Step inside a San Francisco safe injection site

The public got its first glimpse of what a safe injection site might look like if one were to open in San Francisco.

Glide Memorial United Methodist Church played host to the Safer Inside demonstration on Wednesday to show how staff and people injecting drugs intravenously would interact in a safe, supervised, mock facility.

There are more than 120 safe injection sites worldwide, but none in the United States as the idea of allowing drug users off the street to do drugs inside a facility is a controversial topic.

The demonstration at Glide was presented by the Tenderloin Health Improvement Partnership and designed by Capital One Design Pro Bono.

San Francisco could soon be allowed to open a safe injection site after the California Legislature approved Assembly Bill 186, which would allow The City to operate a three-year pilot. The bill now awaits the signature from Gov. Jerry Brown.

Inside the full-scale model at Glide is a check-in desk where a person does not have to disclose any personal information, and can provide nicknames to staff if they so choose to do so.

After a person gets checked in, the person would then be taken to another staff member who would provide supplies to the person, but not before washing their hands at a sink. Lockers would also be available for people to place their belongings in.

Kenneth Kim, clinical director at Glide, said people will receive a harm reduction kit that includes a syringe, twist ties, latex or non-latex tourniquet, cotton balls, alcohol wipes, distilled water, saline solution and cookers to heat the drugs in a dissolvable form for injectable use.

The site would also provide containers in which people using drugs outside of the facility could store used needles for disposal, said Kim.

After receiving the harm reduction kit, the person would go to a booth to do their injection. A sterile table available along with a mirror and a disposable container are provided at each booth.

A wider booth with a curtain was also on displayed for drug users who may inject on their inner thigh.

Kim said:

“The curtain and the wider space allows them some privacy to do that. There’s always a gap underneath so if someone is overdosing we can see what’s happening with them.”

After a person injects themselves, they head to the “chill room” where a person can relax on comfortable chairs and a list of additional services would be available to that person.

Mayor London Breed, who has been supporter and advocate for safe injection sites, said at a press conference in the Tenderloin, that at least 2 million people across the nation are struggling with substance abuse related to drug use and that The City is not immune to the health crisis:

“Last year, 193 people died of drug overdoses. If you walk on the streets of San Francisco, you can see the heartbreaking symptoms of this every single day. People who are struggling with addiction they cannot beat on their own and worst of all, they are suffering alone without access to medical treatment that can actually save their life.”

Breed added:

“Continuing with the status quo and hoping that things will get better is not an option. Substance abuse is not simply going away because we don’t want to see it.”

Critics of injection sites have said that it will lead to an increase of drug use on the streets near the site or that the site is a drug den for people to get their drug fix.

There are a number of studies that differ on whether safe injection sites reduce drug use on the streets and overdoses. But Paul Harkin, the HIV services manager at Glide, believes studies and results from safe injection sites worldwide have shown that they work:

“In fact, what we actually see less drug use for the participants because we offer them stability and a safe place to use and therefore, there’s less chaos in their life and they don’t need to administer drugs to themselves as frequently.”

Harkin added that the public needs to understand why people are coming to a safe injection site in the first place:

“I don’t think people understand that the users of these services tend to have chronic substance abuse disorders and rather than thinking of it as people coming to get high, I would like to public to understand that people come here to get well.”

It’s not just the public that needs convincing, but also federal officials.

Deputy Attorney General Rod Rosenstein wrote an editorial piece on safe injection sites on Monday in the New York Times against cities opening a safe injection site. In the piece, Rosenstein said the sites are dangerous and would make the opioid crisis across the nation much worse.

Rosenstein also sent a warning to cities like San Francisco and New York looking into opening a safe injection site that they are illegal and that violators can spend up to 20 years in prison for having a site that facilitates drug use.

He said the Department of Justice would take “swift” and “aggressive” action towards the opening of a safe injection site.

Breed said she hoped to open one soon, but said it was important to protect the employees working in the facility:

“We know unfortunately that there are legal concerns and we are doing everything we can to create a solution to try and address those particular issues. As soon as we can get those resolved, we want to open one in San Francisco.”

Glide will continue to host the mock safe injection site until Aug. 31 for the public to tour the facility.