Editorial: SFAF should rethink overdose messaging

  • by BAR Editorial Board
  • Wednesday June 14, 2023
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Supervisor Matt Dorsey said the needle and police car images on this poster are problematic.
Supervisor Matt Dorsey said the needle and police car images on this poster are problematic.

We fully support the San Francisco AIDS Foundation's expressed interest in helping to run an overdose prevention center, now dubbed wellness hubs, in the South of Market neighborhood, one that has been hard hit by substance use and desperately needs programs where people can safely use drugs while also being apprised of available services to treat their addictions. But we think SFAF stumbled last week when, at a rally for HIV funding in the city budget, some people held signs urging the funding of overdose prevention sites that included the image of a police car with the word "Death" underneath it. It was on a mock scale of justice that, on the other side, featured an image of a syringe and Naloxone, an overdose prevention drug, with the word "Life." As gay San Francisco Supervisor Matt Dorsey, whose District 6 includes SOMA, wrote in a letter to SFAF, the messaging endangers law enforcement officers and drug users alike.

"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," Dorsey wrote to SFAF CEO Tyler TerMeer, Ph.D., and board President Maureen Watson.

There is broad support among San Francisco leaders for overdose prevention centers. Mayor London Breed has called for $18.9 million in the budget for three wellness hubs, though that does not include funding for drug consumption sites. She previously worked to get a safe consumption site established, but that was thwarted by Governor Gavin Newsom (D), who last year vetoed a bill that would have allowed a pilot program of safe consumption sites in San Francisco, Oakland, and Los Angeles. Federal law also prohibits such services, and City Attorney David Chiu has argued that public funding cannot be used for such facilities.

That means it's up to nonprofit organizations to use private funding for such programs. SFAF would be the primary partner for the SOMA wellness hub, while HealthRIGHT 360 and the Gubbio Project, together with Saint John the Evangelist Episcopal Church, were mentioned in Dorsey's letter as the primary partners for the Tenderloin and Mission wellness hubs, respectively.

Yet the temperature is rising, both among city leaders and nonprofits like SFAF. At Tuesday's Board of Supervisors meeting, Breed defended the policy of arresting drug users, lashing out at progressive Supervisor Dean Preston, whose District 5 includes the Tenderloin, telling him he had never lived what many Black and Brown people go through, including members of her own family, regarding drug use. At the same time, shortly after our article about Dorsey and SFAF was published online, the organization doubled down on its Facebook page, stating it "condemns new city policies to arrest and jail people using substances, attempt to force people into drug treatment, and 'crack down' on public drug dealing."

Dorsey, a long-term HIV survivor and a recovering drug addict, is in a unique position to speak out on this issue. He is also a supporter of harm reduction, which aims to reduce the adverse health effects of drug use and substance use disorder to individuals as well as to the broader community, as he wrote in his letter. He pointed out that the rest of the posters contained straightforward messages such as "End Overdose Now," "Fund Overdose Prevention Sites," "Harm Reduction Saves Lives," and "Action=Life," which is itself a message that was used at the height of the AIDS epidemic to spur government funding and action.

Dorsey's letter highlights another key point: that police are often part of the solution in helping drug users get to overdose prevention centers. He wrote that SFAF's messaging "bodes poorly for the partnership San Francisco will require for the OPCs to succeed." At OnPoint NYC, the first organization in the U.S. to launch safe consumption sites, located in Harlem and Washington Heights in New York City, Sam Rivera, the nonprofit's executive director, told San Francisco supervisors back in January that the relationship between the center and police is critical. Officers help get people to the center instead of arresting them, Rivera pointed out in remarks during a supervisors' budget committee meeting. It was the police who asked OnPoint to develop a card they could hand to a user that states they will escort the person to OnPoint. Dorsey also visited New York City and personally observed OnPoint's services, he wrote.

In his letter to SFAF, Dorsey noted the association between violence and methamphetamine psychosis. The narrative advanced by the foundation's messaging "poses potentially grave dangers to law enforcement officers as well as to drug users recklessly moved to fear them," he wrote.

SFAF CEO Tyler TerMeer, Ph.D., a gay Black man, responded that the agency's messaging was symbolic and meant to refer to the war on drugs, which indeed has resulted in greater numbers of Black and Brown people serving lengthy prison terms. TerMeer said that SFAF has had a long and productive relationship with the San Francisco Police Department, going back decades to when the foundation started syringe exchange programs. We're glad to hear that, but in the overcharged political climate today — including in San Francisco — we expect some neighborhoods to loudly protest these wellness hubs.

We think SFAF and other agencies working to open the wellness hubs should have more inclusive messaging that can't be misinterpreted. Most San Franciscans don't want open-air drug dealing and using on city streets. A significant number also seem to have reservations about wellness hubs in their neighborhoods. That's where the foundation and other organizations need to start — with messages directed at residents about why these centers would be better than the status quo. Once the wellness hubs are open, we suspect that drug users will quickly find their way to them, either through word of mouth or with the help of police or community ambassadors, who should receive training and information about how to direct a person to the facilities.

The bottom line is that San Francisco needs to establish these wellness hubs as quickly as possible. It's been almost a year since Newsom vetoed the pilot program legislation. The number of accidental drug overdoses is staggering — 268 through April, which is 72 higher than in 2022. Dorsey and SFAF should work together on clear messaging for residents — they're the ones who need to be persuaded first.

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