Needles, sharps containers, metal tins for cooking heroin, alcohol wipes and fentanyl detection strips are some items used at San Francisco harm reduction sites. (Kevin N. Hume/The Examiner)
Needles, sharps containers, metal tins for cooking heroin, alcohol wipes and fentanyl detection strips are some items used at San Francisco harm reduction sites. (Kevin N. Hume/The Examiner)

Needles, sharps containers, metal tins for cooking heroin, alcohol wipes and fentanyl detection strips are some items used at San Francisco harm reduction sites. (Kevin N. Hume/The Examiner) Needles, sharps containers, metal tins for cooking heroin, alcohol wipes and fentanyl detection strips are some items used at San Francisco harm reduction sites. (Kevin N. Hume/The Examiner)

SF experiments with sobering center as new solution to drug crisis

Methamphetamine is a dangerous drug, potentially triggering destructive, dangerous behavior that poses a threat to the well-being of users and others.

A meth high can result in some pretty bad outcomes. A trip to the emergency room. Or a ride in the back of a police car. At worst, it can lead to an accidental overdose, which killed more than 700 people in San Francisco last year alone.

But San Francisco’s first hard drug sobering center, opening in SoMa this fall, hopes to provide a new solution, resulting in better outcomes.

Anyone under the influence of meth, fentanyl or other substances will be able to sober up safely and connect with services.

This concept isn’t new. Sobering centers focused on alcohol use have been successful in cities such as Houston, Seattle and Portland.

The SOMA RISE Center will be the first of its kind to focus on the experiences of people using drugs.

“The differences between an alcohol sobering center and this program are considerable, particularly when we consider the differences in how alcohol and street drugs are regulated in our society, and the significant stigma that remains around drug use,” said Gary McCoy, spokesperson for HealthRight 360, the health services provider that will operate the program.

While scientific research on sobering centers’ efficacy remains thin, anecdotal evidence suggests they can be an effective intervention in combating substance use and addiction.

The Houston Recovery Center, for example, has reduced the number of arrests for public intoxication, and more than 2,000 people have enrolled in its 18-month recovery program over the last eight years, according to Leonard Kincaid, the executive director.

Here in San Francisco, the alcohol sobering center on Mission Street has served thousands of people since opening its doors in 2003. Shannon Smith-Bernardin, president of the National Sobering Collective and a registered nurse who has helped to run the Mission Street sobering center, says about two-thirds of people who come into the facility just once per year are currently experiencing homelessness. Of repeat clients, though, that number jumps to about 97 percent.

SOMA RISE will occupy a formerly vacant office space at 1076 Howard St. It will be open 24/7 with 20 private beds exclusively for residents of SoMa and the Tenderloin, the two neighborhoods most ravaged by The City’s ongoing drug crisis with the highest rates of overdoses.

It’s currently only funded as an 18-month pilot, but if deemed effective, The City might expand the program with more neighborhood-based clinics.

“We need 10 times more beds than we currently have, at minimum, and these beds being low access,” Smith-Bernadin said.

According to some experts, a few key elements help to make these programs effective.

Chief among them, the availability of peer support. These are people who have first-hand experience with substance use or addiction themselves, often having lived on the streets as well. They can relate to clients without judgment, and they engender trust and respect between the system and the individual.

SOMA RISE Center will employ staff who have experienced homelessness, incarceration and drug use. All employees will be trained in trauma-informed care and de-escalation.

Experts say it’s key that clients are treated with respect and humanity. That’s not to say clients can act however they want, but good behavior should be encouraged in a compassionate as opposed to punitive manner.

“We want people to be the best they can be,” Smith-Bernardin said. “There’s an assumption many people make that sobering centers are dangerous or clients are violent all the time because that’s how they see them in the ER or jail, but that’s because they’re not being treated well.”

Finally, be quick to use the opportunity to talk with someone about their options moving forward.

“Sobering centers have really become this unique concept that I like to think of as being the tip of the spear,” Kincaid said. “We are able to offer individuals an opportunity to examine their behavior.”

Smith-Bernardin calls the transition from center to social services a “warm hand-off” because staff can help a person struggling with homelessness, substance use disorders or mental illness directly connect with a person on the other end of a complicated, hard-to-navigate system.

She says this education goes both ways, too.

“Help to educate providers across The City of who the clients are as people,” she said. “Help to educate the rest of the health system that these are people who have substance use disorders.”

SOMA RISE was first included as part of the Mental Health SF legislation, a sweeping proposal passed in 2019 to address the dual mental and behavioral health crises in San Francisco. It’s considered a key part of The City’s new strategy to help people experiencing homelessness and struggling with addiction by using social services workers as first responders, as opposed to law enforcement.

“We’re trying to take a different approach, to understand that drug use is not a criminal problem. Drug use is a health problem,” said State Sen. Scott Wiener, who helped secure $4.2 million in state funding to complement the $2 million in local dollars. “So let’s try health interventions and help people get stabilized, and hopefully they’ll stop or maybe use less or use more responsibly.”

A person can arrive at SOMA RISE in two ways: self check-in or brought in by one of The City’s street outreach teams or emergency services. Officials estimate they’ll stay for anywhere from four to 12 hours.

Clients will be monitored as they detox, but they can also access clean showers, food and hygiene materials; obtain harm reduction supplies; and receive health assessments. They can also connect with housing, treatment and other social services.

“The fact that we are serving people who use drugs, in this time of ever-increasing fatal overdoses means that we also have to focus heavily on overdose prevention, and continue to educate drug users about ways to prevent fatal overdoses,” McCoy said.

Officials also say this type of program will lower the costs borne by taxpayers and free up valuable emergency and law enforcement resources to handle situations that fall more directly into their purview.

“I want our police officers addressing crime in San Francisco. I want our fire department focusing on the broad safety needs of our community,” Wiener said. “Making it easier to bring a person to a center or for a person to walk into a sobering center is going to save a ton of money for the taxpayer and benefit the person who is using.”

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