Bay Area Reporter - October 25, 2007
Seth Hemmelgarn

The city's Department of Public Health co-sponsored the meeting, but Barbara Garcia, the department's deputy director, said the department has not taken a position on the issue.

Speakers seemed to agree that help is urgently needed for the city's injecting drug users, but such a facility could be years away. There was consensus that wherever such a facility goes, neighbors will have to be involved.

Laura Thomas, a spokeswoman for the Alliance for Saving Lives, another sponsor of the event, said such a facility would be "a compassion and science-based response to injecting drug use."

The panelists and audience included representatives from community organizations, public health officials, and harm reduction workers.

One objective of the facility would likely be to help prevent overdose deaths. Staff would be on hand to watch for signs of overdose.

According to data from the city's medical examiner that was presented at the meeting, at least 300 people died from overdoses involving heroin from 1999 to 2004. Data for fiscal years 2000-2001 and 2001-2002 weren't available. The deaths appeared to be concentrated in the Tenderloin neighborhood.

According to Alex H. Kral, Ph.D., director of Urban Health Program at the research institute RTI International, more than 60 percent of San Francisco's intravenous drug users considered themselves homeless in 2004. Syringes that had been discarded in Golden Gate Park, where many homeless people sleep, upset neighbors and got heavy media coverage this summer.

New HIV infections among intravenous drug users have dropped in recent years. Kral said about 12 percent of intravenous drug users have HIV. However, he said, about 90 percent have hepatitis C.

Disease can be spread through sharing needles. As with the city's current needle exchange programs, the idea behind an injection site would be for people to reduce the amount of harm they do to themselves, even if they don't want to stop using drugs. The facility would make clean syringes available to users, and it would also give them a place to dispose of their used needles safely.

The facility could also offer detoxification, substance abuse treatment, urgent health care, and links to social services.

"We're talking about the basic need for people to feel connected with humanity," said panelist Dr. Barry Zevin, medical director of community offsites for the Tom Waddell Clinic.

There are 65 safe injection facilities operating in eight countries, according to the alliance. Panelist Sarah Evans is program coordinator at Vancouver's InSite û North America's only supervised safe injection facility.

Evans said the facility faced strong opposition from the community when it started being discussed in the 1990s, but since it opened in 2003, the facility has gained support from the community and many government officials.

Evans said the facility, which has been studied extensively, is working.

"The findings are conclusive," she said.

None of the 800 overdoses that have occurred at InSite have resulted in death, she said. The facility has been associated with a drop in public drug use and the number of people sharing needles. Fewer used syringes are showing up in public places, too, according to the Alliance for Saving Lives.

The alliance, a consortium of several individuals and community groups, distributed a letter for attendees to sign that was addressed to Mayor Gavin Newsom, the city's Board of Supervisors and Dr. Mitchell Katz, the city's health director. The letter urged them "to make this critical program a reality."

Nathan Ballard, the mayor's communications director, told the Bay Area Reporter in a phone interview, "At this point, the mayor is not inclined to support a program like that. It looks like it might create more problems than it would address." Ballard said the facility "could disrupt the harmony of the neighborhood it was placed in." He also said, however, "It's certainly worth having a discussion."

Those attending the symposium appeared to agree that community discussions are crucial. Offering intravenous drug users a place to inject drugs could make neighbors nervous.

"I have to face community members who may not be here today," Garcia, the deputy health director, told the sympathetic audience. "We have a lot of education we have to do with the community."

Audience member John Gilmore, who described himself as a philanthropist involved in drug policy, had a thought for people who might have a problem with the facility: "If you don't want to see this on the street, make a place for it off the street."

For more information, visit www.harmreduction.org.

071025
BR071012

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