San Francisco Chronicle: State bill that would allow drug injection centers advances

Many California communities could open centers inviting addicts to shoot up hard drugs under a bill that has cleared the state Assembly and now awaits a vote on the Senate floor.

The goal is to reduce deaths. Here’s how the concept — modeled after a supervised drug injection center in Vancouver, British Columbia — works:

A user walks into a government-run clinic with heroin in his pocket. He’s greeted by a nurse who directs him to wash his hands before offering an array of clean needles. He sits down at a sterile booth, rolls up a sleeve and shoots up.

As the high sinks in, he makes his way to a chill-out room for a cup of coffee or juice. There, staff members watch for signs of overdose, prepared to administer life-saving medication if needed.

Nothing like this exists in the United States. AB186 would make California the first state in the nation to permit illegal drug use in designated places — and would set up a conflict with federal law, which not only forbids the use of illicit drugs but also prohibits owning or renting buildings for the purpose of consuming them.

It’s a radical response to the scourge of addiction and overdose that has swept the United States. Nationwide, overdoses kill more people than guns or car crashes. In California, 4,571 people died from drug overdoses in 2015, a 33 percent increase over the previous decade.

“We have an opioid epidemic. We have a public health crisis,” said Assemblywoman Susan Eggman, the Stockton Democrat who co-wrote the bill with state Sen. Scott Wiener, D-San Francisco, and who once worked as a drug treatment counselor. “We have traditionally treated addiction as a criminal issue and that has failed. We need to treat it as the public health issue that it is.”

San Francisco is deep into discussions about opening an injection center. The Board of Supervisors has put together a safe injection services task force under the Department of Public Health that is holding public meetings and developing recommendations. The Chronicle reported that city workers in March cleaned up an average of 430 syringes a day.

“People are shooting up on the street, in people’s doorsteps, in children’s playgrounds,” Wiener said. “Anything we can do to reduce the open, public shooting up that we see, we should go in that direction.”

The Assembly bill would allow eight counties — San Francisco, Alameda, Fresno, Humboldt, Los Angeles, Mendocino, San Joaquin and Santa Cruz — and the cities within them to approve supervised drug injection programs. The centers would have to provide clean needles and be staffed with health care workers offering first aid to prevent overdose and referrals to detox for addicts who want to quit.

Visitors to the clinic would have to bring their own drugs, and they would be shielded from criminal charges for using at the site.

Although law enforcement widely opposes the approach, it has gained growing support in the medical field. Research published in the Lancet medical journal shows that overdose deaths decreased by 35 percent in the neighborhood surrounding the Vancouver injection clinic and by 9 percent in the city overall.

The New England Journal of Medicine recently published an article by a substance abuse specialist who teaches at Harvard’s medical school making the case that supervised injection saves lives and improves health. The American Medical Association, the official voice of the nation’s doctors, voted in June to support the development of pilot projects where addicts can use their own intravenous drugs under medical supervision.

“Studies from other countries have shown that supervised injection facilities reduce the number of overdose deaths, reduce transmission rates of infectious disease, and increase the number of individuals initiating treatment for substance use disorders without increasing drug trafficking or crime in the areas where the facilities are located,” the medical association said in announcing its support.

Law enforcement groups argue that the centers would become crime magnets that would normalize hard drugs rather than helping addicts kick them.

The California bill “does not have any robust effort to get addicts into treatment,” said John Lovell, a lobbyist for the California Narcotic Officers’ Association and the Association for Los Angeles Deputy Sheriffs. “Instead, it simply accepts that they will come to the county-operated shooting gallery, shoot up and then leave with all of the other consequences.”

Critics raise questions about liability if a drug user dies or hurts someone after leaving an injection clinic, and they say creating them would be unfair to neighborhoods already suffering from poverty and crime. A coalition of churches in urban areas that works closely with law enforcement on antidrug policies is also fighting the bill.

“The drug dealers will stand around understanding that ... those that are coming out of these safe houses are not going to treatment, but they’re going to be looking for more drugs,” said Ron Allen, a Sacramento bishop who heads the International Faith-Based Coalition and described himself in a hearing as a recovered crack addict.

Opposition from law enforcement is usually a potent force in the state Capitol, so it’s surprising that the bill by Eggman and Wiener has advanced as far as it has. A similar bill last year failed in its first committee. But this year, the bill eked out of the Assembly with the bare number of votes needed and has already passed two committees in the Senate.

Republican state Sen. Jeff Stone of Temecula (Riverside County), who voted against the bill in committee, warned that the idea would put local governments in stark conflict with the Trump administration. Attorney General Jeff Sessions has expressed zero tolerance for marijuana use — much less more potent illegal drugs — although he hasn’t yet directed a crackdown against states such as California that have legalized pot.

“Whether we like or don’t like the present administration,” Stone said, “I think their reaction to recreational marijuana is going to be much different than recreational heroin, and having safe zones for that.”

Laurel Rosenhall is a reporter with CALmatters.org, a nonprofit, nonpartisan media venture explaining California policies and politics.

Read the story on the San Francisco Chronicle website.