Drug Overdoses May Be Declared a Public Health Emergency

The city would be required to outline an emergency plan, one that harm reduction experts are calling to be part of.

Supervisor Matt Haney is calling on the city to treat drug overdoses and deaths as the emergency it is.

Haney, who represents SoMA and the Tenderloin, introduced a resolution on Tuesday declaring a public health crisis on the impact of drug use and overdoses in the city. In 2019, overdoses were the cause of 259 deaths, including a 150 percent increase in fentanyl overdose deaths. The synthetic painkiller is now the leading cause of overdose deaths, and Haney is seeking an emergency plan to prevent those deaths moving forward.

“It’s important that when people die, they don’t die in silence,” says Haney, adding that he’s not informed when someone dies of an overdose in his district. “When someone dies from a car crash or a homicide, I’m called. It’s shocking and just terrible to me that we don’t have the same response for people who are overdosing.” 

Should the resolution pass, the Department of Public Health must present an emergency plan to:

  • target drug use seen on the street
  • increase access to Narcan
  • expand outreach
  • regularly report overdoses and overdose deaths
  • boost support for emergency responders,
  • establish emergency detox and drop-in facilities
  • seek additional funds
  • coordinate to limit the drug supply

But groups on the front lines of harm reduction also know that their work has been effective, long before an emergency declaration. Last year saw 1,658 community-based overdose reversals and by July 2019, 1,100 were reported to the Drug Overdose Prevention and Education (DOPE) Project, which is part of the Harm Reduction Coalition. 

“We are even more disheartened to hear that his office chose to highlight our death numbers instead of a much larger number, one worth celebrating, which are our community-based overdose reversal numbers,” says DOPE Manager Kristen Marshall. “People who use drugs and harm reduction workers are addressing this crisis every day, more successfully than any other agency or group, and they have been for years. Instead of trying to recreate the wheel or erase us, listen to us, support us, fund us, and follow our lead.”

Marshall is waiting to see what action follows the declaration to determine how much impact it could have. What she does know is that without groups like DOPE, Homeless Youth Alliance, and the San Francisco AIDS Foundation included, further action that doesn’t address root causes like poverty and racism would be ineffective and even harmful. 

“Of course the organizations and leaders that have been doing this for decades and saving lives will absolutely be a central part of that response,” Haney says. “I’d like to know how we can support and uplift their work and know they can reach more people. They’re a huge part of the solution.”

Haney points the call for an emergency plan that includes more Narcan access and outreach, intending that to be through organizations working on harm reduction. He also wants to address the issue of drug supplies while avoiding negative impacts of the war on drugs.

Laura Thomas, who directs harm reduction policy at the San Francisco AIDS Foundation, said Haney’s office has reached out several times and that she appreciates the additional focus. One thing she did feel was missing was the inclusion of safe consumption sites, which she called an essential response to overdoses, and the reminder that people who use drugs are primarily the ones reversing overdoses of people in their community. 

“It’s never a bad time to draw more attention to overdoses,” Thomas says. “I’m happy that he’s taking this so seriously, as it needs to be taken.”

In the same meeting that Haney introduced the resolution, the Board of Supervisors unanimously approved a Street-Level Drug Dealing Task Force. It already has $200,000 secured in funding for a task force that will advise city departments on how to eliminate drug dealing in the Tenderloin, Civic Center, Mid Market and SoMa.

In response to the emergency declaration, Mayor London Breed told KTVU that “The department of public health has nurses and outreach workers out on the street every day helping people into treatment and working to prevent overdoses.” But that attitude continues to frustrate Haney.

“People are dying and the residents of my district are furious about the conditions caused by the drug crisis,” Haney says. “But the mayor says everything is fine, and she believes that the things they are doing are perfectly adequate. Totally unacceptable.”

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