A man uses a narcotic-consumption booth at a safe-injection site at OnPoint NYC in January 2022, in New York City. (Kent Nishimura/Los Angeles Times via Getty Images)
Lawmakers in California are debating whether to open sites where people can inject or snort illegal drugs under the watchful gaze of a health care worker. These facilities are an effort to save lives, as overdoses skyrocket across California.
Wiener stresses that so-called "safe consumption" or "supervised injection sites" not only would prevent overdoses, but also slow the spread of HIV and hepatitis by offering clean syringes. On-site health care workers would inspire folks to seek treatment.
The last time supervised injection facilities were on the table in California, in 2018, a bill progressed all the way to Governor Jerry Brown’s desk. He vetoed it. Wiener is trying again. He points to a recent cost-benefit analysis demonstrating that every dollar spent on safe consumption in San Francisco would save the city $2.33.
“Our hospitals, our emergency rooms, our fire department, our ambulances are all spending huge resources on people who are overdosing,” Senator Wiener said.
'I certainly would have been in much better hands'
Gary McCoy, formerly addicted to heroin then methamphetamine, wishes he would have had a safe place to shoot up before he hit rock bottom and nearly died.
He overdosed on heroin for the first time when he was 18 years old, at a gas station. The store attendant called 911 when McCoy deliriously crawled out of the bathroom and collapsed.
“I immediately went back to my dealer's house from the hospital and bought everything that she had because it was the best heroin I had ever done,” he said.
At the time, McCoy was grappling with his sexuality in a conservative town in Virginia.
“I wasn't quite in the closet,” said McCoy. “But I wasn't really open about the fact that I was gay.”
He spent the next decade high, homeless and near the brink. At 24 years old, McCoy learned he was HIV-positive. He was staying in a cheap hotel in San Francisco alone. It was Christmas Eve.
“I weighed 110 pounds, psoriasis was all over my body, I was injecting every day, couch-surfing when I could, and trading sex for drugs or a place to sleep.”
When he didn’t have anywhere else to shoot up, McCoy used bathroom stalls at public libraries.
“I think if I had a place to go where I could safely use, where people could see that I needed medical assistance, I think it would have avoided a lot of trauma,” he said.
McCoy says he spent lots of time in jail spread over many arrests, and landed in the emergency department monthly for at least a decade as his drug habits and AIDS ravaged his body.
Zero recorded overdoses
A safe consumption site can range from a converted RV to a sprawling warehouse. Inside, it typically looks somewhat like a hair salon, with mirrors lining the walls, individual stalls for each client, and sterile supplies laid out on steel countertops.
“You'll have two rooms,” said Alex Kral, epidemiologist for the nonprofit research group RTI International. “The first room is where people can inject under supervision. And then you have a second room where people can basically chill out after they have used drugs and be monitored.”
Health care workers equipped with “crash carts” stocked with naloxone and other lifesaving tools stand by.
“That number is really underreported because there are parts of the country that don't have the resources to do toxicology screens on every death,” said Ron Brooks, president of the National Narcotics Officers’ Associations’ Coalition.
He estimates the accurate tally could be as high as 140,000 deaths nationwide, which is why he says the overdose crisis is the most significant public health epidemic facing the nation. However, Brooks does not support opening “safe consumption sites” to solve the problem because, he says, there is no safe way to do drugs.
“You can call it what you want to call it. It's an open drug scene,” said Anne Marie Schubert, Sacramento County district attorney. “The fact that we're considering allowing our government to essentially aid and abet the illicit use of drugs that are killing our citizens, I find shocking.”
However, Gary McCoy says you can’t force sobriety. When he finally limped into treatment, AIDS had nearly wiped out his immune system. In fact, he was in such ghastly shape that his drug dealer finally nudged him to seek help, which is why he’s now a huge advocate for supervised injection sites.
“I don’t know if I would have stopped using sooner, but I certainly would have been in much better hands,” he said.
These days on morning strolls through his neighborhood in San Francisco, McCoy chats with people getting high on the streets. He lets them know there’s help available, and says that’s the real service outreach workers at safe consumption sites could provide.
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