24 ms·

Safe injection sites in San Francisco could be first in the US

86 points by sethbannon 9y ago

dang 9y ago
The article comes from https://www.cnn.com/2018/02/07/health/safe-injection-sites-san-francisco-opioid-epidemic-bn/index.html https://www.cnn.com/2018/02/07/health/safe-injection-sites-s..., which has the better title but also an autoplaying video, so we'll use the title but stick with this URL.
formol 9y ago
The very lefty mayor of Paris launched one « safe site » in the city. Results : disneyland for drug dealers and addicts in the area, dead people (OD) in the street, noise, fights...
- Andrex 9y ago
  Sources for this would be very helpful. Always interested in alternative viewpoints!
  - zapita 9y ago
    Here is a recent study of drug consumption room programs across Europe (including the one in Paris), and their impact so far. http://www.emcdda.europa.eu/topics/pods/drug-consumption-rooms http://www.emcdda.europa.eu/topics/pods/drug-consumption-roo... Their analysis seems pretty balanced, and seems to skew positive. It definitely contradicts the negative comment you're responding to.
    - chx 9y ago
      The truthiness of that comment can be pretty safely derived from the derisive word "lefty".
  - boudin 9y ago
    I've never seen sources backing up what he says. According to this source results are positive in term of reducing consumption in streets and syringes found in streets. It also allowed to diagnose users with transmissible diseases and provide treatments. Neighbours of the injection site do complain of increase disturbance in the area but it seems due to the fact that it's the only site in Paris. Since the one opened in Paris, another one opened in Strasbourg and one is gonna open in Bordeaux this year http://mobile.lemonde.fr/societe/article/2017/10/12/premiere-salle-de-shoot-un-an-apres-un-bilan-global-positif-selon-la-mairie-de-paris_5199906_3224.html?xtref= http://mobile.lemonde.fr/societe/article/2017/10/12/premiere... There must be a lot more data from sites in Germany, Netherlands and Switzerland that has been opened for much longer.
  - formol 9y ago
    Sources are very hidden : first result page on google (I'm talking for french people) http://www.bfmtv.com/police-justice/paris-emotion-apres-la-mort-d-un-homme-pres-de-la-salle-de-shoot-1219672.html http://www.bfmtv.com/police-justice/paris-emotion-apres-la-m... http://www.leparisien.fr/paris-75010/paris-le-cri-d-alarme-des-riverains-de-la-salle-de-shoot-10-03-2017-6751854.php http://www.leparisien.fr/paris-75010/paris-le-cri-d-alarme-d... https://www.google.fr/search?q=riverains+salle+de+shoot&source=lnt&tbs=qdr:y&sa=X&ved=0ahUKEwjombr2sKDZAhXpBsAKHb3XCXc4ChCnBQge&biw=1409&bih=925 https://www.google.fr/search?q=riverains+salle+de+shoot&sour... to sum up : the neighbours are very unhappy about it. The area was already largely insecure, though (heaven of crack-heads). I don't think the principle of safe site is bad, but it needs a good management team because - by definition - you can't expect any well disciplined behaviour from drug addicts.
    - hycaria 9y ago
      I recommend the rue de Maubeuge. It's just miserable, always a few crackheads hanging around and dealing or whatever. In one article [0], I read that the police deliberately don't act there. The videosurveillance is broken atm anyways. Maybe the nurses and the psychological aid they can freely ask for in the shooting room will save these poor souls so we don't need the police to intervene. But I go by everyday and there's no diminution. [0] https://www.streetpress.com/sujet/1463153023-drogue-paris-crack-skenan https://www.streetpress.com/sujet/1463153023-drogue-paris-cr...
- jdavis703 9y ago
  Don't we already have all of those problems though? Or is this saying this increased those issues? If so I'd love to see the data, maybe it can provide some lessons for SF as it experiments with this.
- api_or_ipa 9y ago
  I don't know much about the site in Paris but I do have experience living nearby Vancouver's first of now two safe injection sites. In my experience what you describe did not happen in Vancouver. Safe injection sights save lives by providing a clean, safe place to minimize harm.
  - Animats 9y ago
    That's Vancouver. Even the druggies are reasonably civilized.
    - api_or_ipa 9y ago
      Not sure if your comment is snide or just humourously dismissive. The homeless, drug addiction and mental health issues experienced in Vancouver, especially in the DTES are very real, and very serious. I don't think Vancouver's homeless population is significantly different than Paris'. Glad to hear Canada apparently has a good reputation abroad.
- jlangenauer 9y ago
  As a counterpoint, the Medically Supervised Injecting Room in Kings Cross (Sydney) has quite radically transformed the area for the better - people who used to live there before it opened tell of sometimes walking over the bodies of addicts who'd OD'd on the streets, and of seeing used syringes everywhere. Now, you'd hardly ever see these things. (I'd link to the Wikipedia article, but it seems to be the subject of an edit war between a couple of groups with agendas to push, so is best ignored.)
- Faaak 9y ago
  There's a safe site in Geneva (quai 9) near the train station, and none of the effects describe can be seen there.
- hashmal 9y ago
  It's interesting, I never heard about such results before (and I live in Paris). Would you care to share some links for further reading? I'm also curious to know why and how the political orientation of the mayor is relevant?
- messy_desk 9y ago
  This comment shows two things, 1. how projects like this will always be blamed for quality of life problems in the area, and how 2. the problems of street people and drug addicts are often much more complex and rooted in previous political clusterfucks. In the 1990s and early 2000s, the Gare du Nord was the main place that people smugglers would assist people in travelling from France to the UK. At the time you could walk onto a Eurostar without having your papers checked by a British border police (only French passport control, who tolerated migrants travelling to the UK with false papers). Lots of desperate and often penniless people pitched up around that area. People smuggling was linked to other forms of criminality, including prostitution and robbery by people trying to get the money to make the trip to the UK. When the border protocol changed, the main staging points for migrants moved to Calais. But that part of Paris remained a centre for migrants to meet and connect. It also remained a centre of street dealing, robbery, other forms of low-level crime like selling fake bags, scams and snatching. It is notorious for street harassment, mainly of women. As far as I can tell, there isn't a particular overlap between people doing this and hard drug addicts. In practice, most cities have somewhere you go to buy drugs on the street in the middle of the night. No-one wants to be that area, but trying to get it to be somewhere else doesn't really solve the problem. There are lots of things which can make this type of area less upsetting for people who have to work, live and travel through it, safe injection sites might certainly be a part of this. Source: have lived in Paris and travelled there extensively over last 20+ years. My friend was an asylum seeker in the UK who got the Eurostar from Paris.
coolspot 9y ago
It is like they are testing there how far they could go.
Phanyxx 9y ago
Here in Vancouver the safe injection sites have saved countless lives and drastically lowered needle sharing. There's a big misconception that safe injection sites somehow promote drug use. They save lives and give people a legitimate pathway to get clean if they choose to. Do the right thing, SF!
- AnabeeKnox 9y ago
  It might be a hard sell to use Vancouver as a model. It has an area which is perhaps the most public display of social decay I've ever encounted in a first-world city, principally from drug abuse.
  - ggg9990 9y ago
    As someone with no stake in this, I would rather have all of that decay in one place I can avoid rather than strewn about my city.
    - s0rce 9y ago
      But realistically that does nothing to solve the problem. We could just designate SF the safe injection site for the USA and the problem would be out of view for the rest of the population.
      - sergers 9y ago
        I don't think safe injection sites solve that problem, it's about making a safe environment for junkies to safely take drugs in hopes they don't do it elsewhere littering needles and drug paraphernalia in other public spaces, especially around children. Now for the junkies, needs to be more than a safe haven to shoot up and definitely agree with your sentiments. I know they offer more than that, but some people just want that and that's the problem
        blackbagboys 9y ago
        The hope is that the "junkies" don't die. If that is all that's accomplished, that's still a success. There doesn't need to be more. Obviously there should be an option for users to enter treatment or receive some sort of assistance, but addicts should definitely not be forced into anything just to satisfy some petit bourgeois stern moral impulse, because that will ultimately drive people away and cost lives.
Cofike 9y ago
The individuals who are using these drugs already use them openly in the street. I see them daily on my way to work as I work in a popular area for vagrants/homeless. If it prevents me from stepping on needles and seeing blood from people shooting up on the street, I am all for it. These individuals will use one way or another if they want to so giving them a place to do it safely off the street seems acceptable. Of course, the ideal solution will be to eliminate heroin and other hard drug use but this is a start.
- zanedb 9y ago
  Well of course people want to eliminate it, but how? Is this not at least a step in the right direction?
  - deleted 9y ago
    [deleted]
- danmaz74 9y ago
  > Of course, the ideal solution will be to eliminate heroin and other hard drug use but this is a start. That's practically impossible. A much more realistic goal is to minimize hard drugs use, and to minimize the negative impact of that use which will stay on both the users and everybody else. The problem of thinking about the "ideal solution", in this case, is that trying to reach it brings us to adopt policies that do the opposite of minimizing the negative impact of use, especially if you consider enriching and encouraging violent gangs and mobsters, corruptions, and ruined lives a negative impact.
- smsm42 9y ago
  > If it prevents me from stepping on needles and seeing blood from people shooting up on the street, I am all for it. For that, all the addicts need to be aware that this center exists, be able to get there (while suffering from withdrawal and other maladies accompanying their addiction) and be motivated to get there as opposed to getting the high right here right now (opioid addicts aren't exactly known for their capacity in delaying immediate gratification). With proper information and enforcement it may happen, but given how the streets of SF look now, this also may not happen. They mention Vancouver as an example. I've been in Vancouver a few years ago, and I must say, if we're talking about people living on the street and doing drugs there, SF has nothing on Vancouver. The site around where Insite is (according to it's Wikipedia article) was occupied by something that looks like a refugee camp in a disaster area, only with a lot of drugs. Maybe not Insite's fault, maybe they are placed there exactly because that's where people who need it are, but certainly it didn't fix it. I mean, maybe this saves these people's lives and is worth it. Vancouver locals certainly think it's worth it. But if you expect not seeing people doing drugs or stepping on needless and other unappetizing stuff - nah, didn't happen.
eddieh 9y ago
I thought the first of these sites in the US were going to be in Seattle? Seems like San Francisco is closer now. https://www.seattletimes.com/seattle-news/crime/seattle-king-county-move-to-create-2-injection-sites-for-drug-users/ https://www.seattletimes.com/seattle-news/crime/seattle-king...
- icelancer 9y ago
  The citizens of Seattle are fighting back against it pretty hard.
  - aaronbrethorst 9y ago
    A group of Seattle NIMBYs are fighting back against it pretty hard. For the sake of my city, I hope they lose.
tcj_phx 9y ago
In days gone by, heroin addicts knew how much heroin they needed to 'stay well'. A major factor in the escalation of deaths in the modern era is the contamination of the street pharmacy's heroin supply with more potent synthetic opioids (fentanyl, etc). Overdoses happen when street drugs are more potent than the user expects, or when the user's tolerance has changed. Two factors in my girlfriend's OD were having been sober for 5 months and having been made addicted to clonazepam (a benzodiazepine that increases the potency of opiates - she'd only wanted this 'as needed', but the professionals at the hospitalization preceeding her OD thought she needed to take the full dose every day). That batch of heroin could also have been contaminated... A clean supply of heroin would be quite helpful in preventing people from killing themselves while self-medicating. Until the politicians find courage to acknowledge that it was a mistake to trust organized crime to control the supply of addictive substances, at least 'safe injection sites' is an intervention that can actually prevent people from causing their own premature expiration.
- blauditore 9y ago
  > Until the politicians find courage to acknowledge that it was a mistake to trust organized crime to control the supply of addictive substances, [...] What would be a better solution in your opinion? Legalizing it, or allowing it with prescription? I see some problems with those alternatives as well; there's probably no magic bullet here.
  - colechristensen 9y ago
    Make everything legal to obtain or manufacture with a license attainable though education and certification – something in between what it takes to get a driver's license and an AA degree. If you want to buy heroin you have to understand it's addictive qualities, how human biology is affected, and how to recognize the negative consequences. Attach liability to the licensee for anything purchased that resulted in harm and to distributing substances with incorrect descriptions.
    - throwaway9990 9y ago
rajeshpant 9y ago
Great! The drug mafia can sell right outside the injection sites and increase sales!
sfstreet 9y ago
"The facilities provide a safe space where people can consume previously obtained drugs" That seems strange. If you actually tolerate drug use why not go the full way and provide clean versions of the drug on prescription, driving illegal dealers out of business?
- askvictor 9y ago
  That would be ideal, but probably not possible politically (at the moment, anyway). But this is a step in the right direction, and will hopefully lead to this in time.
- smsm42 9y ago
  Because then the organizers of the site would be in jail for drug trafficking, and so would be any doctor who prescribed those. That could happen only if drugs are legalized, and not only on the state but on federal level. You can judge how far we are from there if you notice that DOJ, under Sessions, is still battling the benign marijuana, even for medical use (which makes me seeing red and my blood pressure skyrockets each time I think about it - ffs, we use chemicals in medicine that can are like a nuclear weapon compared to marijuana's zippo lighter, and still these people refuse to see the case for even prescribed medical use!). And you're talking about legally dealing out the real bad stuff, which is dangerous. We are decades from that, at the very best.
- bfuller 9y ago
  We're getting there. There are opiate maintenance programs that utilize diamorphine (obviously not in the USA). They will give you pure heroin and supervise you so you don't fall out.
zenbit 9y ago
In 2016 there were 204 deaths due to substance abuse in North Rhine-Westphalia (NRW), with ~17m inhabitants Germany's most populous state. That same year there were 321 deaths in Bavaria. Bavaria has a population of only ~12m and in general has a much lower crime rate than NRW. The difference in deaths is often attributed to the fact that there are safe injection sites in NRW while there are none in Bavaria.
- Jdam 9y ago
  That’s because Bavaria is close to the Czech republic and the bavarian/czech border is a well known import corridor. Google further info on that, if you’re interested. Also, I invite you to compare the NRW numbers to the Berlin ones.
  - zenbit 9y ago
    NRW borders the Netherlands, a country with easy drug access as well. And yes, deaths per capita are much higher in Germany's city-states (Berlin, Hamburg, Bremen). But please go ahead and compare numbers on a per-city basis (2016 numbers). You will note that Munich (62 deaths, 1.4m inhabitants, ~44 deaths per capita) is very much comparable to Berlin (167 deaths, 3.5m inhabitants, ~48 deaths per capita).
    - Jdam 9y ago
      Sure, gaining access to drugs in the Netherlands is easy, but usually people go there to get some of the not-so-deadly drugs, like weed and not heroin or meth, like bavaria.
  - tobltobs 9y ago
    The drug importers don't sell their stuff along their import corridors. They bring it to next distribution center before they start splitting it up. according your logic Texas would be one of the states with a high drug overdose mortality. You are confusing small scale crystal meth smuggling with large scale opiate importing.
folli 9y ago
A well written chronology of the rise and decline of the Needle Park in Zurich, Switzerland: Chapter 1: https://www.tagesanzeiger.ch/extern/storytelling/needletrauma/chapter1/ https://www.tagesanzeiger.ch/extern/storytelling/needletraum... Chapter 2: https://www.tagesanzeiger.ch/extern/storytelling/needletrauma/chapter2/ https://www.tagesanzeiger.ch/extern/storytelling/needletraum... Chapter 3: https://www.tagesanzeiger.ch/extern/storytelling/needletrauma/chapter3/ https://www.tagesanzeiger.ch/extern/storytelling/needletraum... Chapter 4: https://www.tagesanzeiger.ch/extern/storytelling/needletrauma/chapter4/ https://www.tagesanzeiger.ch/extern/storytelling/needletraum... Methadone programs and safe injection sites were crucial elements in resolving the tragedy.
smsm42 9y ago
The article starts with "to open what could become the nation’s first legal safe injection sites aimed at curbing the opioid epidemic". How that should work? I understand that it may help existing drug addicts and reduce mortality from opioid abuse (which by itself is a good thing) but how can it curb the opioid epidemic? I may be that it achieves many other benefits, but what would be the way it may achieve this one? By logic if opioid use becomes easier and less dangerous (which, again, may be a very good thing for current addicts) it would not make people less willing to take opioids, so how that is supposed to work? Is there some component of it that I am missing?
- birken 9y ago
  > have consistently shown them to be effective at reducing overdose deaths, preventing transmission of HIV and viral hepatitis, reducing street-based drug use and linking people to drug treatment and other services There are a lot of people addicted to drugs that don't want to be. In a safe injection site, you have a bunch of health professionals around who are experts at treating addiction. I'm not an expert on opioid addiction but I'd wager that the ease or difficulty of injecting the drugs isn't a major factor for opioid usage. I think the people who are addicted will get and take the drugs by any means necessary, and people who aren't addicted to opioid's probably aren't going to try them all the sudden because there is a safe injection site.
  - smsm42 9y ago
    > you have a bunch of health professionals around who are experts at treating addiction. That'd be nice but the article doesn't say anything about health professionals - it looks like there are just organizations dedicated to supplying clean needles, etc. - which is completely different level of investment than having a doctor specializing on addiction and involved with long enough term that it could actually make a dent. From the article, the most they can do is provide referrals.
meri_dian 9y ago
We are caught in an ideological chasm in the US. On one side is a harsh society wide approach like that of the Chinese. On the other hand is complete tolerance and legalization, which is more compatible with a Western social and political values. We are in an awkward spot somewhere in between. Unfortunately we must measure success of our national drug programs by the number of people who do not become junkies. I say unfortunately because it seems that many people self medicate to deal with sadness or emptiness in their lives, which makes dealing with hard drug use a daunting task. How do we remove sadness from people's lives? How do we heal the abscess of loneliness? Unfortunately people do not always make good decisions, even if they are content, well adjusted people. If we legalize heroin in the manner I believe we should with marijuana, I fear many more people than now will stumble into heroin addiction. So caught in a valley between two extreme responses, one which is antithetical to our Western social constructs and another which does not adequately protect people from themselves, what do we do? Perhaps the case of Portugal represents an alternative. While not legalizing the all drugs - you won't see commercials for Black Tar™ brand Heroin - Portugal has decriminalized all drugs, meaning that while they haven't granted heroin the tacit acceptance that comes with legalization, they have made life easier for those who inevitably do become addicts. Perhaps this is the best we can hope for.
- arca_vorago 9y ago
  "Does not adequately protect people from themselves, what do we do?" What we do as a society founded upon the principles of natural rights and liberties is stop trying to protect people from themselves. It always was, and always will be, a slippery and dangerous slope to collectivism and totalitarianism. The government has absolutely no right whatsoever to tell me what I can and can't do with my body, whether that is drinking beer, coke, smoking weed, or cigars, or eating lettuce. For by accepting the encroachment, you open the floodgates for arbitrary decisions on what can and can't be done. It's not even that these thing need to be "legalized". It was never the right of the government either federal or state to determine them one way or the other. All the proper medical care, mentally and physically, and education about substances, would then be free to do its good work without the interference of lawyers attempting to legislate our lives. This silent acquiescence of increasingly overreaching government must stop. It is anathema to everything America was founded upon. "...a long habit of not thinking a thing wrong, gives it a superficial appearance of being right, and raises at first a formidable outcry in defense of custom. But tumult soon subsides. Time makes more converts than reason." - Thomas Paine Common Sense
ananab 9y ago
Sounds like we're conflating 2 issues: (1) How we can we let addicts shoot up in a way that is safe for them (2) How can we let addicts shoot up in a way that is safe for their community Pardon my ignorance, but I think we should be focused on the safety of the community (2), more than how addicts can continue to abuse drugs safely (1). People have abused drugs for a long time (alcohol included), which results in self-inflicted repercussions. Natural selection tends to weed these genes out if such people don't exert self-control and make a permanent clean break, as difficult as it may be. My solution: legalize all drugs in limited geographic areas — far away from society at large (along the lines of Vegas). What happens there stays there, and feel free to stay there forever if you'd like. I don't say that to be insensitive. I myself enjoyed alcohol too much, until it got me in enough trouble enough times that I decided the pain it caused my family & friends wasn't worth it. I had 2 choices in front of me: drink my life away and drag the people I care about with me through it all, or man up and swear it off for good. I chose the latter. No therapy, AA, etc., just a deep sense of the injustice and lack of empathy in my actions, and living (and dead) examples before me in my family. Had I been so weak to continue favoring my short term pleasure, it would serve me right to die early and put an end to everyone's pain (my own included).
- hycaria 9y ago
  But you realise they can't be on their own, without society and its working businesses to feed themselves, its healthcare facilities to care for them, its giving inhabitants to sustain their addiction... I also really wish I would not have to see the worst humanity and its hopelessness everytime I pass the nearby hospital that has a safe and free injection site, but sadly as a society we can't just give up on those people even though a ridiculous proportion is making it in the end.
acoye 9y ago
I lived in SF for a couple years near TL and I saw people doing it on the streets. To me this site is a good thing, harm reduction policies have shown good track record. They work. A good exemple is the "première ligne" association in Switzerland. They have a big site in Geneva, you can see the building for the train station. I would recommend a read of their website. http://www.premiereligne.ch/ http://www.premiereligne.ch/
IdontRememberIt 9y ago
In Switzerland, we have that kind of structure since ages. They are effective, lower criminality, decrease neigboorhood issues, decrease criminality rate, health issues and lower the medical costs supported by the public hospitals. Of course, it does not solve the major issue: how to make them stop taking drugs. See that one in the center of Geneva: http://www.premiereligne.ch/quai9/ http://www.premiereligne.ch/quai9/ https://www.google.com/maps/contrib/102904556286110178389/photos/@46.2093191,6.1398544,17z/data=!3m1!4b1!4m3!8m2!3m1!1e1 https://www.google.com/maps/contrib/102904556286110178389/ph...
- skellera 9y ago
  Being someone who benefited from needle exchanges, it’s a step in the right direction. It’s a place where users will be exposed to options for getting clean. Ultimately they are the ones who need to come to that decision but having options positively shown to them will help. Addiction becomes a cycle of negative reinforcements and being able to put a possible break in that will make a difference. Many have mental health issues that they are self medicating for. Hopefully there are counselors there to help those who want it.
  - IdontRememberIt 9y ago
    Oh, yes. They provide a lot of services. Very good and positive structure.
tmoneymoney 9y ago
Hamsters "The Wire".

86 points by sethbannon 9y ago

dang 9y ago

The article comes from https://www.cnn.com/2018/02/07/health/safe-injection-sites-san-francisco-opioid-epidemic-bn/index.html https://www.cnn.com/2018/02/07/health/safe-injection-sites-s..., which has the better title but also an autoplaying video, so we'll use the title but stick with this URL.

formol 9y ago

The very lefty mayor of Paris launched one « safe site » in the city. Results : disneyland for drug dealers and addicts in the area, dead people (OD) in the street, noise, fights...

Andrex 9y ago
Sources for this would be very helpful. Always interested in alternative viewpoints!
- zapita 9y ago
  Here is a recent study of drug consumption room programs across Europe (including the one in Paris), and their impact so far. http://www.emcdda.europa.eu/topics/pods/drug-consumption-rooms http://www.emcdda.europa.eu/topics/pods/drug-consumption-roo... Their analysis seems pretty balanced, and seems to skew positive. It definitely contradicts the negative comment you're responding to.
  - chx 9y ago
    The truthiness of that comment can be pretty safely derived from the derisive word "lefty".
- boudin 9y ago
  I've never seen sources backing up what he says. According to this source results are positive in term of reducing consumption in streets and syringes found in streets. It also allowed to diagnose users with transmissible diseases and provide treatments. Neighbours of the injection site do complain of increase disturbance in the area but it seems due to the fact that it's the only site in Paris. Since the one opened in Paris, another one opened in Strasbourg and one is gonna open in Bordeaux this year http://mobile.lemonde.fr/societe/article/2017/10/12/premiere-salle-de-shoot-un-an-apres-un-bilan-global-positif-selon-la-mairie-de-paris_5199906_3224.html?xtref= http://mobile.lemonde.fr/societe/article/2017/10/12/premiere... There must be a lot more data from sites in Germany, Netherlands and Switzerland that has been opened for much longer.
- formol 9y ago
  Sources are very hidden : first result page on google (I'm talking for french people) http://www.bfmtv.com/police-justice/paris-emotion-apres-la-mort-d-un-homme-pres-de-la-salle-de-shoot-1219672.html http://www.bfmtv.com/police-justice/paris-emotion-apres-la-m... http://www.leparisien.fr/paris-75010/paris-le-cri-d-alarme-des-riverains-de-la-salle-de-shoot-10-03-2017-6751854.php http://www.leparisien.fr/paris-75010/paris-le-cri-d-alarme-d... https://www.google.fr/search?q=riverains+salle+de+shoot&source=lnt&tbs=qdr:y&sa=X&ved=0ahUKEwjombr2sKDZAhXpBsAKHb3XCXc4ChCnBQge&biw=1409&bih=925 https://www.google.fr/search?q=riverains+salle+de+shoot&sour... to sum up : the neighbours are very unhappy about it. The area was already largely insecure, though (heaven of crack-heads). I don't think the principle of safe site is bad, but it needs a good management team because - by definition - you can't expect any well disciplined behaviour from drug addicts.
  - hycaria 9y ago
    I recommend the rue de Maubeuge. It's just miserable, always a few crackheads hanging around and dealing or whatever. In one article [0], I read that the police deliberately don't act there. The videosurveillance is broken atm anyways. Maybe the nurses and the psychological aid they can freely ask for in the shooting room will save these poor souls so we don't need the police to intervene. But I go by everyday and there's no diminution. [0] https://www.streetpress.com/sujet/1463153023-drogue-paris-crack-skenan https://www.streetpress.com/sujet/1463153023-drogue-paris-cr...
jdavis703 9y ago
Don't we already have all of those problems though? Or is this saying this increased those issues? If so I'd love to see the data, maybe it can provide some lessons for SF as it experiments with this.
api_or_ipa 9y ago
I don't know much about the site in Paris but I do have experience living nearby Vancouver's first of now two safe injection sites. In my experience what you describe did not happen in Vancouver. Safe injection sights save lives by providing a clean, safe place to minimize harm.
- Animats 9y ago
  That's Vancouver. Even the druggies are reasonably civilized.
  - api_or_ipa 9y ago
    Not sure if your comment is snide or just humourously dismissive. The homeless, drug addiction and mental health issues experienced in Vancouver, especially in the DTES are very real, and very serious. I don't think Vancouver's homeless population is significantly different than Paris'. Glad to hear Canada apparently has a good reputation abroad.
jlangenauer 9y ago
As a counterpoint, the Medically Supervised Injecting Room in Kings Cross (Sydney) has quite radically transformed the area for the better - people who used to live there before it opened tell of sometimes walking over the bodies of addicts who'd OD'd on the streets, and of seeing used syringes everywhere. Now, you'd hardly ever see these things. (I'd link to the Wikipedia article, but it seems to be the subject of an edit war between a couple of groups with agendas to push, so is best ignored.)
Faaak 9y ago
There's a safe site in Geneva (quai 9) near the train station, and none of the effects describe can be seen there.
hashmal 9y ago
It's interesting, I never heard about such results before (and I live in Paris). Would you care to share some links for further reading? I'm also curious to know why and how the political orientation of the mayor is relevant?
messy_desk 9y ago
This comment shows two things, 1. how projects like this will always be blamed for quality of life problems in the area, and how 2. the problems of street people and drug addicts are often much more complex and rooted in previous political clusterfucks. In the 1990s and early 2000s, the Gare du Nord was the main place that people smugglers would assist people in travelling from France to the UK. At the time you could walk onto a Eurostar without having your papers checked by a British border police (only French passport control, who tolerated migrants travelling to the UK with false papers). Lots of desperate and often penniless people pitched up around that area. People smuggling was linked to other forms of criminality, including prostitution and robbery by people trying to get the money to make the trip to the UK. When the border protocol changed, the main staging points for migrants moved to Calais. But that part of Paris remained a centre for migrants to meet and connect. It also remained a centre of street dealing, robbery, other forms of low-level crime like selling fake bags, scams and snatching. It is notorious for street harassment, mainly of women. As far as I can tell, there isn't a particular overlap between people doing this and hard drug addicts. In practice, most cities have somewhere you go to buy drugs on the street in the middle of the night. No-one wants to be that area, but trying to get it to be somewhere else doesn't really solve the problem. There are lots of things which can make this type of area less upsetting for people who have to work, live and travel through it, safe injection sites might certainly be a part of this. Source: have lived in Paris and travelled there extensively over last 20+ years. My friend was an asylum seeker in the UK who got the Eurostar from Paris.

coolspot 9y ago

It is like they are testing there how far they could go.

Phanyxx 9y ago

Here in Vancouver the safe injection sites have saved countless lives and drastically lowered needle sharing. There's a big misconception that safe injection sites somehow promote drug use. They save lives and give people a legitimate pathway to get clean if they choose to. Do the right thing, SF!

AnabeeKnox 9y ago
It might be a hard sell to use Vancouver as a model. It has an area which is perhaps the most public display of social decay I've ever encounted in a first-world city, principally from drug abuse.
- ggg9990 9y ago
  As someone with no stake in this, I would rather have all of that decay in one place I can avoid rather than strewn about my city.
  - s0rce 9y ago
    But realistically that does nothing to solve the problem. We could just designate SF the safe injection site for the USA and the problem would be out of view for the rest of the population.
    - sergers 9y ago
      I don't think safe injection sites solve that problem, it's about making a safe environment for junkies to safely take drugs in hopes they don't do it elsewhere littering needles and drug paraphernalia in other public spaces, especially around children. Now for the junkies, needs to be more than a safe haven to shoot up and definitely agree with your sentiments. I know they offer more than that, but some people just want that and that's the problem
      - blackbagboys 9y ago
        The hope is that the "junkies" don't die. If that is all that's accomplished, that's still a success. There doesn't need to be more. Obviously there should be an option for users to enter treatment or receive some sort of assistance, but addicts should definitely not be forced into anything just to satisfy some petit bourgeois stern moral impulse, because that will ultimately drive people away and cost lives.

Cofike 9y ago

The individuals who are using these drugs already use them openly in the street. I see them daily on my way to work as I work in a popular area for vagrants/homeless. If it prevents me from stepping on needles and seeing blood from people shooting up on the street, I am all for it. These individuals will use one way or another if they want to so giving them a place to do it safely off the street seems acceptable. Of course, the ideal solution will be to eliminate heroin and other hard drug use but this is a start.

zanedb 9y ago
Well of course people want to eliminate it, but how? Is this not at least a step in the right direction?
- deleted 9y ago
  [deleted]
danmaz74 9y ago
> Of course, the ideal solution will be to eliminate heroin and other hard drug use but this is a start. That's practically impossible. A much more realistic goal is to minimize hard drugs use, and to minimize the negative impact of that use which will stay on both the users and everybody else. The problem of thinking about the "ideal solution", in this case, is that trying to reach it brings us to adopt policies that do the opposite of minimizing the negative impact of use, especially if you consider enriching and encouraging violent gangs and mobsters, corruptions, and ruined lives a negative impact.
smsm42 9y ago
> If it prevents me from stepping on needles and seeing blood from people shooting up on the street, I am all for it. For that, all the addicts need to be aware that this center exists, be able to get there (while suffering from withdrawal and other maladies accompanying their addiction) and be motivated to get there as opposed to getting the high right here right now (opioid addicts aren't exactly known for their capacity in delaying immediate gratification). With proper information and enforcement it may happen, but given how the streets of SF look now, this also may not happen. They mention Vancouver as an example. I've been in Vancouver a few years ago, and I must say, if we're talking about people living on the street and doing drugs there, SF has nothing on Vancouver. The site around where Insite is (according to it's Wikipedia article) was occupied by something that looks like a refugee camp in a disaster area, only with a lot of drugs. Maybe not Insite's fault, maybe they are placed there exactly because that's where people who need it are, but certainly it didn't fix it. I mean, maybe this saves these people's lives and is worth it. Vancouver locals certainly think it's worth it. But if you expect not seeing people doing drugs or stepping on needless and other unappetizing stuff - nah, didn't happen.

eddieh 9y ago

I thought the first of these sites in the US were going to be in Seattle? Seems like San Francisco is closer now. https://www.seattletimes.com/seattle-news/crime/seattle-king-county-move-to-create-2-injection-sites-for-drug-users/ https://www.seattletimes.com/seattle-news/crime/seattle-king...

icelancer 9y ago
The citizens of Seattle are fighting back against it pretty hard.
- aaronbrethorst 9y ago
  A group of Seattle NIMBYs are fighting back against it pretty hard. For the sake of my city, I hope they lose.

tcj_phx 9y ago

In days gone by, heroin addicts knew how much heroin they needed to 'stay well'. A major factor in the escalation of deaths in the modern era is the contamination of the street pharmacy's heroin supply with more potent synthetic opioids (fentanyl, etc). Overdoses happen when street drugs are more potent than the user expects, or when the user's tolerance has changed. Two factors in my girlfriend's OD were having been sober for 5 months and having been made addicted to clonazepam (a benzodiazepine that increases the potency of opiates - she'd only wanted this 'as needed', but the professionals at the hospitalization preceeding her OD thought she needed to take the full dose every day). That batch of heroin could also have been contaminated... A clean supply of heroin would be quite helpful in preventing people from killing themselves while self-medicating. Until the politicians find courage to acknowledge that it was a mistake to trust organized crime to control the supply of addictive substances, at least 'safe injection sites' is an intervention that can actually prevent people from causing their own premature expiration.

blauditore 9y ago
> Until the politicians find courage to acknowledge that it was a mistake to trust organized crime to control the supply of addictive substances, [...] What would be a better solution in your opinion? Legalizing it, or allowing it with prescription? I see some problems with those alternatives as well; there's probably no magic bullet here.
- colechristensen 9y ago
  Make everything legal to obtain or manufacture with a license attainable though education and certification – something in between what it takes to get a driver's license and an AA degree. If you want to buy heroin you have to understand it's addictive qualities, how human biology is affected, and how to recognize the negative consequences. Attach liability to the licensee for anything purchased that resulted in harm and to distributing substances with incorrect descriptions.
  - throwaway9990 9y ago

rajeshpant 9y ago

Great! The drug mafia can sell right outside the injection sites and increase sales!

sfstreet 9y ago

"The facilities provide a safe space where people can consume previously obtained drugs" That seems strange. If you actually tolerate drug use why not go the full way and provide clean versions of the drug on prescription, driving illegal dealers out of business?

askvictor 9y ago
That would be ideal, but probably not possible politically (at the moment, anyway). But this is a step in the right direction, and will hopefully lead to this in time.
smsm42 9y ago
Because then the organizers of the site would be in jail for drug trafficking, and so would be any doctor who prescribed those. That could happen only if drugs are legalized, and not only on the state but on federal level. You can judge how far we are from there if you notice that DOJ, under Sessions, is still battling the benign marijuana, even for medical use (which makes me seeing red and my blood pressure skyrockets each time I think about it - ffs, we use chemicals in medicine that can are like a nuclear weapon compared to marijuana's zippo lighter, and still these people refuse to see the case for even prescribed medical use!). And you're talking about legally dealing out the real bad stuff, which is dangerous. We are decades from that, at the very best.
bfuller 9y ago
We're getting there. There are opiate maintenance programs that utilize diamorphine (obviously not in the USA). They will give you pure heroin and supervise you so you don't fall out.

zenbit 9y ago

In 2016 there were 204 deaths due to substance abuse in North Rhine-Westphalia (NRW), with ~17m inhabitants Germany's most populous state. That same year there were 321 deaths in Bavaria. Bavaria has a population of only ~12m and in general has a much lower crime rate than NRW. The difference in deaths is often attributed to the fact that there are safe injection sites in NRW while there are none in Bavaria.

Jdam 9y ago
That’s because Bavaria is close to the Czech republic and the bavarian/czech border is a well known import corridor. Google further info on that, if you’re interested. Also, I invite you to compare the NRW numbers to the Berlin ones.
- zenbit 9y ago
  NRW borders the Netherlands, a country with easy drug access as well. And yes, deaths per capita are much higher in Germany's city-states (Berlin, Hamburg, Bremen). But please go ahead and compare numbers on a per-city basis (2016 numbers). You will note that Munich (62 deaths, 1.4m inhabitants, ~44 deaths per capita) is very much comparable to Berlin (167 deaths, 3.5m inhabitants, ~48 deaths per capita).
  - Jdam 9y ago
    Sure, gaining access to drugs in the Netherlands is easy, but usually people go there to get some of the not-so-deadly drugs, like weed and not heroin or meth, like bavaria.
- tobltobs 9y ago
  The drug importers don't sell their stuff along their import corridors. They bring it to next distribution center before they start splitting it up. according your logic Texas would be one of the states with a high drug overdose mortality. You are confusing small scale crystal meth smuggling with large scale opiate importing.

folli 9y ago

A well written chronology of the rise and decline of the Needle Park in Zurich, Switzerland: Chapter 1: https://www.tagesanzeiger.ch/extern/storytelling/needletrauma/chapter1/ https://www.tagesanzeiger.ch/extern/storytelling/needletraum... Chapter 2: https://www.tagesanzeiger.ch/extern/storytelling/needletrauma/chapter2/ https://www.tagesanzeiger.ch/extern/storytelling/needletraum... Chapter 3: https://www.tagesanzeiger.ch/extern/storytelling/needletrauma/chapter3/ https://www.tagesanzeiger.ch/extern/storytelling/needletraum... Chapter 4: https://www.tagesanzeiger.ch/extern/storytelling/needletrauma/chapter4/ https://www.tagesanzeiger.ch/extern/storytelling/needletraum... Methadone programs and safe injection sites were crucial elements in resolving the tragedy.

smsm42 9y ago

The article starts with "to open what could become the nation’s first legal safe injection sites aimed at curbing the opioid epidemic". How that should work? I understand that it may help existing drug addicts and reduce mortality from opioid abuse (which by itself is a good thing) but how can it curb the opioid epidemic? I may be that it achieves many other benefits, but what would be the way it may achieve this one? By logic if opioid use becomes easier and less dangerous (which, again, may be a very good thing for current addicts) it would not make people less willing to take opioids, so how that is supposed to work? Is there some component of it that I am missing?

birken 9y ago
> have consistently shown them to be effective at reducing overdose deaths, preventing transmission of HIV and viral hepatitis, reducing street-based drug use and linking people to drug treatment and other services There are a lot of people addicted to drugs that don't want to be. In a safe injection site, you have a bunch of health professionals around who are experts at treating addiction. I'm not an expert on opioid addiction but I'd wager that the ease or difficulty of injecting the drugs isn't a major factor for opioid usage. I think the people who are addicted will get and take the drugs by any means necessary, and people who aren't addicted to opioid's probably aren't going to try them all the sudden because there is a safe injection site.
- smsm42 9y ago
  > you have a bunch of health professionals around who are experts at treating addiction. That'd be nice but the article doesn't say anything about health professionals - it looks like there are just organizations dedicated to supplying clean needles, etc. - which is completely different level of investment than having a doctor specializing on addiction and involved with long enough term that it could actually make a dent. From the article, the most they can do is provide referrals.

meri_dian 9y ago

We are caught in an ideological chasm in the US. On one side is a harsh society wide approach like that of the Chinese. On the other hand is complete tolerance and legalization, which is more compatible with a Western social and political values. We are in an awkward spot somewhere in between. Unfortunately we must measure success of our national drug programs by the number of people who do not become junkies. I say unfortunately because it seems that many people self medicate to deal with sadness or emptiness in their lives, which makes dealing with hard drug use a daunting task. How do we remove sadness from people's lives? How do we heal the abscess of loneliness? Unfortunately people do not always make good decisions, even if they are content, well adjusted people. If we legalize heroin in the manner I believe we should with marijuana, I fear many more people than now will stumble into heroin addiction. So caught in a valley between two extreme responses, one which is antithetical to our Western social constructs and another which does not adequately protect people from themselves, what do we do? Perhaps the case of Portugal represents an alternative. While not legalizing the all drugs - you won't see commercials for Black Tar™ brand Heroin - Portugal has decriminalized all drugs, meaning that while they haven't granted heroin the tacit acceptance that comes with legalization, they have made life easier for those who inevitably do become addicts. Perhaps this is the best we can hope for.

arca_vorago 9y ago
"Does not adequately protect people from themselves, what do we do?" What we do as a society founded upon the principles of natural rights and liberties is stop trying to protect people from themselves. It always was, and always will be, a slippery and dangerous slope to collectivism and totalitarianism. The government has absolutely no right whatsoever to tell me what I can and can't do with my body, whether that is drinking beer, coke, smoking weed, or cigars, or eating lettuce. For by accepting the encroachment, you open the floodgates for arbitrary decisions on what can and can't be done. It's not even that these thing need to be "legalized". It was never the right of the government either federal or state to determine them one way or the other. All the proper medical care, mentally and physically, and education about substances, would then be free to do its good work without the interference of lawyers attempting to legislate our lives. This silent acquiescence of increasingly overreaching government must stop. It is anathema to everything America was founded upon. "...a long habit of not thinking a thing wrong, gives it a superficial appearance of being right, and raises at first a formidable outcry in defense of custom. But tumult soon subsides. Time makes more converts than reason." - Thomas Paine Common Sense

ananab 9y ago

Sounds like we're conflating 2 issues: (1) How we can we let addicts shoot up in a way that is safe for them (2) How can we let addicts shoot up in a way that is safe for their community Pardon my ignorance, but I think we should be focused on the safety of the community (2), more than how addicts can continue to abuse drugs safely (1). People have abused drugs for a long time (alcohol included), which results in self-inflicted repercussions. Natural selection tends to weed these genes out if such people don't exert self-control and make a permanent clean break, as difficult as it may be. My solution: legalize all drugs in limited geographic areas — far away from society at large (along the lines of Vegas). What happens there stays there, and feel free to stay there forever if you'd like. I don't say that to be insensitive. I myself enjoyed alcohol too much, until it got me in enough trouble enough times that I decided the pain it caused my family & friends wasn't worth it. I had 2 choices in front of me: drink my life away and drag the people I care about with me through it all, or man up and swear it off for good. I chose the latter. No therapy, AA, etc., just a deep sense of the injustice and lack of empathy in my actions, and living (and dead) examples before me in my family. Had I been so weak to continue favoring my short term pleasure, it would serve me right to die early and put an end to everyone's pain (my own included).

hycaria 9y ago
But you realise they can't be on their own, without society and its working businesses to feed themselves, its healthcare facilities to care for them, its giving inhabitants to sustain their addiction... I also really wish I would not have to see the worst humanity and its hopelessness everytime I pass the nearby hospital that has a safe and free injection site, but sadly as a society we can't just give up on those people even though a ridiculous proportion is making it in the end.

acoye 9y ago

I lived in SF for a couple years near TL and I saw people doing it on the streets. To me this site is a good thing, harm reduction policies have shown good track record. They work. A good exemple is the "première ligne" association in Switzerland. They have a big site in Geneva, you can see the building for the train station. I would recommend a read of their website. http://www.premiereligne.ch/ http://www.premiereligne.ch/

IdontRememberIt 9y ago

In Switzerland, we have that kind of structure since ages. They are effective, lower criminality, decrease neigboorhood issues, decrease criminality rate, health issues and lower the medical costs supported by the public hospitals. Of course, it does not solve the major issue: how to make them stop taking drugs. See that one in the center of Geneva: http://www.premiereligne.ch/quai9/ http://www.premiereligne.ch/quai9/ https://www.google.com/maps/contrib/102904556286110178389/photos/@46.2093191,6.1398544,17z/data=!3m1!4b1!4m3!8m2!3m1!1e1 https://www.google.com/maps/contrib/102904556286110178389/ph...

skellera 9y ago
Being someone who benefited from needle exchanges, it’s a step in the right direction. It’s a place where users will be exposed to options for getting clean. Ultimately they are the ones who need to come to that decision but having options positively shown to them will help. Addiction becomes a cycle of negative reinforcements and being able to put a possible break in that will make a difference. Many have mental health issues that they are self medicating for. Hopefully there are counselors there to help those who want it.
- IdontRememberIt 9y ago
  Oh, yes. They provide a lot of services. Very good and positive structure.

tmoneymoney 9y ago

Hamsters "The Wire".