Editorial: Movement on SF consumption sites

  • by BAR Editorial Board
  • Wednesday January 25, 2023
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San Francisco Supervisor Hillary Ronen, left, and Mayor London Breed have proposed legislation to remove a barrier to nonprofits operating safe consumption sites. Photos: Rick Gerharter
San Francisco Supervisor Hillary Ronen, left, and Mayor London Breed have proposed legislation to remove a barrier to nonprofits operating safe consumption sites. Photos: Rick Gerharter

At long last, there is movement among city leaders to establish privately-run safe consumption sites in San Francisco. Last week, Mayor London Breed and District 9 Supervisor Hillary Ronen announced local steps the city is taking to address a recently identified permitting barrier to move forward with non-city-operated overdose prevention sites. It seems that when the Board of Supervisors approved legislation establishing a permitting structure for city-funded overdose prevention sites in 2020, the law as written does not allow for any overdose prevention program — run by the city or a non-governmental entity — to open until federal and state legal issues have been resolved. As we have written over the past few years, the federal government still does not recognize safe consumption sites. At the state level, also as we've reported, Governor Gavin Newsom vetoed a bill last year that would have allowed pilot programs in San Francisco, Oakland, and Los Angeles. We know that these legal issues have been the main concern of San Francisco leaders and that even though the city purchased a building that could be used for such a program, it was unlikely to do so under city control. Hence, the need for a nonprofit agency to operate a program that's not on city property — at least for now.

Nonprofits, such as the San Francisco AIDS Foundation, have expressed interest in running a safe consumption site, but as it stands now, it would not be able to. The proposed legislation by Breed and Ronen would repeal the 2020 permitting structure, thus allowing a nonprofit to open a site with private funding before state and federal legal issues are resolved. The legislation was to be introduced Tuesday, and Breed has asked board President Aaron Peskin to expedite the ordinance. We agree. The Board of Supervisors needs to hear this in committee and approve it as quickly as possible so that sites can get up and running.

Safe consumption sites allow people to bring their own drugs to the facility and use them under the supervision of staff, thus reducing the possibility of overdose deaths. The city's overdose problem is real, even though deaths have been slightly decreasing the last two years. According to the San Francisco Department of Public Health, which used data from the Office of the Chief Medical Examiner, the city recorded 620 accidental drug overdose deaths in the 2022 calendar year, compared to 640 deaths reported in 2021 and 725 in 2020. So, the downward trend is definitely good news, but 620 accidental overdose deaths is still far too many. There are also racial disparities, as DPH noted. "Black individuals continued to be disproportionately impacted by overdoses," the health department stated. "Preliminary data shows that overdose death rates among Blacks are more than five times the citywide rate, on par with 2021. The 2022 data shows a 14% decrease from the 2020 number when drug overdose rates were at an all-time high in San Francisco, in large part due to the COVID-19 pandemic and the growing presence of the deadly synthetic opioid known as fentanyl."

In announcing the proposed legislation, Breed said the city is working with nonprofits.

"We are committed to opening overdose prevention sites in San Francisco, but due to legal restrictions, there remain significant challenges," Breed stated in a news release. That said, Breed, who supports such programs and even had a demonstration project set up in 2018 so that people could see what one might look like (no drug use was permitted), has been reluctant to flout federal and state laws. While it seems unlikely to us that the Biden administration would go after local programs, Newsom's veto last year of Senate Bill 57, authored by gay state Senator Scott Wiener (D-San Francisco), really quashed momentum among city leaders, who were expecting the state legislation to provide adequate cover. Newsom, a former San Francisco mayor, surely knows about the open-air drug dealing and drug use that has occurred on city streets for years, so not supporting Wiener's legislation was a head-scratcher (it was more likely a cautious move in case he runs for president).

Safe consumption sites are up and running in New York City — operated by nonprofit OnPointNYC — and they have proved effective and have the support of Mayor Eric Adams. As Ronen stated, "There are enough barriers to open safe consumption sites as over 150 cities have done around the world without creating additional local obstacles." She added that she looked forward to swift board action repealing the 2020 ordinance so that safe consumption sites, which she referred to as wellness centers in San Francisco's hardest hit neighborhoods.

City Attorney David Chiu is also on board — his office defends the city, and while he also supports safe consumption sites, the city could have opened itself up to liability if it operated them. "To save lives, I have fully supported a nonprofit moving forward with New York City's model of overdose prevention centers," he stated.

It's heartening to see this development. Now, once the supervisors repeal the old ordinance, qualified nonprofits should be given the necessary directives so that they can get these centers up and running soon.

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