Important note: Information in this article was accurate in 2007. The state of the art may have changed since the publication date.
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San Francisco Examiner - October 19, 2007
Alexandria Rocha, arocha@examiner.com
"Nobody twisted my arm," she said, holding an unlit, unfiltered cigarette outside the Women's Building in the Mission district Thursday. "I was curious."
Now 54, Schwartz has been clean for five months. It's not the first time - she has struggled with heroin addiction for the last 40 years. She is also battling MRSA - a drug-resistant, often-deadly bacteria - and is using a wheelchair.
On Thursday, Schwartz shared her story with a packed room of health officials to voice her support for what is sure to raise a national firestorm - creating a government-sponsored facility in San Francisco where users can inject drugs, including heroin, methamphetamine and crack cocaine, to battle The City's high incidence of fatal drug overdoses.
The discussion was spurred by the Thursday symposium, co-sponsored by the San Francisco Department of Public Health, on the only such "safe injection" facility in North America, a four-year-old Vancouver site where an estimated 700 intravenous users per day self-administer narcotics.
At these facilities, addicts are allowed to bring drugs and shoot up under the supervision of a medical staff. "We are exploring the pros and cons of this," said Grant Colfax, director of HIV prevention for the Department of Public Health. "Our main goal is to get drug users into treatment."
Alex Kral, director of the Urban Health Program for the research institute RTI International, said there are 18,000 injection-drug users in San Francisco. About 80 percent of them use heroin, he said, while the rest use methamphetamine and crack cocaine.
According to San Francisco Fire Department Capt. Niels Tangherlini, about one in every seven calls to San Francisco paramedics from July 2006 to July 2007 was a drug overdose.
Along with Vancouver, nearly 30 other cities across the globe operate such safe injection sites. No facility exists in the U.S., experts said. This is the first time San Francisco has considered it, said Hilary McQuie, of the Harm Reduction Coalition, an advocacy group for alternative drug treatments.
Supporters of the sites say they reduce crime, the number of discarded syringes on the streets and the number of addicts shooting up in public. Critics, however, say they send the wrong message and could increase drug use.
"It could exacerbate the problem," said Howard Epstein, spokesman for the San Francisco Republican Party. "I think it will mean that people who are saying, æBoy, it's going to be tough, I got to go hide, now I can just go down there to do it.' It takes the pressure off them to clean up their act. It's acceptance."
Epstein also said finding an appropriate location would be a difficult task. So far, the idea is only in the discussion phase - no proposals have been approved and no sites have been identified.
"It's really not a black or white issue," said Katie Bouche, with the San Francisco AIDS Foundation. "People are going to inject whether they do it safely or not. Needle exchange started as a radical idea when it came up."
The City's users
18,000 injection-drug users in San Francisco
80 percent of S.F.'s addicts use heroin; others use meth and crack cocaine
More than 60 percent are homeless
9 in 10 have hepatitis C
8 in 10 have hepatitis B
3 in 10 have soft-tissue infections, such as abscesses
1 in 8 overdose each year
1 in 10 have HIV
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