Editorial: SF's unhoused addicted people need help

  • by BAR Editorial Board
  • Wednesday December 7, 2022
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San Francisco's Tenderloin Center closed December 5 without an alternative program in place for unhoused people with drug addictions. Photo: Courtesy CBS5
San Francisco's Tenderloin Center closed December 5 without an alternative program in place for unhoused people with drug addictions. Photo: Courtesy CBS5

It's distressing that Mayor London Breed and San Francisco officials closed the Tenderloin Center just as the cold weather is setting in and people who are already unhoused and struggling with substance and/or mental health issues have nowhere else to turn. While it did cost the city about $12 million, according to the mayor's office, we would argue that it did help by providing basic needs like food and laundry, and connections to social service agencies. Lauded as a key part of Mayor London Breed's Tenderloin emergency declaration less than a year ago, the center near United Nations Plaza shuttered December 5, creating a void in the city's response to homelessness, addiction, and mental illness. The San Francisco Chronicle reported that the mayor's office previously said that the center didn't help as many people as the city had hoped. But not reaching its service goals is no reason to close it without some sort of alternative in place. So far, the mayor has been mum on what she plans to do to replace a center that saw more than 100,000 visits and provided thousands of meals and showers.

District 5 Supervisor Dean Preston, who now represents the Tenderloin following redistricting, issued a scathing news release November 3 stating that neither the mayor nor health department officials have a plan in place to ensure the continuity of services that the center provided. And that was before the center closed. Preston did note that the mayor and health officials have committed to opening new wellness hubs in the city, including one in the Tenderloin, but few details have been provided. A mayoral spokesperson did not respond to a message we sent this week asking about the future plans. We all know it takes a lot of time in this city to get programs up and running, so delays will compound without a transition plan in place.

The Chronicle reported Wednesday, citing the health department, that some of those hubs likely would allow people to use drugs, like a supervised consumption site. But those plans are apparently on hold due to legal issues.

The whole point of the Tenderloin Center was to help prevent drug overdoses, and in that regard it saw some success, with staff reversing more than 300 overdoses, according to the Chronicle. But fewer than 1% of the visits resulted in linkages to mental health or drug treatment, the paper noted. There were 711 overdose deaths in the city in 2020, and 640 in 2021. The city's number of fatal drug overdoses this year is down just slightly from last year, according to reports. We would argue that the center needed more time to make a difference, and now it's gone. We disagree with city officials who closed the center without another program up and running. That just sets up for failure people with substance use and/or mental health issues, and the gap in services likely will put a strain on emergency medical services that ends up costing the city more than a center would.

"There are lives at stake," Vitka Eisen, a lesbian and CEO of HealthRIGHT 360, stated in Preston's release. "And all I have to say is that from December 5 on, City Hall owns every single overdose in this city. Every single death lies right here."

Eisen should know. She's a former heroin addict who turned her life around and today leads one of the city's larger health service providers.

Meanwhile, as noted above, there's been little movement on the part of city officials to open an actual supervised consumption center. (That was one of the knocks against the Tenderloin Center, as it allowed drug use as sort of an informal supervised site.) The city has purchased property that could be used for one, and these programs have been found to save lives. After Governor Gavin Newsom vetoed a bill earlier this year that would have allowed for pilot programs in San Francisco, Oakland, and Los Angeles, many officials expressed support for moving forward with a plan in San Francisco, likely utilizing a nonprofit. But, to date, nothing has come of it. That's what the city really needs: a formal supervised consumption site that provides referrals to treatment. There are two New York facilities, located in East Harlem and Washington Heights, that were already operating as needle exchange sites and began allowing on-site consumption just over a year ago, in November 2021, according to an announcement from New York Harm Reduction Educators, one of two nonprofits that merged to form a new organization dubbed OnPoint NYC.

We know there are lots of unanswered questions regarding supervised consumption sites, including whether they could even be located in a city-owned building. But local officials need to start studying and addressing those issues instead of promising that some wellness hubs would be open by the end of the year and later backtracking. We simply can't wait for Newsom to have his health secretary convene officials to discuss minimum standards and best practices, as he wrote in his veto message this summer.

In the meantime, some of the city's most vulnerable residents are left out in the cold, as leaders ponder next steps that they should have begun considering a year ago.

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