S.F. INJECTION CENTER IDEA DRAWS, SUPPORT AND DOUBT

About 150 people gathered Thursday in the Mission District to discuss
an idea that some say is crazy even for San Francisco: opening a
city-funded, legal center where intravenous drug users can
congregate, get free needles and inject themselves in a safe environment.

Momentum for such a center seems to be gaining strength among drug
reform advocates and some public health workers, who say it will help
stop the spread of HIV and hepatitis C, prevent deaths from drug
overdoses and keep dirty needles off city streets.

Advocates for the center, who call themselves Alliance for Saving
Lives, sponsored the event along with the city's Public Health Department.

They are gathering signatures on a letter to send to Mayor Gavin
Newsom, the Board of Supervisors and Dr. Mitch Katz, head of the
Public Health Department.

Supporters include the San Francisco AIDS Foundation, the Mission
Neighborhood Resource Center, the Harm Reduction Coalition and San
Francisco General Hospital's Opiate Treatment Outpatient Program.

The letter reads in part, "We call on San Francisco to create a legal
Safer Injection Facility staffed with trained medical professionals.
. Please help us make this critical program a reality."

But so far, no San Francisco politician appears ready to champion the
cause. Newsom, meeting Thursday with The Chronicle editorial board,
said he doubts any neighborhood in the city would be willing to play
host to hundreds of intravenous drug users on a daily basis.

The obvious choice for the center - the Tenderloin, where many of the
users live - already deals with more than its share of social service
providers while also being home to many families and children, Newsom said.

"You put another center in there, you're going to enhance and advance
some conflicts that are already there," he said. "I'm not
ideologically against it - I'm just pragmatically concerned."

The hesitation doesn't surprise those who work in British Columbia at
Insite in Vancouver's Downtown Eastside, which is akin to San
Francisco's Tenderloin in that it is an impoverished neighborhood
with many drug users. Insite, which opened four years ago, is North
America's only injection drug center, though many exist in Europe.

It took 10 years of community organizing for the Vancouver center to
go from idea to reality, said Sarah Evans, the center's program
coordinator, who spoke Thursday at the San Francisco symposium.

Insite is a rather bland, sterile place used by 800 intravenous drug
users every day. They bring their own drugs - most often heroin,
crack, cocaine and crystal methamphetamine - but are given free
needles by the center's staff. The center hands out and collects 2
million needles a year.

The center has three rules: no violence, no dealing and no injecting
anybody but yourself. Eight staff, including nurses and counselors,
are at the center at any given time. It recently opened an on-site
residential detox and recovery program.

Despite a lot of initial skepticism, the Vancouver center now has the
backing of the majority of the public, the mayor, the police chief
and local merchants, Evans said.

"The evidence is really clear that we're achieving our goals for the
users and the community," Evans said. "The more you look into it, the
more you realize it's crazy not to do it."

The center has proven it can help stop the spread of disease and
prevent deaths from overdoses, said Dr. Thomas Kerr, an HIV/AIDS
researcher at the University of British Columbia. He has studied
Vancouver's injection facility since its inception, and spoke at
Thursday's event.

Kerr said 800 overdoses have happened at the facility, but they have
resulted in no deaths because trained professionals are right there.
Without the center, overdoses would happen in back alleys or
single-room-occupancy hotel rooms where there would be no help, he
and other supporters of the facility said.

"It's really been studied to death - it's time to move on," Kerr
said. "It's obvious this is something that works."