Breed says fight for safe injection sites isn’t over
Gov. Jerry Brown’s veto of legislation that would have allowed San Francisco to begin a four-year trial of safe injection sites for drug users hasn’t killed the idea alto- gether, but has made opening one even more complicated and distant.
Mayor London Breed, sounding a bit frustrated, said in an interview Monday she still has a “strong desire” to open a site in which injection drug users could shoot up in a city-sanctioned facility under supervision. While such facilities exist in Canada, Europe and Australia, none operate in the United States. But Breed said she wants to ensure protection for the nonprofits and their workers that would operate such a facility, considering the Trump administration has made it clear it considers safe injection sites completely untenable and against federal law.
Brown’s approval of the pilot program would have given Breed not only a public relations coup, but some politi-
HEATHER KNIGHT On San Francisco
cal cover against the federal government.
“I think it’s premature at this time to say that I would go ahead with opening a site,” Breed said. “I think it’s more appropriate to say I’m not giving up on the possibility.”
While Breed has successfully rallied the entire Board of Supervisors, and even more conservative groups like the Chamber of Commerce, to back the controversial idea, the brush-off from a governor normally on the cutting-edge of embracing strong scientific evidence is a major setback. Studies have shown safe injection sites lower overdose rates and nudge some users into treatment, but Brown argued in his veto letter that “enabling illegal and destructive drug use will never work.”
A main driver in opening an injection site would have been getting drug users and their dirty needles off the sidewalks and out of public view, a notion Brown didn’t even address.
When pressed on whether a safe injection site would be open by the time she faces re-election in November 2019, Breed laughed and joked she didn’t want to answer the question.
“That’s hard to say,” she finally said. “Fifty-fifty.”
And that’s probably overstating the odds. There appear to be three options for moving forward without the governor’s approval, none of which would happen quickly.
Wait a year and try again. State Sen. Scott Wiener, D-San Francisco, who teamed with Assemblywoman Susan Eggman, D-Stockton, on the legislation for the four-year pilot program, said he plans to introduce the proposal again when the Legislature reconvenes in December.
Brown will be termed out, and California will have a new governor — almost certainly former San Francisco Mayor Gavin Newsom, who loves being the first to push important policies and relishes fights with President Trump. Newsom has indicated he’s willing to back safe injection sites.
He told Chronicle columnist Phil Matier in August, “I’m open to it. I think it’s a novel strategy.”
Newsom wouldn’t be able to sign the legislation until September, however. That’s a long time to wait in a city that’s already turned into one big unsafe injection site — dirty needles litter its sidewalks, BART trains and stations, playgrounds and pretty much everywhere else.
Wiener, not exactly a raging leftie, said if he were mayor, he wouldn’t wait for Sacramento’s approval. He would just open a site.
He said it’s unlikely San Francisco police or the district attorney or California Attorney General Xavier Becerra would go after those working at a safe injection site.
And so the roadblock remains the Trump administration, with or without California’s backing. Rod Rosenstein, deputy attorney general for the United States, recently warned in a New York Times op-ed that anyone who maintains a safe injection site would face up to 20 years in prison, fines and forfeiture of the property used for the injection drug use.
But whether the Trump administration would risk the terrible optics of dragging clinicians helping homeless people out of a nonprofit in the Tenderloin is an open question. Whether San Francisco needs to address its drug epidemic is not.
“We have an epidemic on our streets of public injecting, which is terrible for neighborhoods and terrible for the health of people who are injecting in an unsafe, dirty, unhealthy environment,” Wiener said. “We can’t just keep waiting around for policy makers at all levels to understand.”
Open the site as a medical research center. Breed is in discussions with New York Mayor Bill DeBlasio’s administration about opening safe injection sites together as medical research facilities.
There are federally established procedures for allowing the use of controlled substances as part of research studies, but they’d require review and approval from a number of agencies, including the U.S. Department of Justice.
Even if the same department that has threatened “swift and aggressive action” against safe injection sites agreed to allow them if they have a scientific element — a big if — it would certainly take a long time
Declare an emergency, open one and hope for the best. This is basically what then-Mayor Frank Jordan did when he sanctioned the city’s controversial needle exchange program back in 1993.
An underground needle exchange program run by volunteers had existed for five years by that point, in an attempt to reduce the transmission of HIV and AIDS. Jordan said Monday he vividly remembers going to visit thenGov. Pete Wilson to ask for permission to sanction the program. Wilson refused.
Jordan, a moderate former police chief, declared a state of emergency, which got around some state regulations, and gave his blessing to the needle exchange anyway. It’s now credited with dramatically reducing the spread of AIDS by injection drug users and has been replicated around the world.
Jordan said it could be argued San Francisco has a health emergency now with so many injection drug users and discarded, dirty needles on the sidewalks.
“I think she should be pursuing it even though the governor has vetoed it,” Jordan said of Breed. There are two differences. One? The president at the time was Bill Clinton — not Donald Trump.
Two? The San Francisco AIDS Foundation was fully on board with running the needle exchange program.
Now, four nonprofits are in discussions about opening a safe injection site. They’re Glide Memorial Church, Healthright 360, St. Anthony and, again, the San Francisco AIDS Foundation.
They were in discussions Monday about Brown’s disappointing veto and agreed the already challenging task of opening the nation’s first injection site under Trump was made even harder.
Kenneth Kim, clinical director at Glide, said no one organization would brave the risk alone, and it must be a “fully coordinated effort” with the city.
Kim said the governor clearly doesn’t understand the point of safe injection sites and that they gradually help drug users make better decisions, like not using dirty water out of a pothole to mix with their drugs.
Asked to describe the chances a site would open in the next year, he said, “Very low, I imagine.”
Asked about two years, he said, “Still very low.”
Clearly, City Hall officials need to come up with other ideas to tackle the city’s injection drug use epidemic in the meantime. Opening a safe injection site — quickly — has been their one, big answer to solving the problem, but that solution isn’t going to happen anytime soon.
Brown said in his veto letter that “a comprehensive effort at the state and local level is required” and that we need more drug treatment programs undertaken voluntarily or imposed by the courts. Too bad he did little on this score in office. Let’s see who’s willing to step up and make it a reality.