Andy Berger (left) sits with friend Spencer Gray, who prepares a fentanyl injection inside a tent in San Francisco on Jan. 10. The debate on how the city should use millions of dollars from opioid settlements in S.F.’s drug crisis is heating up.
Stephen Lam/The ChronicleSan Francisco supervisors and activists are pressuring City Attorney David Chiu to use more than $130 million the city is set to receive from pharmaceutical companies in opioid litigation to open supervised drug consumption sites.
Supervisor Hillary Ronen, who is leading the charge to open the sites, has accused Chiu of standing in the way. Chiu has said he wants nonprofits to pay to supervise drug consumption to shield the city from liability.
That’s because such sites are technically illegal under federal law, and the Trump administration sued a Philadelphia nonprofit that tried to open one. But under President Biden, a New York City organization has run two sites without repercussions for more than a year, and Rhode Island is set to open its own by the end of this year using opioid settlement dollars.
Chiu repeated in an email statement Tuesday that he supports the New York model, which uses no city funding, property or staff to supervise drug use. A local nonprofit raised money to pay for supervision and used public funds for all other services.
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Princess Surak, 27, prepares to inject heroin into her neck at OnPoint NYC, a supervised drug injection site in New York on March 23, 2022. S.F. City Attorney David Chiu said, “I believe that overdose prevention centers can open in San Francisco under this model.”
Gabrielle Lurie/The Chronicle 2022
But the three San Francisco nonprofits that could run sites told The Chronicle they either can’t raise the nearly $2 million a year per site needed to pay staff to supervise drug consumption or are unwilling to take on the legal liability without full city support.
“There are problems that are worth taking a risk for,” Ronen told The Chronicle on Tuesday. “And I say that two people dying a day of drug overdoses and children having to see so much really traumatic drug use on their streets are two issues worth taking a risk for.”
Advocates for years have wanted to open sites where people could use drugs under medical supervision,arguing research showssites around the world have reduced the risk and frequency of drug use without increasing public drug use. Critics contend sites enable addiction without pushing for abstinence or prosecuting drug dealing.
The debate is heating up as opioid settlement dollars flow into city coffers. On Tuesday, the Board of Supervisors had been set to approve two more payouts — one with CVS and another with Walmart — that would bring in between $7 million and $19 million. The range depends on how many other jurisdictions sign on. On Wednesday, the board approved two more payouts — one with CVS and another with Walmart — that would bring in between $7 million and $19 million. The range depends on how many other jurisdictions sign on.
The amount would add on to half a dozen other settlements that could tally up to at least $130 million. The city has already received $7 million.
While it’s up to supervisors to decide how to use the opioid settlement funds, Chiu has power to approve contracts, which the city would need in order to run a site with a nonprofit.
Chiu said Tuesday that he shares the supervisors’ frustration with the current state of the law, but said, “It’s my job to legally defend the City and County of San Francisco.”
他说,他相信在过量pre的能力vention sites to save lives. As a former state Assembly member, he was the principal co-author of a law that would have allowed San Francisco, Oakland and Los Angeles to open pilot supervision programs and protected medical professionals who worked at the centers from being stripped of their licenses. Gov. Gavin Newsom vetoed the law last year, citing unspecified “unintended consequences.”
After the veto, Chiu publicly came out in support of the New York model and said he has advised San Francisco policymakers to move forward since visiting New York City’s sites in 2021.
“I believe that overdose prevention centers can open in San Francisco under this model,” he said.
Advocates disagree with Chiu’s opinion that opioid settlement dollars are public funds that would pin liability on the city, since most of the money comes from private lawsuits. The Public Defender’s Office also contested the legal risk of opening sites in a memo, arguing that a ruling in the ongoing Philadelphia case doesn’t apply because it’s in a different jurisdiction.
支持者也认为回推的N次方ew York model, which is struggling financially, is not feasible. Chiu and supervisors are set to discuss the use of funds from opioid lawsuit settlements and related legal matters behind closed doors on April 18.
Ronen said she has the support of Mayor London Breed, and told The Chronicle on Tuesday that city Policy Director Andres Power told her that her office would support using opioid settlements for supervised drug consumption with the city attorney’s blessing.
Breed’s office, in an official email statement Tuesday, reiterated the mayor’s support for the New York model. The office said it continues to seek federal legal clarity on the use of public funds to open a site, won’t use them until they get it and deferred to the city attorney to determine what funds are eligible.
Ronen and others point out that the city already funded an unofficial supervised consumption site last year at the Tenderloin Center in U.N. Plaza. Staff allowed visitors to use drugs in an outdoor area and reversed 333 overdoses.
Breed closed the site after 11 months, saying it was a temporary measure that didn’t link as many people to housing and treatment as she hoped. Overdose deaths jumped after that, which expertssuspected was linked to the closure.
The S.F. health department said it would open smaller similar centers, but Breed's administration pulled the rug on two locations last year, arguing they were still waiting on federal legal guidance.
Lydia Bransten, executive director of the Gubbio Project, one nonprofit set to open a site, said on Tuesday she was asking Chiu to “support this cause in an act of civil disobedience with us to save the lives of people who are using drugs.”
She said her nonprofit has an annual budget of around $500,000 and expressed frustration that San Francisco concluded it was too risky to fund and then told small nonprofits to fundraise with that risk.
“The big city isn’t going to help bear the liability; you’re going to ask the little guy to. It’s not fair,” she said.
Gary McCoy, spokesperson for HealthRight 360, said the nonprofit has been trying to raise funds to open a site, with no luck yet. He and Laura Thomas with the AIDS Foundation, another organization that wants to run a site, said they believe it’s the city’s responsibility to fully support sites.
Supervisors did pass an exemption to city law last month that allows Breed and her staff to fundraise for supervised consumption sites. At the time, Breed’s office said they were working to identify funds, but didn’t have an update on any progress Tuesday.
Reach Mallory Moench: mallory.moench@sfchronicle.com
