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SAN FRANCISCO – San Francisco Mayor Daniel Luley, who won the election in November on a pledge to crack down on the city’s fentanyl crisis, announced on Wednesday a new public health policy that will force drug users to more forcefully push them for clean needles and other supplies that have been linked to addiction.
The new policy for implementation on April 30 shows a dramatic shift from the strategies San Francisco has been using in recent years to encourage overdose.
For years, San Francisco and other cities have driven the growth of community programs that provide what is called harm reduction services. Such programs are generally targeted to homeless people suffering from addiction and send street workers to distribute sterile syringes and clean smoking kits (foils, pipes, straws, etc.) with the aim of preventing infectious diseases such as HIV and hepatitis. Many such programs also distribute Narcan, a drug that rapidly reverses the effects of opioid-type forms.
The harm reduction approach has solid advocates who say this strategy will help protect drug addicts until they are ready to commit to treatment. Some tired critics say that the concept of “meeting an addict” has not been proven to be effective enough to seek treatment from people or reduce mortality.
During a press conference at City Hall, Lurie said the era of San Francisco distributing drug supplies without “end” people, and the overdose crisis that has been fueled to fentanyl, mandating a more aggressive response.
“There’s a lot to do in this town,” Lurie said. “We see people suffering from addiction. We see people dying from overdose. And we have to make a change.”
Under the new policy, city staff and nonprofits receiving city funds are prohibited from handing out sterile syringes and other supplies unless they are actively working to connect people with treatment and counseling. The policy prohibits workers from placing smoking items on the streets, in parks and other public spaces, and instead requires that such handouts be implemented indoors or in city-approved locations. The rules regarding the distribution of clean syringes in public places remain unchanged.
“We’re excited to be able to help you get started,” said Daniel Tsai, director of San Francisco Public Health.
The tougher restrictions are that last month, prompting the Trump administration to cancel federal grants for billions of people to fund mental health and addiction services across the country. The prospect of a significant cut in federal funding for community-level services is particularly worrying for San Francisco leaders, who have been facing a fiscal deficit of nearly $1 billion since this year.
Lurie, who has generally avoided talking about Trump for the first few months of Trump’s office, said his administration will “focus on what we have control now.” Over the past few weeks, he has announced a series of policy shifts to keep San Francisco away from what critics and many voters recognize from the soft approaches to block open drugs and drug use that plagues some neighborhoods, including downtown and Tenderloin and market districts.
Shortly after taking office in January, Lurie joined forces with the Board of Supervisors to pass measures that gave him more power to bypass the bureaucratic hurdles that slowed the expansion of shelter and treatment programs for the homeless, as well as more bureaucratic hurdles to pursue private funds to fund those initiatives.
He works to open a 24/7 “stabilization centre” in the heart of Tenderloin, where police can drop off people in need of medical care. He is also moving forward with the campaign promise of opening another 1,500 treatment beds.
Lurie’s early efforts have surprised frontline street workers who say they are abandoning strategies to effectively prevent overdose.
Tyler Turmoore, CEO of the San Francisco AIDS Foundation, warned that the new policy could cause more people to inject smoking drugs, increasing the likelihood of overdose of infectious diseases.
“The San Francisco AIDS Foundation is solid in the knowledge that providing people with information and resources they need to take care of themselves, including safer supply, treatment, and counseling services, is best suited to the health of those who use the substance,” Termere said.
Lurie’s office said the public health sector will “ensure that this policy is consistent with overall public health goals” by transmitting overdose rates and HIV and hepatitis C.
Lurie and Tsai admitted that implementing a new approach is not easy. For one thing, the city is not close to the treatment beds enough to accommodate all those in need. And the rules don’t end up forcing people to be treated. Still, Lurie said San Francisco has to overturn the status quo despite expanding its capabilities in treatment and interim housing.
“What we’re doing isn’t working,” Lurie said. “I’m not going to sit down and take action.”
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