On a public sidewalk in the Civic Center Friday afternoon, a man prepared to shoot a syringe loaded with cocaine into a vein bulging below the leather belt tied around his upper right arm.
He ordinarily shoots “Cris,” another name for crystal methamphetamine, but he couldn’t find his usual dealer that day.
“I don’t like cocaine,” he said. “It’s not that I don’t like it. It’s not my drug of choice.”
He had a silver spoon, where he prepared the drug, along with multiple needles and a kit of other drug paraphernalia, laying on the waist-high cement wall behind the Asian Arts Museum, at Hyde and McAllister streets, near the Main Library.
“The first time I shot I was 19 years old,” he told the San Francisco Examiner. He is now in his 30s, though he declined to share his exact age and said he went by the name of Vegg Odinsson.
Odinsson was aware of San Francisco’s ongoing debate about whether to open safe injection sites. “I am all in favor,” he said, “because it’s very stressful doing this out here and people fuck with you.”
He said he would “absolutely” use the services and was able to stay sober for four and a half years at one point.
He examined the needle full of a clear liquid. He wondered how it would affect him. “Very thick. Very thick. So it’s going to ring my bell hard. It might even send me into a flop. We will see how it goes.”
Over the years, he said he has managed to stay disease-free. “I have good habits,” he said. “My blood test is clean. I am going to keep it that way.”
He obtained his syringes and other supplies to reduce his risk of disease from the AIDS Foundation’s Harm Reduction Center on Sixth Street.
He began his “ritual.” He took deep breaths “to have proper vibes and shit” and then, despite passersby and wind gusts, created a sense of peace around him before he injected the needle.
Setting sights on being first in the nation
That Harm Reduction Center where Odinsson obtained his equipment could become the first safe injection site in the U.S.
“As we continue to look at meeting the health care needs of substance users and given our success in serving this community, I believe that the Harm Reduction Center would be a good site to pilot safer consumption services, should The City support those services through one site or multiple sites,” Joe Hollendoner, the San Francisco AIDS Foundation CEO, told the Examiner on Friday.
That would mean Odinsson, instead of injecting his drugs on the street, could engage in the activity within the confines of a facility that provides medical care and other services to help addicts. Ultimately, helping him off of drugs altogether would be the goal.
People who go to the site now “can safely dispose of used works, and access sterile injection supplies, HIV and Hepatitis C testing, linkage to care, treatment adherence support and a host of other services that help them address the life challenges they face,” Hollendoner said.
Safe injection sites recommended
San Francisco should operate multiple safe injection sites in conjunction with social services in neighborhoods where drug use is most prevalent, The City’s Safe Injection Task Force recommended Friday.
The recommendation moves San Francisco closer to becoming the first U.S. city to open safe injection sites, although there are about 100 operating in 65 cities around the world.
“The task force’s overarching recommendation is to support the operation of safe injection services in San Francisco,” the report says. “The rise in public injection drug use and its harmful public health and safety outcomes has long reached critical mass in The City, and this urgency is commonly felt by members of the task force and San Francisco residents alike.”
Safe injection sites allow people to inject drugs under medical supervision. Studies show they prevent overdoses, reduce the spread of HIV and Hepatitis C, increase proper disposal of syringes and connect people to services to help them ultimately recover from their drug use.
The task force also recommends “operating multiple safe injection service sites in neighborhoods where public injection drug use, overdoses and improperly discarded syringes most often occur.”
About 22,500 people in San Francisco inject drugs like heroin and methamphetamine, according to a 2015 estimate, mostly in the the Tenderloin, South of Market, Mission and Bayview-Hunters Point neighborhoods.
The effort suffered a setback when Assembly Bill 186, which would have allowed a handful of counties including to San Francisco to legally operate safe injection sites under state law, failed to pass out of the state Senate. The bill’s authors plan to try again next year.
But supporters of safe injection sites argue The City should still proceed.
“We’re hopeful that the issue will continue to be discussed and that The City may explore innovative, legal ways to offer these life-saving services,” Hollendoner said.
He noted The City was “among the first cities to legalize syringe access decades ago.”
In the 1980s, California law prohibited needle exchange programs, but The City defied state law by declaring a state of emergency and funding programs that handed out clean needles to intravenous drug users to reduce HIV infections. Needle exchanges became legal in the state in 2000.
The task force acknowledges the legal challenges. “In order to proceed with operating safe injection services, San Francisco must be deliberate in formulating a way forward for local agencies, community organizations and building owners that includes local protections and procedures to respond to potential legal repercussions,” the task force recommends.
Other recommendations include making sure the sites are a “welcoming space for people who inject drugs” and include “on-site services and linkages to other services.”
Board of Supervisors President London Breed, who called for the creation of the task force, said in the report that “it is simply not enough to provide voluntary detox services or clean syringe exchanges.”
“We need to provide a robust continuum of care and a welcoming environment for those struggling with drug abuse,” Breed continued. “We need a one-stop-shop of wraparound services that provide hope for a healthier life and opportunities for rehabilitation. Safe injection services could potentially provide that opportunity.”
Mayor Ed Lee is open to the idea. “The mayor will review the recommendations of the task force and looks forward to working with the Board of Supervisors and the community on this issue,” the mayor’s spokesperson Ellen Canale said in an email Friday.
The task force recommendations will undergo a hearing Wednesday before the Board of Supervisors’ Public Safety and Neighborhood Services Committee.