Peering inside the city’s plan for safer injections
Site would offer addicts counseling, a haven off street
Stepping into the mock safe injection site set up inside Glide Memorial Church, with its friendly receptionist, stainless-steel medical tables and modestly furnished recovery area, it can be easy to forget that it’s just a model.
If it were real, it would be populated by injection drug users who’ve come to take advantage of the clean, safe space and the counselors on hand to guide them to recovery services. That reality is the aim of San Francisco Mayor London Breed and other city officials who want to open the nation’s first supervised injection site.
Through Friday, Glide’s Freedom Hall will be home to a prototype safe injection site, a display meant to give the public a realistic, tangible sense of what such a facility could look and feel like.
At Glide, the antiseptic characteristics of a medical clinic are blended seamlessly with a relaxed atmosphere meant to encourage people struggling with addiction to use their drugs more safely and without judgment.
The demonstration starts with a brief registration with no requirement that first-time users give their real names. “Clients” are then led back to the injection room, where they are presented with a “harm reduction kit” that consists of clean
syringes, disinfecting wipes, cotton balls, tourniquets and “cookers,” small caps where water and powdered drugs are mixed and heated before being pulled into a syringe and injected.
At each table a small, square mirror is affixed to the wall so that staff can observe the injection and check for potential infections from a distance.
“This way, we can check in on them without actually having to invade their space and their privacy,” said Kenneth Kim, clinical director at Glide.
From there, users are led to a so-called chill-out room, a comfortably furnished space where users can collect themselves as their highs subside.
Anel Muller, director of Capital One Design Pro Bono, who designed the demonstration facility, said perhaps the most important aspect of the room was the long list of services that drug users can ask to access.
San Francisco public health officials hope that by providing access to meal services, showers, dental care, mental health and medical referrals, they can help slowly guide people away from their addictions and street life and toward more stable environments.
“The readiness to take that next step or maybe go to recovery can start in a place where there’s dignity and respect and relationships,” Muller said. “That’s not something that will happen overnight, but once you’re creating those great foundations, it becomes much easier to talk about a lot of different things.”
By giving people the opportunity to tour the site, ask questions and hear from experts and supporters, city officials and public health advocates hope to show that a safe injection site can provide professional, humane help to addicts. The sites are also seen by proponents as an essential tool for combatting the growing opioid addiction crisis.
“I work with people who inject drugs on the street regularly, so I wanted to see what something like this is going to look like for them,” said Shannon Ducharme, a medical worker with the city’s Homeless Outreach Team who toured the facility Tuesday. “It’s a genius idea that’s working in other countries that San Francisco definitely needs. It’ll help save lives and also link people to treatment and other things,” she said.
Breed, who is among the most powerful and vocal supporters of safe injection sites, is expected to tour the facility Wednesday.
“I refuse to accept what we see on our streets — the needles, the open drug use, the human suffering caused by addiction — as the new status quo,” she said through a spokesman. “Safe injection sites are a proven, evidence-based approach to solving this public health crisis. This demonstration shows that these sites will not only help provide treatment and prevent the spread of disease, but also reduce public drug use and the discarded needles seen on our streets.”
Opening day for the prototype site came less than 24 hours after the state Assembly signed off on a final round of amendments to AB186, a bill that would allow San Francisco to create a pilot program for safe injection sites through January 2022. The bill is now awaiting Gov. Jerry Brown’s signature.
But even with state backing, supporters of safe injection sites still have to confront what could be their most daunting obstacle: the federal government. Federal law prohibits anyone from “maintaining or providing access” to a space where illegal drugs are used, which could subject anyone operating a safe injection site to raids and arrests — including city officials.
On Monday, U.S. Deputy Attorney General Rod Rosenstein took to the opinion pages of the New York Times to reiterate the Trump administration’s stance against safe injection sites, calling them “very dangerous” and liable to “only make the opioid crisis worse.”
“Because federal law clearly prohibits injection sites, cities and counties should expect the Department of Justice to meet the opening of any injection site with swift and aggressive action,” Rosenstein wrote.
Kim, the Glide clinical director, agreed that even if the city is able to find funding and a suitable location to host a real safe injection site, the threat of a federal crackdown remains the biggest barrier.
“I think there has to be more conversations with the city attorney, with city leaders, about what are we willing to risk, what are we willing to do,” he said.