Drug-injection facility still sparks debate in San Francisco

A year ago, the San Francisco Public Health Department, the Alliance for Saving Lives and a consortium of community members gathered to discuss the idea of opening a legal injection facility.

San Francisco's Tenderloin district — home to many drug users, as well as families and children — has been identified by officials as the most likely location of the Safer Injection Facility. But residents are concerned about the impact of a state-sanctioned center for drug use in their neighborhood.

The resistance doesn't surprise Capt. Gary Jimenez of the Police Department's Tenderloin station.

"I do know that on the issue of a safer injection facility, many people in the community are saying, 'Good, but not in my neighborhood," he said.

While Jimenez concedes that the Tenderloin would be an ideal site because of its high rates of injection-drug use and lethal overdose, he would rather see the center elsewhere.

"But I think the folks in Pac Heights and Bay View would say 'No thank you" he said.

Some Tenderloin residents have suggested incorporating the facility into existing social service programs.

"Instead of creating an entirely separate institution, there already are a number of services that this can be rather smoothly implemented into," said Lauren Enteen, a manager for the Harm Reduction Coalition, a member of the Alliance for Saving Lives.

The Tenderloin district is home to some 3,500 children, some who are frequently exposed to drug use near their schools and playgrounds. According to Jimenez, the injection facility would alleviate that problem by providing a sanctuary for those who inject on the city's streets and alleys, as well as a safe place to dispose of syringes.

"None of us want to shoot out here in front of kids," said Adam Archie, of San Francisco, a homeless drug user. "If we had a place to shoot, then we'd also have a place to put our dirty needles, which is a problem out here."

Supporters point to the success of injection facilities that have operated in Europe and Australia for more than 20 years, starting with Switzerland in 1986, and most recently in Vancouver, British Colombia, where the Insite facility was established in September 2003.

"Studies in Vancouver show that people are more likely to engage in other services once they've used the injection facility," Enteen said. "We've seen less public injection, fewer fatal overdoses, less public disposal of syringes and more people trying to get clean. You just can't argue with Vancouver's findings."

The Canadian facility consists of three levels: the first floor is a safe injection center, the second a detoxification center, and the third a rehabilitation center. The idea is that clients will move up in the center, entering as drug users and eventually leaving clean.

According to figures presented at last year's symposium, hundreds of overdoses have occurred at the Insite facility yet resulted in no fatalities because medical staff were standing by. Additionally, users of the facilities aren't allowed to share needles, reducing the spread of hepatitis C and HIV.

The city of Oakland has funded the Casa Segura Needle Exchange program for 17 years, but hasn't discussed an injection facility.

"We'd probably wait to see what happens in San Francisco, and then there will be a precedent set," said Joy Rucker, executive director of Casa Segura. "Oakland just isn't as progressive as San Francisco in terms of looking at a public health model for injectors."

Dr. Paul Quick, a physician involved in the care of homeless people in San Francisco, said many of the city's homeless drug users suffer from underlying mental illnesses. For these individuals, the injection facility not only would address their addictions but also their mental health needs.

"When you have a facility that people can use safely, you stand on better moral ground as a community to demand that people not use on the street." Quick said. "It's simply not acceptable for society to let addicts use on the street and die."

Source: Philip Hoover, The Oakland Tribune, 27/12/2008