Could harm reduction kits do more damage than good with SF drug treatments? Look at controversy here

Lyanne Melendez Image
Sunday, October 29, 2023
Controversy over harm reduction supplies for drug treatment in SF
There are a number of organizations in San Francisco doing important work to keep drug users from dying on the streets.

SAN FRANCISCO (KGO) -- There are a number of organizations in San Francisco doing important work to keep drug users from dying on the streets. Many are distributing self-help kits that contain life-saving Narcan and clean needles to reduce the transmission of diseases. But there are often other items inside those harm reduction kits, critics argue, that enable bad behavior.

JJ Smith: "This is aluminum foil, this is a lot of it."

Lyanne Melendez: "What is it used for?"

JJ Smith: "This is used so they could put their fentanyl on here, and then they burn it and they smoke it through a straw."

Longtime Tenderloin resident JJ Smith showed us what's inside a harm reduction kit accessible to any drug user in the neighborhood, which include straws and other drug paraphernalia.

"The hypodermic needles and syringes, I can understand you don't want to pass borne diseases with those items but there's a lot of items in there that doesn't have anything to do with passing diseases," said Smith who then showed us some small tin cans included in the kit.

"This tin can they give you to cook up drugs in, which shouldn't have nothing to do with harm reduction because you cannot catch any disease from the can, so this is an enabling device right here," he added.

MORE: How a Bay Area mom is turning grief into action by distributing Narcan in San Francisco

But others argue that giving out straws and pipes keep drug users from sharing with one another, therefore preventing the spread of hepatitis C and other infections.

"We're worried about people having cracked lips or blood at the source of the site of smoking and by offering these supplies, we reduce the risk of folks transmitting between sharing supplies," explained Tyler TerMeer, the CEO of the San Francisco AIDS Foundation.

It's part of San Francisco's public health strategy called "harm reduction," taking steps to reduce the negative consequences of using drugs.

We want to make it clear, the San Francisco AIDS Foundation does not offer pipes as part of their harm reduction strategy, but some other organizations do.

MORE: Rogue nonprofit workers set up pop-up safe injection site in SF Tenderloin

A few medical studies have found that Hepatitis C can be passed among drug users by sharing their pipes, but only under certain circumstances.

"That other person has to have open sores for blood to enter their blood stream from this pipe, so in general, yes clean and your own material is a good thing," said Dr. Monica Gandhi, an infectious disease expert and director of the UCSF Center for AIDS Research.

Advocates say harm reduction kits keep people healthy yet as we have witnessed many times, some of those suffering from addiction are not always so particular about how and with whom they share their drugs.

Los Angeles Councilmember Traci Park came to San Francisco to meet with people affected by the drug crisis.

"We're seeing the same type of approaches being used in Los Angeles. It's not working, it's making things worse. We have to shift the focus to actual rehab and recovery so that we can treat the whole person and get them stabilized and on a path to recovery," insisted Councilmember Park.

MORE: LA councilmember tours San Francisco streets as both cities grapple with fentanyl crisis

California grapples with an increasingly complex drug overdose crisis with elected officials and mothers coming together to find solutions.

But as far as we can tell, there's no mention of getting people off drugs, not even brochures when handing out harm reduction supplies.

Smith recorded several interactions he had with people who distribute harm reduction supplies in the Tenderloin and quickly discovered none of them had information on drug treatment.

Smith: "You got one of those thing you put needles in?"

Worker: "Yeah, we do. We have these fancy boys, you get the last one."

Smith: "Oh, what about the black ones?"

Worker: "You prefer the black ones? I call them the pencil boxes. Do you need anything else?"

MORE: 385 died of fentanyl overdose in SF this year; could set record, health officials say

Despite efforts to curtail the fentanyl crisis in San Francisco, health officials are reporting that 71 people died of an accidental overdose in July.

Smith: "Oh yeah, one more thing, do you have any pamphlets on detox or treatment?"

Worker: "I don't have any pamphlets on that."

Here's a second interaction with a different worker.

Smith: "The things they put the needles in?

Second worker: "Gotcha."

Smith: "Do you have any pamphlets if somebody wants rehab?"

2nd worker: "We don't have any paper work.

Smith: "OK."

Second worker: "Right on. Take care."

MORE: Here are reasons why San Francisco has a hard time convicting drug dealers

San Francisco's fentanyl epidemic continues to impact the city. Law enforcement says it's so difficult to convict drug dealers.

Smith then went to a nonprofit in the Tenderloin, again using his cell phone.

Third Worker: "Hi, how can we help you?"

Smith: "Yes, do you have any type of information like literature or anything like programs are at or what the programs are about?"

Third Worker: "You mean like rehab?"

Smith: "Yes!"

3rd Worker: "I don't have anything that I can give you."

The San Francisco AIDS Foundation told us they offer a brochure on how to prevent overdoses when handing out Narcan.

"We're in a really better era than we used to be for actual treatment for substance use so I would completely agree with the sentiment that anything you can give out to encourage safe use should also be giving material to reduce use and to seek treatment, expressed Dr. Gandhi.

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