San Francisco Could Open Safe Injection Sites

A legal victory in Philadelphia could pave the way for safe injections here.

The possibility of a safe injection site opening in San Francisco inched a step closer to reality last week.

Mayor London Breed and Supervisor Matt Haney said they would introduce legislation allowing non-profits to open sites where people could consume drugs under medical supervision. The ordinance is contingent on the passage of matching legislation at the state level authorizing a pilot program in San Francisco.

Two days earlier, Safehouse, a Philadelphia nonprofit, achieved a landmark legal victory when a U.S. District Court ruled a proposed safe injection site on the East Coast would not violate federal law. That paved the way for Philadelphia to become the first city in the country to open a safe injection site. But later that same week, after strong pushback from the South Philadelphia community, Safehouse said it would delay opening their facility.

“One thing we have here that they don’t have as much of in Philadelphia is buy-in from the community,” says Robert Avila, a spokesperson for Glide Memorial Church in San Francisco.

In 2018, Glide and other organizations banded together to launch Safer Inside, a mock facility to show the public what a real safe injection site might look like.

“That’s what the Safer Inside mock site was all about — bringing the public in,” Avila tells SF Weekly.

At the time, AB 186 had just passed the California legislature and was waiting for a signature from then-Gov. Jerry Brown. The bill would have allowed San Francisco to operate safe injection sites as part of a two-year pilot program, through the end of 2021. But Brown vetoed the bill.

A new bill, AB 362, is now making its way through the legislature, where Assemblymember David Chiu — a co-author of the bill — says it will probably be considered over the next few months. Like the previous bill, it would authorize a short-lived pilot program in San Francisco, this time through the end of 2025.

“Governor Newsom has expressed some openness to considering this, and that was certainly a different perspective from our previous governor,” Chiu tells SF Weekly. “We want to place the bill on his desk to allow San Francisco to save lives. We’re hopeful.”

Chiu pointed to many similar programs throughout the world which have embraced a harm reduction approach.

“The idea is that if we provide these sites, individuals will come into contact with critical health services like detoxification, and treatment, and other services they otherwise wouldn’t if they’re shooting up on the streets,” he says. “Given the intensity of the crisis, we have to try new things.”

There were at least 330 overdose deaths in 2019, according to city records, up from 259 deaths the year before. An estimated 24,500 people inject drugs in San Francisco.

Assuming the state bill becomes law, and assuming Breed and Haney are able to pass a local ordinance, it remains unclear today which nonprofit would step up to operate a site in the city.

“I’m not sure anyone knows who in the end will come forward to ask for a permit,” Avila says.

Even if a state law was in place to provide some legal cover, there’s still a risk of federal prosecution. The U.S. District Court ruling in Philadelphia doesn’t apply to San Francisco, and it may or may not foreshadow how a similar case in California would fair.

“We are taking a page from Philadelphia again…and talking about how we could use their model and create a 501c3 that’s separate, and protects the other programs,” says Ken Kim, senior director of programs at Glide. “Our biggest concern is we don’t want to risk all the other services we provide for this one endeavor.”


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