Senator Wiener’s Legislation to Legalize Overdose Prevention Programs — Also Known as Safe Consumption Sites — Passes Assembly Health Committee

January 12, 2022

SACRAMENTO - Senate Bill 57, authored by Senator Scott Wiener (D-San Francisco), has passed the Assembly Health Committee by a vote of 9-4.It now heads to the Assembly Public Safety Committee. SB 57 legalizes overdose prevention programs, also known as safe consumption sites or safe injection sites, as pilot programs in San Francisco, Oakland, the City of Los Angeles, and Los Angeles County. The City Council or Board of Supervisors of each pilot jurisdiction has requested to be included in the legislation, and each will decide locally whether to participate and to what extent. SB 57 simply removes the state prohibition that currently makes such programs illegal.

“The time has come for an all-hands-on-deck approach to our overdose death crisis, and safe consumption sites are a proven strategy to save lives,” said Senator Scott Wiener. “Public health interventions to address this crisis exist, and they are working well in other countries. We can’t keep saying no to safe consumption sites and hope that somehow our challenges around addiction, overdoses, and mental health will just go away. They won’t, and they’re getting worse, because we’re not using every tool we have to reduce harm, save lives, and help people get connected to treatment and services. We need these programs, and today’s Assembly Health Committee hearing is a step toward getting this done.”

COVID-19 has increased the urgency to legalize overdose prevention programs, given that overdoses and substance use overall are rising significantly. For example, San Francisco saw a record number of overdose deaths in 2020, with 699 deaths total. Nationally, 100,000 people died of drug overdoses from April 2020 to April 2021, including approximately 10,000 people in California. This is a public health crisis, and it is preventable.

Overdose prevention programs — which have been in existence for years in Europe, Canada, and Australia, with proven success — are supervised facilities where those using drugs intravenously or otherwise can do so more safely, with the goal of transitioning them into recovery programs. In the decades that these approximately 170 facilities have been open in other parts of the world, not one overdose death has occurred in one of them.

Over an 18-month study period of Insite in Vancouver, 336 overdoses were reported – but in every instance, the person overdosing lived. This is because there were trained professionals onsite to administer live saving treatments like Narcan, and get people emergency help. Studies also suggest that overdose prevention programs reduce the burden on emergency services – like ambulances and emergency rooms – that traditionally respond to overdose events. 

Recent studies of an unsanctioned overdose prevention program also suggest that there is no increase in crime, violence, or drug trafficking in areas surrounding these programs. Crime actually decreased in these areas. Studies also show that overdose prevention programs lead to less injection-related litter, like dropped syringes.

SB 57 gives San Francisco, Los Angeles, and Oakland the local discretion to establish and run these programs, where adults may use their own controlled substances under the supervision of staff trained to prevent and treat overdose, prevent HIV and hepatitis infection, and facilitate entry into drug treatment and other services. SB 57 is a pilot program that will run for five years, through January 1, 2028.

San Francisco’s Mayor and Board of Supervisors have repeatedly requested this authorization. Oakland’s Mayor and City Council requested last year to be included. The Los Angeles County Board of Supervisors voted unanimously to support SB 57 and to ask that Los Angeles County be included in the pilot, and the Los Angeles City Council also voted to support the legislation and be included.

Trained professionals provide those who visit overdose prevention programs with clean needles, have supplies such as Narcan on hand to help in the case of an overdose, and may have testing strips for fentanyl and other potentially lethal drug additives. Studies show that these programs prevent overdose deaths and help those struggling with substance use disorder get connected to treatment and other services. Additionally, overdose prevention programs are an important harm reduction measure that help limit the spread of communicable diseases, like HIV and Hepatitis C, through intravenous drug use. They also reduce crime and syringe litter in the surrounding area and give those who use drugs the ability to avoid using in public spaces. Overdose prevention programs also relieve pressure on hospital emergency rooms.

This legislation has been introduced multiple times, and it passed the legislature in 2018 in a previous form. It was vetoed in 2018 by then-Governor Jerry Brown. The legalization of overdose prevention programs has broad support from the leadership of San Francisco, Oakland, and Los Angeles County, as well as public health and addiction treatment leaders.

The following organizations are co-sponsoring SB 57: Drug Policy Alliance, San Francisco AIDS Foundation, California Society of Addiction Medicine, National Harm Reduction Coalition, Healthright 360, Tarzana Treatment Center, and the California Association of Alcohol & Drug Program Executives.

“We are in the midst of an opioid epidemic that is taking too many lives in our country,” said Mayor London N. Breed. “We know that overdose prevention programs save lives, prevent public drug use, and get people the help and care they so desperately need. We must have programs in place across our state that can better address the needs of individuals suffering from addiction and save lives. I want to thank Senator Wiener for his leadership on this issue and continued work to fight for the life and well-being of every Californian.”

“San Francisco AIDS Foundation continues to support the establishment of safe consumption services, also called overdose prevention programs, in San Francisco and California. We are pleased that SB 57 passed out of the Assembly Health Committee, and look forward to seeing this bill passed in California. We are in the midst of a devastating overdose crisis, and are losing Californians every day to overdose. We cannot afford to slow or stall the establishment of these evidence-based and life-saving services,” said Kevin Rogers, Interim CEO of San Francisco AIDS Foundation.