Safer Consumption Sites (also referred to as Safer Injection Facilities, Overdose Prevention Programs, Supervised Consumption Services) have been a hot topic nationwide, but especially here in San Francisco. There are over 25,000 people who inject drugs in San Francisco alone and the overdose crisis has only worsened during the COVID-19 pandemic. Many see the rising overdose statistics as a result of fentanyl, despite it being prevalent on the West Coast since around 2014. Those working in drug policy, harm reduction and general substance use tend to recognize that overdose rates rising during quarantine has more to do with resources (including housing, mental health, harm reduction and hygiene) being ripped away from our communities rather than the drug supply itself.
More lives have been lost to overdose than to COVID-19 both last and this year, according to data from the San Francisco Department of Public Health. San Francisco nonprofits, grassroots organizations and community members gather to push for more to be done. Safer Consumption Sites (SCS) work by having naloxone, oxygen and medical staff available to minimize overdose risks. SCS also provides a safe and clean place, without stigma or the pressure to rush. In addition to issues of safety regarding overdose death prevention, SCS offer several other benefits to people who use drugs and to our communities such as reducing public and visible drug use; reducing risk for abscesses, endocarditis and bacterial infections; reducing risk of infection diseases including Hepatitis C and HIV; reducing improperly discarded syringes; decreasing surrounded criminal activity; improving linkage to other services and resources; encouraging marginalized communities to accessible healthcare; and, of course, one of the most swaying benefits to the City and County: saving millions of dollars in medical expenses.
There are over 120 SCS operating worldwide successfully. Evidence has shown SCS have consistently been effective at reaching their goals including reducing death and harm, reducing public drug use and connecting clients to further services. Also, it has been shown that these sites do not lead to increased crime or injection drug use, but rather the opposite. Most importantly, to this day there have been no instances of overdose deaths in any SCS worldwide. In spite of overwhelming evidence, critics grasp onto myths that people who use drugs won’t use the services provided, that the money is better spent on punitive approaches, or that SCS will cause an increase in neighborhood loitering and crime.
It has been a long and arduous fight for SCS in San Francisco. The first city-wide symposium on SCS was the Alliance for Saving Lives in 2007 at The Women’s Building. The policy fight for SCS began as AB 362 introduced by Susan Talamantes Eggman, before more or less becoming Senate Bill 57 (often referred to as Scott Wiener’s Overdose Prevention Program). The postponement of SB 57 pushed this demand for a call for a public health state of emergency, which brings us to today.
Demonstrations and policy demands have been championed by the Safer Inside Coalition, a collection of local nonprofits comprising HealthRight360, The Gubbio Project, San Francisco AIDS Foundation, GLIDE Memorial Church and St. James Infirmary. Advocacy work done so far has included demonstrations across the city on Overdose Awareness Day, mobilization at City Hall (including a hunger strike by Gary McCoy as well as a die-in), teach-ins, film screenings and public comment to supervisors. Supervisor Matt Haney has provided tremendous support. His office drafted the resolution calling for a public health state of emergency. The Board of Supervisors voted unanimously to support it and urged the mayor to as well. Ideally, declaring a public health state of emergency will push this movement forward by demonstrating strong local support for public health measures rather than criminalization.
There are many ways to get involved and show support in this movement. Organizations and coalitions such as Safer Inside Coalition, San Francisco AIDS Foundation’s HIV Advocacy Network and Yes to SCS California offer updates, petitions and further resources. Being active in community meetings and general conversations is another helpful way to have your voice heard. Anytime issues come up around HIV and Hepatitis C, homelessness, harm reduction, hygiene and/or mental health, bring up and tie in the discussion in your public comment to SCSs and normalize those intersections. Finally, the simplest way to get involved is to empower and educate yourself around harm reduction and harm reduction culture.