San Francisco's plan for safe injection sites draws strong support from supes

Used syringes are viewed at a needle exchange clinic where users can pick up new syringes and other clean items for those dependent on heroin on February 6, 2014 in St. Johnsbury, Vermont. (Photo by Spencer Platt/Getty Images)

San Francisco could potentially open safe injection sites within eight to 12 months if a proposal to create them gets approved, city health officials said today.

Department of Public Health director Barbara Garcia, speaking at a hearing of the Board of Supervisors' Public Safety and Neighborhood Services Committee on a report calling for the opening of multiple safe injection sites, said several interested service providers have already approached the city.

However, even with that support it will still likely take eight to 12 months to obtain funding, establish protocols, hire and train staff, and set up programs if the city decides to move ahead, Garcia said.

The city launched a task force earlier this year to explore the possibility of opening safe injection sites, which provide a clean space for drug users to shoot up with medical supervision.

San Francisco public health officials estimate the city has around 22,000 injecting drug users and about 100 overdose deaths a year, mostly from heroin and other opiates.

While controversial, safe injection sites are used in a number of other countries including Canada to prevent overdose deaths, reduce the spread of diseases such as HIV and hepatitis C, and get users access to services including drug treatment programs. The programs can also help get drug use off the street, out of public view, and reduce needle litter.

A 2016 cost-benefit analysis found the city could save around $3.5 million a year by opening a safe injection site because of reduced health care costs and increased drug treatment uptake.

The task force's report, which was released Friday, calls for the creation of multiple sites in locations where other services such as primary medical care and social services can also be provided.

No other city in the United States is currently operating a safe injection site, although several are exploring it and Seattle officials are currently working to open a site.

"I think within the next few years we're going to see a number of these sites opening across the country," said task force member Laura Thomas, deputy state director of the Drug Policy Alliance. "We may or may not be first but we probably won't be the only one for long."

Legal obstacles remain. Efforts to pass Assembly Bill 186, which would have allowed counties including San Francisco to legally operate safe injection sites, failed to gain enough votes to pass the state Senate.

However, the bill was tabled and will return to the state Legislature in the next year for another try, Thomas said.

In the meantime, San Francisco can explore declaring a public health state of emergency, which is what it used to establish needle exchange programs at a time when they were still illegal in the state. However, that would not eliminate potential issues with federal law.

The report drew support today from the Board of Supervisors committee, and Mayor Ed Lee has expressed openness to looking at the idea.

Supervisor London Breed, who sponsored the legislation creating the task force, said she had been initially skeptical but had been persuaded in part by seeing how the sites work in other countries. She and other city officials have visited a safe injection site in Vancouver to see how they work firsthand.

"They promote safe injecting conditions, reduce overdose, enhance access to primary care and reduce outdoor syringe litter," Breed said. "In Vancouver, I saw how safe and welcoming the space can be and how it can change lives."

Supervisor Hillary Ronen said the city should move forward without delay to open the sites.

"I really believe that this is the right intervention at the right time in San Francisco," Ronen said, citing the ongoing nationwide opioid epidemic.

Garcia said city staff would bring potential legislation or further actions back to the board for consideration.