INJECTION CENTER COULD HELP SOLVE S.F. NEEDLE PROBLEM

A month after we chronicled "the march of the junkies" at the needle
exchange center near Golden Gate Park, longtime neighbors say things
have improved. Residents who live near the center on Haight said it
was the source of used syringes being discarded in the park and in
their yards by drug users.

"It has lightened up, I have to admit," says Les Silverman, who has
lived a block from the Panhandle on Cole Street since 1975 and told us
he'd found needles in his front yard garden. "It's a little better."

Park gardeners (who have been told not to talk to the media) say they
are coming across fewer needles, and our recent morning trip to the
park did not find nearly as many syringes as a month earlier.

That's great. But insiders say it doesn't have anything to do with
serious reform in the way needles are distributed to intravenous drug
users, something the city has been facilitating since 1992 to curb the
spread of disease.

"As much as I'd like to claim credit," says Peter Davidson, chairman
of the board of the Homeless Youth Alliance, which runs the Haight
needle exchange, "I think it is because of the police doing these
sweeps and moving people out."

Again, that's terrific, but how long will the sweeps last? (A police
source tells us that four officers and a sergeant are being pulled off
the street for two hours every morning.)

If we're really serious about a long-term solution for discarded
needles littering our parks, it may be time for a bold, new initiative
- a city-sponsored injection center where drug users could go, receive
a clean needle, and inject themselves in a sanitary
environment.

Sounds shocking, doesn't it?

Dr. Thomas Kerr, an HIV/AIDS researcher at the University of British
Columbia, who has studied an injection facility in Vancouver - the
only one in North America - understands the reaction.

"When the average person first hears about it," says Kerr, who has
studied the Vancouver facility for four years, "They say, 'Oh my God,
this is going to make drug use go crazy.' People think it enables drug
use."

But the concept of a needle exchange faced the same kind of opposition
20 years ago. Other countries, including Switzerland, Germany and
Canada, have used the injection facility concept successfully, but it
has not been tried in the United States.

Davidson says he was at a conference recently when a Swiss researcher
was asked about the program.

"It is not because the Swiss are nice to junkies," the researcher
said, according to Davidson. "It is because injecting is a public
nuisance, and we wanted to get them off the street."

Kerr puts it this way: "If you don't like seeing addicts injecting in
public places, if you are concerned about finding discarded needles,
if you have a problem with public order, the injection facility does
make sense."

There's certainly a need for something. Davidson says it is no wonder
we found discarded needles when we toured Golden Gate Park in July. He
says there are an estimated 15,000 "injecting users" in San Francisco,
many of whom inject drugs as many as 10 times a day.

"You're talking about millions of 'injectable events,' " Davidson
says.

And if every user does so with a clean needle - which is the idea of
needle exchanges - that's millions of needles. The problems are
obvious. First, you are talking about intravenous drug users, a group
not considered incredibly responsible. And second, although Davidson
says it has not been illegal since 2005, many fear being caught with a
used syringe.

"Users are very concerned and fear arrest by SFPD, and this may be
motivation for discarding syringes in haste," said a recent report on
the topic by San Francisco's Department of Public Health.

That's two good reasons why users are more likely to toss a needle in
the bushes, rather than dispose of it safely.

As Dr. Mitch Katz, San Francisco's public health director, says, "We
feel the needle exchange is a success in terms of preventing disease.
What needs to be improved is cleanup."

An understatement, to be sure. Residents and neighbors to Golden Gate
Park are understandably shocked to find used needles during their
daily walks. The public health department has gotten that message.

It launched an analysis of the needle exchange programs when Chronicle
columns and stories on the subject began appearing a month ago. And
some changes are in the works.

Katz says his agency has ordered "Fitpacks" - 10-pack syringe
dispensers with a built-in disposal compartment - that will be
distributed at the exchange centers.

In addition, outreach workers will go into the park with portable
biohazard boxes to collect used syringes from users.

It also is safe to say that the city is keeping closer tabs on local
needle exchange facilities and how they're working. Although all 17 of
the facilities are technically independent, a large part of their
funding ($275,000 in the case of the Haight exchange) comes from the
city.

"The great thing about this," Davidson says, "is that we have really
had it shoved in our faces how we affect the community. We all have a
real interest in getting along with the neighbors. If there are
needles in the park, it is bad for everyone."

In other words, everyone is saying all the right things. And there's
no question they are making an effort to change and improve the
situation. But you have to wonder, now that we've got your attention,
isn't this the time for dramatic steps? San Francisco seems like the
kind of place where a case could be made for an injection center.

Kerr says researchers in British Columbia have done 25 scientific
studies in the last four years and published their results in medical
journals such as the New England Journal of Medicine and the Lancet.
Every study of the injection center, he says, has shown improvement -
fewer discarded needles, less injection in public, and even higher
drug treatment numbers.

"I think a lot of people thought it was crazy four years ago," Kerr
says. "But today, 70 percent of Vancouverians support the injection
center."

San Franciscans might want to give it a try. We already know almost
100 percent of them don't like things as they are now.