San Francisco moves toward opening a safe drug use site

Many hurdles remain before it’s up and running

For years, San Francisco’s quest to open a safe drug consumption site has been more talk than action.

Officials such as Mayor London Breed reiterated support for these sites — where people can use drugs under the supervision of health care professionals who can reverse overdoses — but were wary of moving forward without the approval of the state and federal governments.

Now, that’s starting to change. Following an October vote by the Board of Supervisors urging Breed to use her emergency powers to open a safe consumption site, The City is moving quickly to acquire a building in the Tenderloin that could house the site. Officials are also working out the legal and logistical details of its operation.

The two safe consumption sites New York City opened in November — which so far have not been shut down by federal officials — have increased the pressure on the federal government to provide clarity on their legality. And a bill from State Senator Scott Wiener could pave the way for California to legalize safe consumption sites by the start of 2023.

Still, many challenges remain to getting one or more of these sites up and running in San Francisco, where 545 people died of overdoses between January and October.

On Wednesday, the Board of Supervisors’ Budget and Finance Committee voted unanimously to acquire 822 Geary St. and an adjacent lot that could house a safe consumption site. The matter will go before the full board for approval Tuesday, where it’s expected to pass.

The path from there is less clear.

The agency in charge of opening a safe consumption site is the Department of Public Health (DPH). In a statement, a department spokesperson wrote that The City “remains in the exploratory phase of opening a safe consumption site.” The department is “considering” using the space at 822 Geary as both a safe consumption site and as a crisis diversion unit, which would provide 15 behavioral health beds. The $6.3 million purchase price for the site would come from Prop. C, The City’s tax for homelessness services passed in 2020.

DPH is planning to host community meetings and provide other opportunities for the public to weigh in on its plans for 822 Geary, which so far have taken place largely behind closed doors. While city officials had previously targeted an opening date as early as next spring, at Wednesday’s Budget and Finance committee meeting DPH staff reported the facility could be open by September.

In parallel, City Attorney David Chiu has begun reaching out to federal and state officials regarding a safe consumption site in San Francisco, and is advising the mayor on how to proceed, according to his spokesperson, Jen Kwart.

Clarity could be coming soon, with a Department of Justice brief expected by Jan. 5 on a safe consumption site case out of Philadelphia. Also in January, Wiener intends to reintroduce SB 57 in the state legislature, a bill held from last year that would legalize safe consumption sites in California’s big cities, his office confirmed. If passed, the bill — the latest in a long line of attempts to legalize safe consumption sites at the state level — wouldn’t go into effect until January 2023.

Already, the location of the proposed site in San Francisco, and The City’s communication around it, have sparked criticism.

Randy Shaw, executive director of the Tenderloin Housing Clinic, and an occasional Examiner contributor, supports safe consumption sites, but opposes the Geary location. Glide Memorial Church, or another existing needle exchange closer to the heart of the Tenderloin, would make more sense, he said. Shaw also said the location tracks with the Tenderloin’s history as a “containment zone” for drug use.

“This idea that the Tenderloin is the right place because that’s where the drug dealers are — I mean, that’s where The City put the drug dealers,” Shaw said.

But for harm reduction advocates, the site on Geary is just a first step. “​​In order for this program to be successful, there has to be more than one site,” says Gary McCoy, policy director at the nonprofit HealthRIGHT 360, who previously held a hunger strike advocating for The City to open a safe consumption site. “One site would not cover the capacity necessary to prove successful and to actually save the lives that we need to save.”

Data from the Office of the Chief Medical Examiner indicates the Tenderloin is a good place to start. Data shows that 21% of The City’s drug overdose deaths in 2021 took place there — more than any other neighborhood — with another 17% in adjacent Nob Hill, close to the proposed site at 822 Geary.

While San Francisco proceeds carefully, outgoing New York City Mayor Bill de Blasio offers another template: daring the federal government to shut down that city’s safe consumption sites in a year when the U.S. recorded 100,000 overdose deaths. De Blasio “just didn’t care about the NIMBYism because this is an emergency,” McCoy said. “I don’t think anybody wanted to be first, but I hope New York City motivates everyone else that has wanted to do this.”

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