SF supe Dorsey critiques AIDS agency's messaging on drug overdose centers

  • by John Ferrannini, Assistant Editor
  • Tuesday June 13, 2023
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San Francisco Supervisor Matt Dorsey wrote to the San Francisco AIDS Foundation complaining about this poster at a recent rally for HIV funding, stating that the word "DEATH" over a police car, seen in the sign at lower right, was endangering to law enforcement and drug users alike. Photo: Matthew S. Bajko
San Francisco Supervisor Matt Dorsey wrote to the San Francisco AIDS Foundation complaining about this poster at a recent rally for HIV funding, stating that the word "DEATH" over a police car, seen in the sign at lower right, was endangering to law enforcement and drug users alike. Photo: Matthew S. Bajko

A gay city supervisor is taking issue with some of the San Francisco AIDS Foundation's messaging in support of overdose prevention centers, saying it is endangering law enforcement and drug users in addition to being irresponsible and tone-deaf.

District 6 Supervisor Matt Dorsey wrote a letter to the foundation's gay CEO, Tyler TerMeer, Ph.D., and board chair Maureen Watson on June 12 in reference to a sign being displayed at an HIV Long-Term Survivors Awareness Day march and rally that took place June 5. The sign, headlined "End Overdose Now," shows a scale. On one end is a syringe and Naloxone, a drug that can be given to someone experiencing an opioid overdose, designated as "LIFE," and on the other is a police car and handcuffs, designated as "DEATH."

It is the image of a police car with the word "DEATH" over it that is troubling to Dorsey, who said that police and nonprofit organizations must work together when overdose prevention sites are opened in the city. They will likely be funded by private dollars, as City Attorney David Chiu has argued that city funds cannot be used for them.

California Governor Gavin Newsom last year vetoed a bill that would have allowed pilot programs of overdose prevention sites, also called supervised consumption sites or wellness hubs, in San Francisco, Oakland, and Los Angeles. Federal law does not recognize such interventions, as drugs like heroin and fentanyl remain illegal and public funds cannot be used for programs that allow people to use drugs.

Dorsey wrote in his letter that the poster's message endangers law enforcement and drug users alike.

TerMeer told the Bay Area Reporter that Dorsey's letter is based on "a number of incorrect assumptions about the signs ... in order to make the point that San Francisco AIDS Foundation is unwilling to forge productive and respectful relationships with the San Francisco Police Department."

"It is unfortunate that Supervisor Dorsey has misinterpreted the meaning and intent of these posters, but we stand firm in our statement that criminalization of people who use drugs only causes harm, and we stand behind our activism on this issue," TerMeer continued.

Dorsey told the B.A.R. that he saw the sign at the June 5 event, during which he spoke in support of long-term HIV survivors and ensuring their needs are met in the city's next two fiscal year budgets. A lead organizer of the rally had been SFAF.

Overdose prevention centers, which the city is working on, are proposed sites where people who use drugs could go to do so under supervision. City officials, including Dorsey, have long supported the creation of such sites as a continuation of the city's tradition of harm reduction, exemplified by the needle exchange program during the AIDS epidemic, which is credited with having helped some intravenous drug users avoid contracting HIV.

As the B.A.R. has previously reported, Mayor London Breed proposed $18.9 million to open up to three Wellness Hubs in her budget proposal for the next two fiscal years "to improve the health and well-being of people who use drugs, including those experiencing homelessness, and reduce public drug use." But any safe consumption site "would be funded by private entities," specifies her budget document.

Dorsey, a long-term HIV survivor who is also a recovering drug addict, stated in his letter to SFAF that he is committed to supporting a wellness hub in the South of Market neighborhood he represents.

"Together with two other proposed 'Wellness Hubs' — one in the Tenderloin neighborhood and another in the Mission district — these services will afford those who use drugs with better access to appropriate services and a safer venue for consumption in a manner that affirms the promise of San Francisco's long-standing harm-reduction policy, which aims to reduce the adverse health effects of drug use and substance use disorder to individuals as well as to the broader community," he wrote.

Dorsey stated it is his understanding that the AIDS foundation intends to be the "primary nonprofit partner for the SOMA Wellness Hub, with HealthRIGHT 360 and the Gubbio Project (together with Saint John the Evangelist Episcopal Church) serving as primary partners for the Tenderloin and Mission Wellness Hubs, respectively."

In his letter, Dorsey, who used to be the communications director for Police Chief William Scott and before that worked in communications under former city attorney Dennis Herrera, elaborated on why the AIDS agency's poster is problematic for law enforcement.

"In my view, the most woefully ill-advised aspect of this messaging is its implication that individuals who use drugs should fear for their lives in their encounters with law enforcement officers in San Francisco," he stated. "The association between violence and methamphetamine psychosis, in particular, is well established, of course, and the narrative advanced by this portrayal poses potentially grave dangers to law enforcement officers as well as to drug users recklessly moved to fear them. Whatever else this marketing strategy may be, it isn't reducing harms but elevating them."

The second objection was that it paints the police as adversarial when, as part of the city family, they are needed for supervised drug consumption sites to succeed, wrote Dorsey.

"Importantly, the police department's role in the success of overdose prevention centers, or OPCs, isn't speculative. It's a cornerstone of the 'New York Model' I personally observed with OPCs run by OnPoint NYC in the East Harlem and Washington Heights neighborhoods of New York City," stated Dorsey, who traveled with other city officials earlier this year to tour the East Coast facilities.

OnPoint runs the only legal overdose prevention site in the country. It is funded with private donations.

The San Francisco Police Department did not respond to a request for comment.

Finally, Dorsey found the imagery used in the rally signage to be "tone-deaf."

"While I understand and appreciate that clean needles and Naloxone are potentially life-saving interventions for people who use drugs, I shouldn't need to explain that the visual representation of drug paraphernalia as 'LIFE' is unlikely to find agreement with large numbers of San Franciscans evaluating whether to support Wellness Hubs in their neighborhoods," Dorsey stated.


One person who took issue with Dorsey's letter is Gary McCoy, a gay man and recovering addict who is vice president of policy and public affairs with HealthRIGHT 360. McCoy, who previously worked for Congressmember Nancy Pelosi (D-San Francisco), said the letter "could have been a simple phone call," and accused Dorsey of undermining the AIDS foundation's efforts.

"The San Francisco AIDS Foundation has provided care and advocacy to our LGBTQ+ community through more than one crisis over many decades, saving countless lives through direct-service and activism when most others have largely been silent — from the height of the HIV/AIDS crisis to the mpox outbreak last year," McCoy told the B.A.R.

"At a time when the LGBTQ+ community faces yet another dangerous uptick in hateful rhetoric and the trans community is facing unprecedented attacks and violence, we should be working together to better the lives of those suffering with substance use disorder on our streets through evidence-based best practices, not sending a 6-page letter that could have been a simple phone call, over a flyer at a critical rally for HIV funding," he added.

When asked about the messaging Dorsey took issue with, McCoy stated that "we have ample historical data, specific to not only the LGBTQ+ community, but also Black and Brown communities, associating terrible policies with death."

TerMeer issued the B.A.R. a lengthy response June 13. He stated the AIDS foundation has "maintained productive and fruitful relationships with SFPD and the Police Commission for many years — actively hosting captains of the Southern Station to our Harm Reduction Center, attending police community meetings to discuss our mobile sites, and staying in active communication with members of SFPD to coordinate the roll-out of new harm reduction and overdose prevention services to the community. This history of collaboration goes back decades, as SFPD were integral to the success of early harm reduction efforts to curb the transmission of HIV by injection drug use."

TerMeer continued that, with regard to the messaging Dorsey took issue with, "we used symbolic imagery meant to convey the message that criminalization of drug users and drug use leads to overdose death and contributes to/increases risk of other health issues/conditions (hepatitis C, HIV, homelessness)."

"This is not simply rhetoric — we know from peer-reviewed public health research that people who are incarcerated are at a significantly increased risk of overdose upon release, and that drug arrests lead to an increase in overdose in areas surrounding the drug arrests for up to three weeks afterwards," TerMeer added, stating that the imagery was meant to highlight the destructive effects of the war on drugs.

"We have shared this research on criminalization with Supervisor Dorsey and his staff, at their request," TerMeer continued. "The police car and handcuffs used on our posters were meant to symbolize 'criminalization' and the devastating impacts of the war on drugs in general. We do not believe, as Supervisor Dorsey has stated, that the posters could inadvertently 'glamorize deadly drug use and further encourage mounting drug-related lawlessness.' We also take issue with the claim that the posters will 'endanger law enforcement officers and drug users.'"

Law enforcement crackdown

When asked if it's possible the messaging on the poster would encourage people who are in need of harm reduction services to seek out such programs, Dorsey told the B.A.R. that it's nonetheless "irresponsible" and "potentially dangerous" to equate police with death.

The city has been starting to enforce public intoxication laws in recent weeks and, as of June 8, at least 58 people were arrested on either public intoxication or drug possession charges.

Six California Highway Patrol officers were assigned to the Tenderloin by Newsom; later, the sheriff's department announced it was deploying 130 deputies for six months, a move Dorsey stated he supported.

"We must send a clear message that our communities won't tolerate the destructive influence of drugs and open-air drug scenes. That's why I'm committed to working with the sheriff's department to increase enforcement efforts in the hardest-hit neighborhoods," Dorsey stated in a June 8 news release. "Together, we will create an environment where families can feel safe, where children can thrive, and where our city can flourish once again."

McCoy differs with Dorsey on this issue, too, citing it in his defense of the AIDS foundation's messaging.

"In fact, the city's newly announced drug enforcement program is once again prioritizing a failed carceral approach over an evidence-based public health approach, targeting people who use drugs — and we know policing, through decades of research, will most certainly increase the number of fatal overdose deaths on our streets," McCoy said.

To back up that assertion, McCoy cited a 2023 study out of Marion County, Indiana, published in the American Journal of Public Health, which found that "supply-side enforcement interventions and drug policies should be further explored to determine whether they exacerbate an ongoing overdose epidemic and negatively affect the nation's life expectancy."

When asked if even supervised drug use would be enabling drug users in a potentially life-threatening addiction — the city hit a new record for accidental overdose deaths this year: 268 through April, which is 72 higher than in 2022 — Dorsey stated he is a "strong believer in harm reduction."

"Especially in light of the potent lethality of drugs like fentanyl that are flooding street-level drug markets, I think harm reduction strategies can save lives and provide an entry point to services to support people's journey in recovery free from substance use," Dorsey stated.

He also had a word for those fed up with public drug sales and use.

"I think Wellness Hubs reflect everything our harm-reduction strategies should be — which means to reduce harms to the individuals, and also reducing harms to the community by getting public drug use and antisocial behavior off of neighborhood streets," he stated.

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