STICKING POINT

Mayor Gavin Newsom Has Ignored Proposals For Safe Syringe Collection

The Homeless Youth Alliance (HYA) has quietly operated a drop-in
center and needle exchange program in the Haight for the last 10
years. Until last month, very few people besides their clients even
knew they existed.

Then the San Francisco Chronicle ran a series of overheated articles
about used syringes littering Golden Gate Park. One of the pieces
singled out HYA for handing out drug needles "by the double handful."

But the HYA and similar groups have long urged city leaders to deal
with needle waste, urging them to install the type of needle
collection receptacles used in other cities that share San
Francisco's official "harm reduction" approach to drug use. "We've
been trying to get disposal boxes [for syringes] into the park for
over a year and a half," HYA executive director Mary Howe said.

Yet Mayor Gavin Newsom and his administration have ignored that
advice -- apparently concerned about its political implications --
and have instead ordered police and outreach workers to crack down on
the homeless.

"Since the [Chronicle] articles, a few people have decided to stroll
in off the street and tell us what they think of us," Howe told the
Guardian. "Clearly, they want to think that the syringe problem is on
me and on the needle exchange."

But Howe and other public health experts say San Francisco's
15-year-old needle-swap program has not only dramatically contained
HIV, Hepatitis C, and other deadly diseases among IV drug users, it
also has actually reduced the number of cast-off needles in public spaces.

Santa Cruz, New York, Baltimore, Vancouver, and many other cities
feature disposal boxes in drug hot spots. New York State Department
of Health spokesperson Claire Pospisil told us her agency has more
than 80 such receptacles around the state. While Newsom has borrowed
get-tough programs like community court (for quality-of-life offenses
generally committed by the homeless) and some aspects of his Care Not
Cash plan from New York, his administration nixed requests to put the boxes in.

Instead, shortly after the first Chronicle articles appeared in late
July, the city launched another crackdown on people sleeping in the
park, as other mayors before him have done during election years. But
several public health and law enforcement professionals told us the
raids will never rid the park of addicts looking for a safe place to
fix -- or the occasional used needle that they leave behind.

"It's one thing to sweep the park and displace an entire community if
you have someplace to put them," Howe argued. "But they don't have
any place to put them."

Howe said her attempts to have syringe containers placed in the park
are consistent with the San Francisco Health Commission's
seven-year-old "harm-reduction" mandate, which calls on city health
workers and city-funded contractors like needle-exchange programs to
minimize, as much as possible, the health dangers associated with
drug abuse. Used needles, Howe contends, count as one of these dangers.

But Newsom spokesperson Nathan Ballard confirmed by e-mail that the
administration has considered and rejected the idea for now. "The
mayor is not eager to put such boxes in the park," Ballard wrote. He
added that Newsom has asked the Health Department to consider
installing "receptacles ... in the right places," but when we asked
him in a follow-up e-mail where such "right places" might be, he did
not respond.

Rose Dennis at the Recreation and Park Department said that, in the
past, the department "floated the idea" of disposal boxes at public
meetings. But when it became clear that the containers would not be
politically popular, the department quickly gave up on them.

"People were really, profoundly opposed to it ... and we just didn't
have the confidence that we weren't going to be vilified for it,"
Dennis said. "We're not just going to politically put our asses out
there just because someone has an idea."

Several sources in the public health profession lamented this kind of
political ass-covering. Dr. Alex Kral, a noted San Francisco
epidemiologist, told us, "It's not that we don't have solutions to
these problems. We have solutions. The problem is the politics.... If
you take the politics out of it, we should have syringe disposal
boxes in the park and wherever [IV drug users] congregate. At the
very least we should have them at the edges of the park."

Even C.W. Nevius, the Chronicle columnist who stirred up the syringe
controversy in the first place, supports Howe's disposal box
proposal. "What's the downside of putting these boxes in?" he told
us. "People might think that boxes would somehow encourage people to
use drugs in the park, but the reason why [drug users] stay there
would not be because there are these boxes."

Nevius added that Newsom called him after his columns came out and
"yelled at me for 45 minutes.... He was very upset with the stories
and the way they showed what's happening."

Ballard touted the city's aggressive new actions to clean up Golden
Gate Park. He said that, in addition to the recent raids on homeless
encampments, 13 new Rec and Park patrol officers will be dispatched
to the park within a month, and "we're adding additional HOT
[homeless outreach] teams to connect more homeless people to the
services they need."

Lt. Mary Stasko at the San Francisco Police Department's Park Station
explained how social workers in the HOT teams interact with park
squatters during the early morning operations. "The outreach teams go
with the police officers and the clean-up crews, and they tell
people, 'We can put you in a bed tonight, we can give you a hot meal
right now if you come with us.'

But Stasko was doubtful that sweeps alone will stop homeless drug
users from returning to the park. City shelters do not permit
substance use, she reasoned, meaning anyone who wants to accept the
HOT teams' offers must choose immediate abstinence. "For the people
who are interested in quitting, [the city's new outreach efforts] are
working like a charm. But then you have the hard-core people who
don't want to stop using. They're the ones who end up coming back.
Those are the types that have been in the park since 1967."

Canadian epidemiologist Dr. Evan Wood cited San Francisco's
"high-threshold," abstinence-only approach to services as a major
factor in Golden Gate Park's chronic cycle of homelessness and
substance abuse. He has been involved with implementing Vancouver's
successful "safe injection site," where people can safely shoot up
and dispose of their needles.

Similar facilities are already widespread in Europe.

"Trying to simply eliminate these behaviors does not work," Wood went
on. "You have to meet these people on their turf."