San Francisco is permitting folks to make use of medication inside new Tenderloin remedy linkage middle
San Francisco is allowing people to use drugs in an outdoor area of Mayor London Breed’s new Tenderloin Linkage Center in United Nations Plaza, interviews and Chronicle observations confirm.
Several people told The Chronicle in interviews Tuesday that they had used drugs inside the fenced-in area bordering the center’s entrance on UN Plaza. In addition to the outdoor area, the city offers basic hygiene services, food, clothing and connections to services such as treatment and housing on the first floor of the seven-story building.
The mayor’s spokesperson, Jeff Cretan, said in an email that the “emergency initiative is about doing everything we can to help people struggling with addiction, and getting them connected to services and treatment. As part of that, the linkage center is serving as a low-barrier site to bring people off the street.”
The revelation that people are using drugs at the week-old site was first reported on the Substack newsletter of Michael Shellenberger, an author who has criticized progressive policies in San Francisco he sees as too permissive.
Addiction experts and advocates differ on whether allowing those who struggle with substance use disorder to get high at the site will help them get connected to treatment, with some saying it acknowledges a necessary reality on a journey to get help and others calling it counterproductive.
Shellenberger accused the city of running an “illicit drug consumption site” and a “supervised drug consumption area,” which is currently illegal under state and federal law.
Francis Zamora, a spokesperson for the Department of Emergency Management, which is running the linkage center, denied the city was operating a supervised consumption site. San Francisco is working to follow New York City in opening such a site which would provide medical supervision and clean supplies, despite its questionable legal status.
Even if city officials are turning a blind eye to illegal drug use, they’re unlikely to face legal liability, said Robert Weisberg, a Stanford law professor and co-director of the school’s Criminal Justice Center.
“Prosecutors have almost unreviewable discretion not to bring a charge,” Weisberg said. “I don’t think anybody would have standing to complain,” he said, because it would be hard for an individual to show he or she was injured by San Francisco’s actions or inactions.
Used syringes are seen littered along Hyde Street in San Francisco, Calif. Tuesday, Jan 18, 2022.
Stephen Lam / The Chronicle
Last month, Breed announced a state of emergency in the tenderloin in a bid to reduce overdose deaths and said she wanted to crack down on drug dealing and use in the neighborhood. She said people using drugs on the streets would be told that they had a choice of going to the linkage center or jail.
But the Department of Emergency Management and the Police Department said the day the center opened that social workers and public health workers were leading the outreach to get people to the center, but they were not being arrested for refusing to go, at least for now.
So far, police have not stepped up patrols and arrests in the tenderloin, although the mayor has indicated she still wants to do so when staffing and the budget increases.
Journalists are not allowed inside the linkage site, but a Chronicle reporter standing outside on Tuesday observed several people in the fenced-in area holding drug paraphernalia including foil and lighters used to smoke fentanyl and pipes used to smoke meth.
Three men with foil said they were glad to have a calm place to use drugs. Others were also appreciative, saying they could connect with the center’s services while taking advantage of a more private place to use drugs than the sidewalk.
Kayla Simpson, 28, sitting outside the center in UN Plaza, said she went in Jan. 18, the first day the center opened. While waiting in the fenced-in area, she said she felt the need to smoke, so she did.
“They were cool about it,” she said Tuesday.
Shellenberger, author of the new book “San Fransicko: Why Progressives Ruin Cities,” wrote that two people who did not identify themselves as journalists entered the site and took videos of people using drugs in the fenced-in area, while city contractors working at the site stood by.
When asked by The Chronicle what happens if someone tries to use drugs in the outdoor or indoor areas of the linkage center, and whether staff will allow the practice to continue, Zamora did not answer directly.
“This site is about getting people connected with immediate support as well as long-term services and treatment,” he said. “Part of being a low-barrier site means bringing people in without asking a lot of questions.”
Other city staff and nonprofit contractors interviewed at the center Tuesday gave a similar answer about a “low-barrier site.”
City homelessness department spokesperson Denny Machuca-Grebe said the area is not a supervised consumption site, “but if people overdose, at least they’re right next to staff that can help them.”
Since the center opened, staff members have reversed three overdoses, the city said. But those overdoses might be the result of someone using drugs prior to entering the site.
No one interviewed mentioned using drugs inside the building, only in the fenced area. People can come into the center and stay as long as they like; the center is open 12 hours a day now but will expand to 24 hours. Fentanyl users on the street said they sometimes need to use every hour to avoid symptoms of withdrawal.
Those who embrace the city’s harm-reduction policies said that allowing people struggling with addiction to use drugs at the center makes sense. Brooke Lober, director of harm reduction at St. James Infirmary, an organization that supports sex workers, said she wasn’t surprised by the reports people were using drugs at a drop-in center.
“They remain welcome there, and I think that’s how all services have to be if they are appealing to people if they use drugs,” she said. “The alternative would be to kick people out or otherwise send them on their way. The norm of these places is we are trying to meet people where they’re at.”
Lober said her organization does not support coerced services and has condemned the city’s law enforcement crackdowns and homeless sweeps.
dr Josh Bamberger, a clinical and family medicine professor at UCSF, said that allowing addicts to use drugs in a safer situation than on the street or the sidewalk is generally preferable, although he didn’t comment directly on the linkage center.
He said health care workers who help people addicted to drugs in street settings are in a similar, often “difficult” situation because users may want to get high in front of them to avoid getting sick from withdrawal. Outreach workers may offer medication-assisted treatment, such as Suboxone or methadone, but an addict may not want to accept on the spot, Bamberger said.
Tom Wolf, who was formerly addicted to drugs and is now a recovery advocate, said he visited the center Tuesday and was discouraged when he saw people using drugs inside the fenced area.
“I’m not saying totally prohibit drugs, because people will have it on them. I’m just saying don’t let them use inside,” Wolf said. “I respect what they’re trying to do there, but if you’re going to allow someone to come in with a bag of dope and use it, that’s not good. How is that going to work if you walk up to someone who just smoked and say, ‘Hey, do you want rehab?’ That’s not going to work. You’re messing with that guy’s high. How can you engage him at that moment?”
Keith Humphreys, an addiction medicine specialist at Stanford University School of Medicine who has advocated for more treatment options and supported the mayor’s promised crackdown on open-air drug markets, said the city should not mix active drug use with people seeking treatment.
“If you’re coming into a place that’s supposed to guide you toward the end of seeking treatment and recovery and there are people using drugs around you, that becomes an incentive to keep going,” he said. “It’s like trying to have an AA meeting in a bar.”
Some people who use drugs said there were few alternatives.
“It’s not like they’re advertising it, but what are you going to do when you’re waiting around and you need to use?” said Ray, who did not provide his last name, as he sat outside the center Tuesday. “If someone overdoses in there, they can help. What’s wrong with that?”
Ray said he had smoked in the fenced-in area at the linkage center on Monday and that staff members were “cool” with it. He went to the center to get rehab and housing and planned to return.
Trent, who also did not provide his last name, said in an interview in the plaza that he had smoked inside the fence on Sunday.
“They were very professional about it. That’s kind of like a safe site right now because it’s partitioned off. We need that,” he said.
He said he went inside looking for housing, rehabilitation services, medication to treat drug use and tools for harm reduction, and was hopeful he would get them.
“It’s very impressive,” he said. “I saw hopeful stuff.”
Chronicle staff writer Bob Egelko contributed to this report.
Mallory Moench is a San Francisco Chronicle staff writer. Email: mallory.moench@sfchronicle.com Twitter: @mallorymoench