Former SF Political Aide Announces End to Hunger Strike After City Leaders Pledge More Action on Drug Overdose Crisis

Gary McCoy once lived on the streets of San Francisco, where he experienced substance use disorder and witnessed drug overdose deaths firsthand.

Years later, he rose to the upper echelons of San Francisco's City Hall. On Sunday, McCoy began a round-the-clock hunger strike on its steps, urging the city to take action to prevent opioid-related overdose deaths.

On Tuesday, McCoy ended his strike at 60 hours after receiving support from the majority of the San Francisco Board of Supervisors. McCoy said officials will introduce a resolution urging the mayor to declare a state of emergency and authorize the use of safe consumption services.

McCoy's journey from homelessness to San Francisco's gold-painted rotunda made him popular within San Francisco political circles: He's been a congressional aide to House Speaker Nancy Pelosi and has worked for both state Sen. Scott Wiener and Mayor London Breed.

San Francisco saw nearly 700 fatal opioid overdoses last year, nearly twice the number of people who died from COVID-19.

An analysis by KQED and Documenting COVID-19, the latter a project started at Columbia University’s Brown Institute for Media Innovation, found that the number of fentanyl overdoses rose sharply from 2019 to 2020 in three Bay Area counties: 170% in Santa Clara County, 68% in San Francisco and 29% in Alameda County.

McCoy, 43, believes he narrowly escaped that fate. He feels the city isn't doing enough to address the crisis and wants the mayor to implement safe consumption sites where people can use drugs with safety monitoring by staffers to prevent death.

The matter is legally thorny, and efforts at the state level to implement them has been met with setbacks; Wiener's effort to pass SB 57, to allow some safe consumption sites, won't be heard next among state lawmakers until 2022. Breed's office said they want to create safe consumption sites but there are legal concerns. Meanwhile, a special city team that will provide resources to overdose survivors begins its work Monday.

McCoy is director of policy and public affairs with HealthRIGHT 360, a health services provider.

This interview has been edited for length and clarity. 

KQED's Sara Hossaini: So tell us about what you're doing out in front of City Hall.

Gary McCoy: I set up my chair and have a couple of books with me and a couple of jugs of water. And I am committed to sitting out here day and night and not eating solid foods, drinking water and herbal teas for as long as it takes until we can get a commitment from our city leaders to declare a state of emergency for the overdose crisis and authorize, fund and implement safe consumption services.

That's a big commitment. And you're no stranger to this place, right?

No, I'm no stranger to the building. I've worked in this building under three different supervisors in different capacities over the last decade or so and then across the street with the San Francisco Recreation and Parks Department for several years. And so I'm very familiar with the area. I used to live right over here, except this time I won't have as ready access to a restroom and, you know, indoor living.

Why is this issue so important to you?

I was born and raised in Norfolk, Virginia. It was very, very conservative. For me being gay, I don't know that I was in the closet, but I certainly wasn't shouting from the rooftops that I was gay when I was younger.

I moved here when I was in my very early 20s, and within a matter of months I was on the streets. I had once again picked up my substance use disorder. This time it was meth. Before I moved here in my teens, it was heroin. And my life got pretty dark, pretty quick.

And I don't know how I'm here today, but I vowed that because I'm here today, I will certainly do everything I can to try to at least help other people have the same opportunities.

I have a great life today. I have a husband that is very supportive of me, and we have a dog and we live in a market-rate-rent apartment and I'm working full time. And I've worked for some incredible people up until now. And while I've been abstinent from drugs and alcohol for a little over a decade now, I wouldn't have had that opportunity ... if it weren't for harm reduction [practices and policies] that got me there. I was a tough case for sure.

So when you were homeless, do you remember people dying of overdoses?

There were people around me that died of overdoses when I was using, but it was very few and far between. But with fentanyl now, people just don't know what they're using, and it's unsafe.

I think in 2017 we had something like 222 overdose deaths that year, and now we're well over 700 and counting.

I know the city has had to sort of struggle with the onset of the pandemic. And, you know, it's hard to prioritize things. I know that they've done a lot of work in prioritizing this issue. But again, it's time to open a safe consumption site.

Why do you consider safe consumption sites to be the answer?

I don't think they're the end-all, be-all. But they're a much-needed approach to connect to the harder-to-reach population who use drugs. And if you can start building that reputation and trust with somebody that's coming in to use in a supervised setting, then you sort of open up the dialogue to maybe gently nudge them to be seen by a clinician and take care of health issues.

How is it for you to be so open about all of this? What's it like to choose this moment to share all of this?

I think the more folks that can see that change is possible, I think the better. And so I've always been more than happy to put everything out there that I've experienced. And I've had no problems with it.

It strikes me that you're putting your body at risk again, but for a totally different reason.

I've been thinking a lot about this for the last couple of days, and my husband is — how do I put this? My husband has no issue reminding me that what I'm doing can be dangerous.

There was a lot of PTSD around me being on the streets and the things that I experienced, and I have been housed for over a decade now. And so I imagine there's going to be some things that come up while I'm out here. And, I think, I'm just ready to handle that mentally.

I think the bigger purpose for me being out here is to bring more attention to this issue and to make sure that the city can act rather than sort of us sitting in limbo for the next six months at least.