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US Attorney Threatens Legal Action if San Francisco Opens Supervised Injection Sites

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Speaking to reporters at Glide Memorial Church in the Tenderloin District on Wed., Feb. 26, San Francisco Mayor London Breed and Supervisor Matt Haney discuss a proposal to open supervised injection sites in the city. (Shannon Lin/KQED)

The federal government threatened legal action against San Francisco on Tuesday if the city follows through on a proposal to open supervised drug injection sites.

“Facilitating or tolerating illicit intravenous drug use may feel compassionate in the moment, but it is not compassionate," David Anderson, the U.S. Attorney for Northern District of California, said in a statement. "Adding medical supervision to such inherently destructive conduct does not change poison into medicine. The U.S. Attorney's Office will respond to supervised injection sites by enforcing federal law."

The warning comes in response to a bill recently proposed by San Francisco Mayor London Breed and Supervisor Matt Haney that would allow nonprofits in the city to open and operate the injection sites, where drug users could also receive medical assistance and rehabilitation services.

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Breed, who has long advocated for safe injection sites in the city, said she is "very clear" in understanding "the threat posed by the federal administration," but still intends to move forward with the measure, which she formally introduced at a Board of Supervisors meeting Tuesday. Steps would be taken, she said, to shield city workers from any ramifications should the Trump administration pursue legal action.

“[This] is an opportunity to do something different that may make people uncomfortable but could actually turn things around for this city and for the people we’re trying to help,” Breed said during a press conference last Wednesday at Glide Memorial Church in the Tenderloin District.

But even if San Francisco passes the proposed measure, the city still can’t legally open any sites unless the state Legislature approves a separate bill — AB 362 — that would grant legal protection to facility operators. That measure is expected to be taken up later this year.

The city's legislation comes amid a notable uptick in drug overdose deaths in San Francisco, with a 27% increase in 2019 over the previous year, according to the city's Department of Public Health. Particularly alarming has been the spike in fatal heroin and fentanyl overdoses, which more than doubled — from 90 in 2018 to 234 last year, the San Francisco Chronicle reported, based on preliminary statistics from the city’s medical examiner’s office.

Roughly 24,500 people in San Francisco inject drugs, city officials estimate, many in public.

Multiple studies have shown the effectiveness of supervised injection sites in reducing fatal drug overdoses and the spread of injection-related diseases. There are currently at least 100 sites worldwide — mostly in Europe — but none within the United States, where the treatment approach remains highly controversial and has been staunchly opposed by the Trump administration. Still, San Francisco is among at least a dozen cities that have considered opening supervised injection sites to stem recent jumps in overdose deaths.


San Francisco's proposed legislation comes just days after a Philadelphia nonprofit postponed plans to open what would have been the first supervised injection site in the United States, amid mounting pushback from residents and local lawmakers.

The cancellation marks an about-face following a significant court ruling handed down by a federal judge in late February determining that the Philadelphia site would not violate federal drug laws, despite efforts by federal prosecutors to block it.

Corey Davis, director of the Harm Reduction Legal Project in Los Angeles, said the judge's ruling may foreshadow what’s to come in California if federal prosecutors pursue litigation.

"Judges have found weight in precedent cases from their peers, so they may look to what fellow judges have ruled," Davis said. He noted, however, that San Francisco's district court would not be legally bound to the ruling in Philadelphia. "There is no clear legal answer as of yet."

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