Amid COVID-19, San Francisco sees opioid overdoses skyrocket


In early 2019, a previously homeless man named Tom Wolf posted a thank-you on Twitter to the cop who had arrested him the earlier spring, when he was strung out in a doorway with 103 tiny bundles of heroin and cocaine in a plastic baggie at his ft.

“You saved my life,” wrote Wolf, who had lastly gotten clear after that bust and 90 days in jail, ending six months of sleeping on scraps of cardboard on the sidewalk.

As we speak, he joins a rising refrain of individuals, together with San Francisco’s mayor, calling for the town to crack down on an more and more lethal drug commerce. However there may be little settlement on how that ought to be finished. Those that demand extra arrests and stiffer penalties for sellers face highly effective opposition in a metropolis with little urge for food for locking folks up for medication, particularly as Black Lives Matter and the motion to defund the police push to drastically restrict the ability of regulation enforcement to cope with social issues.

Drug overdoses killed 621 folks within the first 11 months of 2020, up from 441 in 2019 and 259 in 2018. San Francisco misplaced a median of about two folks a day to medication in 2020, in contrast with the 178 who had died of COVID-19 by Dec. 20.

As in different components of the nation, a lot of the overdoses have been linked to fentanyl, the highly effective artificial opioid that laid waste to the jap United States beginning in 2013 however didn’t arrive within the San Francisco Bay Space till about 5 years later.

Simply as the town’s drug scene was awash with the deadly new product — which is 50 instances stronger than heroin and sells on the road for round $20 for a baggie weighing lower than half a gram — the COVID-19 pandemic hit, absorbing the eye and sources of well being officers and isolating drug customers, making them extra more likely to overdose.

The pandemic is contributing to rising overdose deaths nationwide, based on the federal Facilities for Illness Management and Prevention, which reported this month {that a} document 81,000 Individuals died of an overdose within the 12 months ending in Might.

“That is shifting in a short time in a horrific course, and the options aren’t matching it,” mentioned Supervisor Matt Haney, who represents the Tenderloin and South of Market neighborhoods, the place almost 40% of the deaths have occurred.

Haney, who has hammered Metropolis Corridor for what he sees as its indifference to a life-or-death disaster, is asking for a extra coordinated

“It ought to be a harm-reduction response, it ought to be a therapy response — and sure, there must be a regulation enforcement side of it too,” he mentioned.

Tensions throughout the metropolis’s management got here to a head in September, when Mayor London Breed supported an effort by Metropolis Atty. Dennis Herrera to wash up the Tenderloin by legally blocking 28 identified drug sellers from getting into the neighborhood.

However Dist. Atty. Chesa Boudin, a progressive elected in 2019 on a platform of police accountability and racial justice, sided with activists opposing the transfer. He referred to as it a “recycled, punishment-focused” strategy that might accomplish nothing.

Folks have died on the Tenderloin’s needle-strewn sidewalks and alone in resort rooms the place they have been housed by the town to guard them from COVID-19. Older Black males residing alone in residential accommodations are dying at notably excessive charges; Black folks make up round 5% of the town’s inhabitants however account for 1 / 4 of the 2020 overdoses. In February, a person was found hunched over, ice-cold, within the entrance pew at St. Boniface Catholic Church.

Hyde Street between Golden Gate and Turk is one of the Tenderloin's most notorious blocks.

Hyde Avenue between Golden Gate and Turk is likely one of the Tenderloin’s most infamous blocks. Medicine are routinely offered and consumed in broad daylight, generally yards away from cops.

(Rachel Scheier/Kaiser Well being Information)

The one motive drug deaths aren’t within the hundreds, well being officers say, is the outreach that has change into the mainstay of the town’s drug coverage. From January to October, 2,975 deaths have been prevented by naloxone, an overdose reversal drug that’s often sprayed up the nostril, based on the DOPE Project, a city-funded program that trains outreach employees, drug customers, the customers’ relations and others.

“If we didn’t have Narcan,” mentioned program supervisor Kristen Marshall, referring to the frequent naloxone model identify, “there could be no room at our morgue.”

Town can be hoping that state lawmakers in 2021 will approve secure consumption websites, the place folks can do medication in a supervised setting. Different initiatives, resembling a 24-hour meth sobering middle and an overhaul of the town’s behavioral well being system, have been placed on maintain due to pandemic-strained sources.

Efforts such because the DOPE Mission, the nation’s largest distributor of naloxone, mirror a seismic shift over the previous couple of years in the way in which cities confront drug abuse. As extra folks have come to see dependancy as a illness moderately than against the law, there may be little urge for food for locking up low-level sellers, not to mention drug customers — insurance policies left over from the “struggle on medication” that started in 1971 beneath President Nixon and disproportionately punished Black Individuals.

Outreach groups in the Tenderloin distribute meals, substance abuse services and naloxone.

Outreach teams within the Tenderloin distribute meals, substance abuse providers and naloxone — a medicine designed to quickly reverse an opioid overdose.

(Rachel Scheier/Kaiser Well being Information)

In apply, San Francisco police don’t arrest folks for taking medication, actually not within the Tenderloin. On a sunny afternoon in early December, a red-haired younger lady in a beret crouched on a Hyde Avenue sidewalk together with her eyes closed, clutching a bit of foil and a straw. A number of blocks away, a person sat on the curb injecting a needle right into a thigh lined with scabs and scars, whereas two uniformed cops sat in a squad automobile throughout the road.

Final spring, after the pandemic prompted a citywide shutdown, police stopped arresting sellers to keep away from contact which may unfold the coronavirus. Inside weeks, the sidewalks of the Tenderloin have been lined with folks in tents.

The streets turned such a narcotics free-for-all that lots of the working-class and immigrant households residing there felt afraid to go away their houses, based on a federal lawsuit filed by enterprise homeowners and residents. It accuses Metropolis Corridor of treating much less rich ZIP Codes as “containment zones” for the town’s ills.

The go well with was settled a number of weeks later after officers moved a lot of the tents to designated “secure sleeping websites.” However for a lot of, the deterioration of the Tenderloin, juxtaposed with the gleaming headquarters of corporations like Twitter and Uber simply blocks away, symbolizes San Francisco’s starkest contradictions.

Mayor Breed, who lost her younger sister to a drug overdose in 2006, has referred to as for a crackdown on drug dealing.

The Federal Initiative for the Tenderloin was one such effort, introduced in 2019. It goals to “reclaim a neighborhood that’s being smothered by lawlessness,” U.S. Atty. David Anderson mentioned at a current digital information convention saying a major operation through which the feds arrested seven folks and seized 10 kilos of fentanyl.

Legislation enforcement businesses have blamed the continued availability of low-cost, potent medication on lax prosecutions.

Boudin, nevertheless, mentioned his workplace recordsdata fees in 80% of felony drug instances, however most contain low-level sellers whom cartels can simply substitute in a matter of hours.

He pointed to a federal sting in 2019 that culminated within the arrest of 32 sellers — principally Hondurans who have been later deported — after a two-year undercover operation involving 15 businesses.

“You go stroll via the Tenderloin right this moment and inform me if it made a distinction,” Boudin mentioned.

His place displays a rising “progressive prosecutor” movement that questions whether or not decades-old insurance policies that target placing folks behind bars are efficient or simply.

In Might, the killing of George Floyd by the Minneapolis police energized a nationwide police reform marketing campaign. Cities across the nation, including San Francisco, have promised to redirect millions of {dollars} from regulation enforcement budgets to social applications.

“If our metropolis management says in a single breath that they need to defund the police and are for racial and financial justice, and within the subsequent speak about arresting drug sellers, they’re hypocrites and so they’re fallacious,” mentioned Marshall, chief of the DOPE Mission.

However Wolf, 50, believes a concerted crackdown on sellers would ship a message to the drug networks that San Francisco is not an open-air unlawful drug market.

Like tons of of hundreds of different Individuals who’ve succumbed to opiate misuse, he started with a prescription for the painkiller oxycodone, in his case after foot surgical procedure in 2015. When the tablets ran out, he made his approach from his tidy dwelling in Daly Metropolis, simply south of San Francisco, to the Tenderloin, the place sellers in hoodies and backpacks loiter three or 4 deep on some blocks.

When he may not afford tablets, Wolf switched to heroin, which he realized how one can inject on YouTube. He quickly misplaced his job as a caseworker for the town and his spouse threw him out, so he turned homeless, holding giant portions of medicine for Central American sellers, who generally confirmed him pictures of the lavish homes they have been having constructed for his or her households again dwelling.

Trying again, he needs it hadn’t taken six arrests and three months behind bars earlier than somebody lastly pushed him towards therapy.

“In San Francisco, it looks like we’ve moved away from making an attempt to induce folks into therapy and as a substitute are simply making an attempt to maintain folks alive,” he mentioned. “And that’s not likely understanding that nice.”

This story was produced by Kaiser Health News, which publishes California Healthline, an editorially impartial service of the California Health Care Foundation. KHN will not be affiliated with Kaiser Permanente.


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