Library staff may help save addicts
Employees could provide drug to reverse overdoses
In addition to checking out and re-shelving books, San Francisco library staffers may soon be trained to give lifesaving medication to reverse overdoses among the growing number of heroin users mixing in with the homeless in and around the Main Library.
“It does save lives,” City Librarian Luis Herrera said of the plan being floated to allow his staff to administer naloxone, also known by the brand name Narcan. The idea surfaced after an addict was found dead in one of the Civic Center library’s restrooms in early February.
Alarmed by the scope of the problem, the Department of Public Health assigned a couple of staffers to patrol the perimeter of the library last week in two shifts — one between 9 and 10
a.m. and the other between 5 and 6 p.m. — to talk with people who appear to be at risk and to administer the opioidblocking drug when needed.
“San Francisco is a city with lots of drug use,” health department spokeswoman Rachael Kagan said, “and we consider people with drug-use issues part of the population we feel responsible for.”
She said the patrol hours were set “based on feedback and observations on when drug use is the heaviest among the people who gather there.”
The library also has a social worker and six formerly homeless health and safety associates who scour the Main Library and its 27 branches and provide outreach to those in need. Plus there are city police officers assigned to work overtime in and around the Main Library.
In a Feb. 28 email to his staff, Herrera cautioned that no decision about training librarians to treat overdoses with naloxone would be made “without fully exploring the matter.”
“Furthermore,” he added, “if we determine that library staff may use it, it will be on a strictly voluntary basis.”
Naloxone typically is administered by a nasal spray or leg injection — we’re told the library staff probably would be taught the spray method, with assistance from the Drug Overdose Prevention & Education Project. The group, which is funded by the Department of Public Health, already hands out naloxone to addicts through its needle access program.
San Francisco’s Main Library has become a magnet for the city’s exploding homeless population. Coincidentally or not, the neighborhood has seen epidemic numbers of users of heroin and prescription painkillers — opioids such as codeine, morphine and OxyContin.
Just around the corner, in fact, BART police arrested 27 suspected drug users last week during a three-day sweep of the Civic Center Station.
Library security guard Gloria Cowart has watched the passing show for years, as San Francisco police officers chase neighborhood drug dealers and addicts from one corner to the next — and back again. The addicts often wind up inside the library, shooting up in the stacks or restrooms.
“We might catch somebody (shooting up) once or twice a week,” Cowart said. “There is nowhere for them to go.”
In 2016, the Main Library tracked 689 instances of patron misbehavior, ranging from vandalism and altercations to verbal disturbances and drug use. Of those incidents, 72 were described as “severe violations” that merited the patron being suspended from the library for a year or longer.
Separately, records compiled by the San Francisco Department of Emergency Management show fire or ambulance crews were dispatched to the Main Library 138 times last year.
Fire Department spokesman Jonathan Baxter, who was assigned to a station in the Civic Center area for eight years, said the calls often involved homeless people who were intoxicated — though some were for injuries and ailments from living on the streets.
The health department’s most recently available estimates are from 2012 and put the number of addicts injecting drugs in San Francisco at between 15,000 and 22,000.
San Francisco has taken a compassionate approach when dealing with the problem, offering both free and unlimited access to syringes, plus methadone treatment on demand to help people better manage their addictions.
City police and emergency workers have long been trained how to administer naloxone, which has been in use for decades.
The overdose prevention project, operating on a $245,000 annual budget, not only hands out naloxone to addicts, but also trains welfare hotel staff and community service workers to identify signs of overdosing and how to dispense the lifesaving medication.
In 2014, there were 127 fatal opioid overdoses in San Francisco, the vast majority from prescription medicines, Kagan said. The same year, there were 365 overdose reversals with naloxone, she said. In 2016, the number of reversals more than doubled, to 877.
“When an overdose occurs in the library, we are the people most likely to be on the scene, not emergency responders,” librarian Kelley Trahan recently told colleagues at a staff meeting, urging that they get on board with the naloxone program.
“Drug use should not be punishable by death.”