The San Francisco Department of Public Health estimates there are 22,000 intravenous drug users in San Francisco. That’s well over twice our homeless and unhoused population — and, not everyone who is homeless is a person who injects drugs. Let that sink in. There are thousands of people who are currently housed and inject drugs — putting them at risk of becoming homeless at some point during their active addiction.
Supervised injection facilities are controlled health care settings where people can more safely inject drugs under clinical supervision and receive health care, counseling and referrals to health, mental health and social services. These facilities generally offer access to drug detox programs and substance abuse treatment resources and programs, and prevent fatal drug overdoses.
I support supervised injection facilities, and it’s time San Francisco join the more than 65 cities worldwide that currently offer supervised consumption services. I also support Assembly Bill 186 introduced by Assemblywoman Susan Eggman, D-Stockton, and co-authored by state Sen. Scott Wiener, D-San Francisco, which would clear state hurdles to make these a reality.
These facilities are not only critical to public health and saving lives, they significantly prevent transmission of HIV and Hepatitis C. From a neighborhood safety perspective, studies show they reduce public disorder, street-based injection drug use, syringe litter and discarded syringes. They do not increase drug sales or drug-related crime.
I recently celebrated an annual milestone in my recovery from crystal meth addiction — another year of not touching alcohol or any illegal substances. For me, complete abstinence is a choice I made for myself, though abstinence hasn’t always been my recovery path. I chose abstinence after dipping my toe in the harm-reduction pool on several occasions over many years. Harm-reduction is what planted the seed that recovery from addiction was attainable, and I’ll always be grateful for that.
My personal experience as a homeless drug addict with untreated AIDS, to my eventual recovery and passion for advocacy, is not uncommon. The person I have become since turning my life around is not the same person I was a decade ago, and the person I was a decade ago does not define who I am today.
During my active addiction, I was a person who injected drugs for well over 10 years. Every single day. I remained in near-total isolation during much of my using years for fear of being criminalized. I skipped out on appointments with my primary care physicians. I experienced severe mental health challenges compounded by my addiction. I went years with untreated HIV, even after my AIDS diagnosis. I was treated for many blood infections and staph infections, always finding myself back in the emergency room at San Francisco General Hospital without insurance. After a Kaposi’s Sarcoma diagnosis, I began taking anti-retroviral medications, but found it increasingly difficult to remain adherent to them as a result of my drug addiction. My challenge with adhering to daily medications caused a resistance to multiple anti-retroviral regimens. Whenever I did get the courage to be around the functioning public, I visited needle exchange programs for new syringes, and later in my addiction I visited “Wellness Wednesdays” — a testing and needle exchange program with folks from the San Francisco AIDS Foundation.
To be very clear, substance abuse is an epidemic. Addiction does not discriminate, and no age, race, gender or sexual orientation is excluded. Addiction can come in many forms — including both illegal substances and prescription medications. We have the studies and research, and it’s time we implement this tool and add it to our arsenal.
In recent years, I have had the extraordinary honor of serving as a Legislative Assistant to several members of the San Francisco Board of Supervisors. I have served, and continue to serve, on multiple city commissions and advisory committees, nonprofit organizations and democratic clubs. I married my soulmate and best friend. Over time, I was fortunate to have the ability to come off of federal and state disability benefits and go back to working a full-time job. I hold various commitments in the recovery community and mentor others. I give back to every inch of this community that kept me alive when I didn’t know how to take care of myself.
We can recover when we have the resources, support and opportunities to succeed. Thanks to Laura Thomas and her years of work on this initiative, and to board President London Breed for listening to the community and public health experts — and putting forward a task force to look at the positive impact supervised injection facilities can have in our city.
Gary McCoy is a homeless advocate and HIV and AIDS activist.