word gets out, and people adapt their use by using less, more slowly, or avoiding a dealer’s current supply altogether. But unexpected changes can still be fatal — particularly when combined with a stigma around drug use, or a loss of community, both of which can lead people to use alone.

“When there’s a shift in our very inconsistent street drug supply like there was recently, people who use drugs are prepared to respond and saved hundreds of lives,” explains Kristen Marshall, project manager of the Drug Overdose Prevention and Education (DOPE) Project. But someone has to be around to reverse an overdose, and if you live alone — for example, in a single-room occupancy hotel — it can be safer to use on the streets where someone could save your life than indoors. “Most people are dying from overdoses in San Francisco when they are inside and alone,” Marshall says. AB 362 could change that. “Evidence-based approaches like syringe access, naloxone distribution, and safe consumption sites provide people with the information, resources, and — in some cases — the care, dignity, and space to stay safe,” she says.

A sample safe consumption site table. (Photo: Nuala Sawyer)

San Franciscans are largely supportive of launching the first safe consumption site in California. In January, the San Francisco Chamber of Commerce and Dignity Health conducted a poll on San Francisco voters, which uncovered that 77 percent believe overdose prevention programs are a solution to many of the health crises seen on our streets.  One of the largest local supporters of the facilities is the San Francisco AIDS Foundation — which operates several needle exchange sites throughout the city. On Thursday its staff expressed “deep disappointment” in the postponement of the bill, and launched a petition to encourage Sacramento to move it forward faster.

“San Francisco has a history of bold moves toward implementing best-practice public health interventions. We call on the city to take action to save lives now,” said Courtney Mulhern-Pearson, senior director of policy and strategy at the Foundation. “The health of our families, the vibrancy of our communities, and our lives are at risk. We have the tools to change this horrifying reality, but we need the political will. We can’t wait another year while people are dying on our streets.”

It’s obvious to anyone walking through Sixth Street or the Tenderloin that change is needed, and that our current efforts in trying to fight a failing War on Drugs are clearly not working. For those who work with drug users every day, it’s a painful process waiting for politicians to catch up to research.

It is unfathomable to me that people can look around, see what’s happening, what’s been happening long before this current phase of this crisis, and think that more police and less space for folks to go is a reasonable solution,” Marshall says. “It’s not. It never has been. There are four decades worth of evidence proving that.”

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