Perhaps you don’t visit the California Department of Public Health’s website, which lists resources for “People who Use Drugs.”
It advises everyone, wisely, not to do drugs alone. But, if you must, it suggests you dial a 1-800 number — one for English-speakers and one for Spanish — and stay on the line with an operator. If you become unresponsive, that person will call for an ambulance to come and save you.
So, that’s legal. That’s happening. That’s promoted on the state Department of Public Health website. If you’re doing drugs — perhaps in your room, perhaps in an alleyway — someone will stay on the phone with you, and send help if you start to die. And, hopefully that help gets there eventually.
What’s not yet legal, what’s not yet happening — and what Gov. Gavin Newsom explicitly vetoed — is a situation where Californians could do drugs in a clean, supervised site and someone would be there in person and, if things go sideways, provide medical help immediately.
The word “serious” feels like it’s in heavy rotation these days, spurred in large part because of Logan Roy’s stinging rebuke of his feckless children on “Succession:” “I love you. But you are not … serious people.”
When it comes to addressing rampant drug-use deaths, we don’t feel like a serious state. Let alone a serious city.
San Francisco is a city famous for its fog and, at times, it feels like we govern through one.
So, earlier this month, elements of a half-baked plan began wafting out of back rooms and through closed doors. There would be … a tent! And there was a search underway for a suitable Tenderloin site for it. God help us, but all too many disturbingly impromptu city plans seem to start with someone saying, “Hey! Let’s get a tent! A big tent!”
This big tent would serve as something of a forced sobering center (read: 21st century drunk tank) where people in the throes of drug use could be transported, whether they liked it or not, by law enforcement. The details one gleaned as time went by changed, because the plan was changing.
At present, there is no tent, and the current iteration of the plan floating about the political ether — which is still, clearly, amorphous and a work in progress — directs cops to arrest and temporarily detain incapacitated drug users, who are a risk to themselves and others. This would be done under statutes that police tell me, like Dorothy Gayle, they’ve had the power to use all along. But they haven’t, because they found that detaining incapacitated people for a few hours a pop to be a labor-intensive and poor use of police resources , and did little to alter the situation on the streets.
Well, that tracks. If the plan is to detain dope-sick, suffering drug users for several hours and proselytize to them about turning their lives around via services they’re not able or willing to accept — while the city’s services aren’t presently able to accommodate even people who are able and willing — that doesn’t sound like a winner.
It sounds more like appeasing anger over the deplorable state of San Francisco’s streets in an exercise of cruel futility at the expense of the city’s most vulnerable. And this — this has consequences of its own.
An April paper in the Journal of the American Medical Association found that the wanton and continual involuntary displacement of homeless people — jerking people around, in non-scientific terms — may contribute to a mortality spike of between 15.6 percent and 24.4 percent over a 10-year period. And yes, this paper included data from San Francisco.
“Our study found that continuing to forcibly displace people who are experiencing homelessness, as is being proposed in San Francisco, is responsible for up to 25 percent more deaths in a 10-year period,” said Alex Kral, an epidemiologist from the East Bay independent nonprofit research institute RTI international, and one of the paper’s many authors.
“That policy literally kills people in the long run.”
Last week, San Francisco took in the spectacle of Board President Aaron Peskin holding the monthly mayoral question session on UN Plaza, and asking Mayor London Breed pointed queries about the city’s surge in overdose deaths. It remains mystifying what Peskin or anyone felt could be accomplished in holding this meeting out-of-doors on the plaza, where the predictable heckler’s veto was, in fact, superseded by a heckler’s tossed brick.
And this predictable and predicted meltdown was not, as was claimed afterward, a sign of a devolution of San Francisco public space. Raucous people would’ve overwhelmed this meeting if the subject matter was fentanyl overdoses or conditional use authorizations or selecting the city’s official mineral. And this could’ve happened at any time in the past 55 or so years; Civic Center has been a haphazard place for a long time, and there’s a reason we hold government meetings indoors.
So, that was odd. As was Mayor Breed’s get-tough stemwinder about confronting this city’s drug problems — she does realize she’s been mayor since 2018, right? Breed on Tuesday told the Board that “We are looking at being more aggressive with people who are struggling with addiction … compassion is killing people.”
On Thursday, however, she said that “San Francisco is a compassionate city that leads with services in our efforts to help people struggling with addiction …”
Well, to crib one of the lesser-known lines from “Oh Brother, Where Art Thou?”: “That don’t make no sense!” But the mayor’s competing and often negating impulses regarding misery and drug use in the heart of the city — Initiate evidence-based solutions! And get the cops out there arresting people! — were long ago called out as cognitively dissonant by bewildered community members. So this inconsistency is, in fact, consistent.
And if compassion is now viewed as killing people, the city seems ready to pivot to cruelty.
Yes, San Francisco is continuing to invest in treatment solutions, even in the face of a massive budget shortfall. Yes, in October, the city published a comprehensive overdose prevention plan. But the city’s planned augmentations — 30 beds here, 30 beds there — are almost comically inadequate. And the comprehensive overdose plan hasn’t come close to being fully enacted.
Alarmingly, the overarching goal of our big overdose prevention plan is to reduce the deaths by just 15 percent — by 2025. That’s a depressingly modest milestone. And, tragically, we’re failing miserably to reach even that. At present, overdose deaths aren’t going down but, rather, are 41 percent above this point in 2022. And 2022 was bad.
So, yes, things are bad. And, in response, the city continues to propose law-enforcement responses to address a public health crisis. That’s bad, too.
Also bad is that the backbone of the city’s big overdose prevention plan is the creation of multiple safe consumption sites. This hasn’t happened and, thanks to Newsom’s veto, they can’t be publicly funded. The city can’t even use the $230 million settlement it recently won from Walgreens over the pharmaceutical chain’s admitted wrongdoing in fueling this city’s opioid epidemic — because that, too, is government money.
The present city budget calls for funding “Wellness Hubs” to combat rampant drug use and overdoses. But without the safe-consumption element, this is a bit like putting hamburgers on the menu without the patties.
The hubs won’t have a safe-consumption element unless the nonprofits running them can pay for that part themselves. As you’d guess, this is not the easiest fundraising ask. And the city’s lack of urgency on this matter is perplexing: We are told that San Francisco officials and nonprofits’ next scheduled meeting to discuss the funding of safe-consumption sites isn’t until mid-June.
In a city where around 67 people are dying by overdose every month, this languid timeframe simply beggars belief.
Cruelty, it turns out, can take many forms. Including a serious problem and a government response that is, fundamentally, not serious.
And there’s no 1-800 number to call for help about that.