Editorial: With the opioid epidemic raging, San Francisco takes a smart gamble on preventing overdoses

A man prepares heroin he bought on the street to be injected at the Insite safe injection clinic in Vancouver, Canada.
(Darryl Dyck / Associated Press)

With the opioid epidemic raging and thousands of people dying from overdoses annually, four Democrats in the California Legislature proposed a controversial but potentially effective response: letting a handful of counties experiment with safe injection sites.

At these government-sanctioned centers, drug users could bring illicit controlled substances to inject in a clean space with clinical supervision to guard against lethal overdoses. In Canada and Europe, where injection sites have been used for decades, they are credited with saving lives and helping direct addicts into treatment. The sites are among the so-called “harm-reduction” strategies that, along with programs that provide clean needles and equip first responders with a drug that reverses overdoses, are intended to keep drug addicts alive at least until they can get into treatment.

But worries about encouraging drug use among non-addicts, or at least appearing to do so, stymied the proposal in the Legislature. The bill is back again this year, and this time lawmakers should pass it. Meanwhile, the rest of the state isn’t content to wait as the death toll mounts. San Francisco health officials on Tuesday decided to move ahead with what may well be the first safe injection sites in the U.S. by July 1, with or without the blessing of state authorities.


They argued that the damage from drug addiction is so serious — people dying from opioid overdoses and used needles littering the street — that it demands extralegal action. San Francisco is taking a gamble, of course, since it’s a violation of state and federal law to operate a facility where people consume illicit drugs. But with even the American Medical Assn. now on record supporting safe injection pilot projects, California Atty. Gen. Xavier Becerra has good reason not to spend his limited resources shutting down a few centers created to keep people from overdosing or contracting illnesses from dirty needles. Federal law enforcers have better things to pursue as well.

In addition to the lives we hope will be saved, the payoff from San Francisco’s efforts will be the data. If the results mirror the very well-examined experiences of the first safe injection center in North America — the Insite clinic in Vancouver — they should quell fears once and for all that these injection centers will just be modern day opium dens. The sooner the effort begins, the better.

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