Lee open to in­jec­tion sites

San Francisco Chronicle Late Edition - - BAY AREA - By Emily Green

Mayor Ed Lee said this week that he is open to the idea of safe in­jec­tion sites in San Fran­cisco, a sig­nif­i­cant shift from his ear­lier out­spo­ken op­po­si­tion to the con­cept.

“I have to say we are open. I had to kind of force my­self to be open to the idea be­cause it doesn’t come as a nat­u­ral thing,” Lee said Wed­nes­day at Seat­tle Univer­sity in a mod­er­ated con­ver­sa­tion about home­less­ness with Seat­tle Mayor Ed Mur­ray.

Lee’s com­ments raise the prospect that San Fran­cisco could be­come the first city in the United States to open a safe in­jec­tion site. Of­fi­cials in New York, Ver­mont, Mary­land and Washington are also ex­plor­ing the idea, ac­cord­ing to the Drug Pol­icy Al­liance.

State Sen. Scott Wiener, D-San Fran­cisco, said Fri­day he plans to co-spon­sor leg­is­la­tion with As­sem­bly­woman Su­san Eg­gman, D-Stock­ton, that would al­low San Fran­cisco and other cities in Cal­i­for­nia to open up safe in­jec­tion sites on a pi­lot ba­sis. Such sites are il­le­gal un­der state law.

“The cur­rent sit­u­a­tion with in­jec­tion drug use in San Fran­cisco isn’t work­ing, and we need to be will­ing to try new things, and it makes a lot of sense to try a safe in­jec­tion site and see if it works,” Wiener said.

Open drug use is a com­mon sight in San Fran­cisco, where peo­ple liv­ing on the streets can be seen us­ing nee­dles to shoot up heroin and metham­phetamine. The num­ber of com­plaints to the city about dis­carded nee­dles sky­rock­eted from 440 in 2012 to more than 2,565 to 2015, ac­cord­ing to the city’s 311 por­tal, which records cit­i­zen com­plaints.

At a pub­lic ap­pear­ance Fri­day when he was asked about his com­ments in Seat­tle, Lee re­it­er­ated that he was open to safe in­jec­tion sites but re­mained un­con­vinced.

“If the med­i­cal ex­perts that I en­gage with are telling me that there is both data and med­i­cal prac­tice to sug­gest that a safe in­jec­tion site could save lives on the long run as well as the short run, could al­low peo­ple to make bet­ter de­ci­sions, does not nec­es­sar­ily pro­long the use of drugs, which I’m ob­vi­ously against — I have to be open to that idea,” the mayor said. “They have not con­vinced me thus far. But I have to sug­gest that if the health depart­ment is say­ing there is a bet­ter al­ter­na­tive, then I’ve got to be open to that very fact. That’s all I was say­ing. Thus far, that per­sua­sion isn’t there.”

Even so, his open­ness to the idea is a marked dif­fer­ence from the full-throated op­po­si­tion he ex­pressed al­most a year ago, when asked about for­mer Su­per­vi­sor David Cam­pos’ pro­posal to open up a safe in­jec­tion site at a home­less shel­ter.

“We have a vig­or­ous dis­agree­ment over al­low­ing peo­ple to in­ject heroin and meth, to lit­er­ally de­stroy their bod­ies and their minds, in a city­funded shel­ter, as some have pro­posed,” Lee said at the time.

There are now about 100 safe in­jec­tion sites open in nine coun­tries: Switzer­land, Ger­many, the Nether­lands, Nor­way, Lux­em­bourg, Spain, Den­mark, Aus­tralia and Canada. But the idea has met wide­spread re­sis­tance in the United States be­cause of the crim­i­nal­iza­tion of drugs and a fear that the cen­ters will en­able ad­dic­tion.

That re­sis­tance is soft­en­ing some­what in light of re­search show­ing that safe in­jec­tion sites save lives and money.

In De­cem­ber, Bar­bara Gar­cia, the city’s top pub­lic health of­fi­cial, for the first time pub­licly en­dorsed the con­cept, telling The Chron­i­cle she be­lieved the sites were a good idea. Gar­cia also said that to make a real dif­fer­ence, the city would need to open up at least six sites, at a cost of around $3 mil­lion to $3.5 mil­lion an­nu­ally.

A study pub­lished in the Jour­nal of Drug Is­sues in De­cem­ber con­cluded that ev­ery dol­lar spent on a safe in­jec­tion site in San Fran­cisco would gen­er­ate $2.33 in sav­ings be­cause of fewer trips to the emer­gency room and a re­duc­tion in the num­ber of peo­ple who con­tract hep­ati­tis C, HIV and soft-tis­sue ab­scesses.

The num­ber of opi­oid over­dose deaths — the lead­ing cause of deaths from drug over­dose — in San Fran­cisco has stayed con­stant at around 100 peo­ple a year over the past decade, ac­cord­ing to city statis­tics. Opi­oids in­clude heroin and mor­phine, but not metham­phetamine and other stim­u­lants.

Su­per­vi­sors in City Hall praised the mayor’s evolv­ing thoughts on the mat­ter.

“On the one hand, I am hap­pily sur­prised. On the other hand, I am not sur­prised be­cause the ev­i­dence shows these sites work,” said Su­per­vi­sor Hil­lary Ro­nen.

Su­per­vi­sor Jane Kim said the city has a re­spon­si­bil­ity to make sure peo­ple with drug ad­dic­tions are get­ting help.

“The al­ter­na­tive is un­ten­able: No one sup­ports hav­ing ad­dicts self-in­ject on the street and in our pub­lic spa­ces,” Kim said in email. “Su­per­vised sites are an idea worth ex­plor­ing.”

For now, the prospect of safe in­jec­tion sites will de­pend on what the state Leg­is­la­ture does. Eg­gman pushed a bill last year to al­low pi­lot pro­grams, but it failed to make it out of com­mit­tee. She said she hoped that by try­ing again this year, at the be­gin­ning of the two-year leg­isla­tive ses­sion, there would be more time to per­suade her col­leagues.

“To any­one, at the first men­tion of (a safe in­jec­tion site), it sounds like why are you do­ing it,” she said. “The more you look at it, the data shows it makes good sense.”

Paul Chinn / The Chron­i­cle

S.F. Mayor Ed Lee says he could be per­suaded to sup­port safe drug in­jec­tion sites if ex­perts can show they would save lives.

Dar­ryl Dyck / Cana­dian Press 2011

An ad­dict in­jects heroin at the In­site safe in­jec­tion clinic in Van­cou­ver, Bri­tish Columbia. No U.S. cities have such clin­ics.

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