SAN FRANCISCO—The current state of the United States’ opioid epidemic has prompted more cities across the nation to open up the discussion of opening safe injection facilities, as medical professionals become more outspoken in support of the treatment strategy. There are nearly 100 such facilities around the world. Seattle, Washington is also considering safe injection facilities like San Francisco. 

Vermont announced a task force last month to examine opening a safe injection site in Burlington, and the Massachusetts Medical Society is voting later in April to take an official position in support of safe injection facilities. The Drug Policy Alliance has shown support in cities across the nation to open safe injection sites. A poll from voters in San Francisco last year showed support of more than 70 percent.

There are an estimated 22,000 intravenous drug users in San Francisco. San Francisco Board of Supervisors President London Breed introduced legislation last week to have the Department of Public Health convene a task force over the next 3 months to study opening the facilities in locations like the Tenderloin District.

Medications like methadone or buprenorphine, which San Francisco’s Homeless Outreach Team hands out to addicts on the street, can offer help and support in the endeavor.

The city’s own examination of the issue comes as Bill AB186 was recently introduced by California Assemblymember Susan Talamantes Eggman, D-Stockton, and co-authored by state Senator Scott Wiener that would lift barriers for local municipalities to open safe injection sites by legalizing drug use in such facilities. Drug users would be allowed to inject drugs onsite under the supervision of health care professionals to ensure they are using clean equipment, do not overdose and receive the counseling they need to curb the addiction.

San Francisco has experienced a steady number of drug overdoses from opioids, cocaine and methamphetamine each year during the past decade of about 175 deaths, though numbers do show that opioid overdose deaths declined between 2015 and 2016 with the increased use of naloxone.

The Drug Overdose Prevention and Education (DOPE) Project, which works to reduce overdose fatalities in San Francisco, reported an increased number of opioid overdose reversals by lay people with naloxone each year with 886 in 2016, according to the DPH. Fatal heroin overdoses in San Francisco decreased from 120 in 2000, to about 30 in 2014. The bill has been opposed by several law enforcement groups, including the California Police Chiefs Association.

A study published in the Journal of Drug Issues in December 2016 indicated that the safe injection model, Insite in Vancouver, Canada has an operation of 13 booths for clients operating 18 hours per day. The same idea was applied to San Francisco. The study found that “the supervised injection facility would prevent 3.3 cases of HIV and 19 cases of hepatitis C virus per year, reduce skin and soft tissue infection hospital stays by 415 days annually, save an average of 0.24 lives per year, and facilitate 110 people to enter medication-assisted treatment.”

With the injection sites in place, the city could see about $6.1 million in health savings, and the facility would cost $2.6 million, a net savings of $3.5 million, according to the study.

The bill has official support from nearly 40 groups, including several in San Francisco, such as the Drug Policy Alliance, HealthRight 360, San Francisco Homeless Coalition, the Glide Foundation, the Gubbio Project, San Francisco AIDS Foundation, St. Anthony Foundation, Saint Francis Foundation and St. James Infirmary.

A similiar bill was proposed, but denied in 2016. The newest bill was approved by the Assembly Health Committee in a 9-4 vote in March 2017 after it was amended to sunset in January 2022. The bill is limited to the counties of Alameda, Fresno, Humboldt, Los Angeles, Mendocino, San Francisco, San Joaquin and Santa Cruz. The Assembly Public Safety Committee will vote April 18 on the bill.