SAN FRANCISCO – A 26-year-old Oakland man has been charged with selling fentanyl and methamphetamine in San Francisco’s Tenderloin District, according to the US Attorney’s Office.

Dixis Archaga-Reyes appeared in US District Court on Friday to face charges he distributed 40 or more grams of fentanyl and 4 or more grams of methamphetamine, prosecutors said in a news release.

The charges are laid out in a criminal complaint unsealed Friday. Written by Drug Enforcement Administration Task Force Officer Michael Cunnie, the complaint alleges Archaga-Reyes sold drugs at least four times to an undercover officer between Nov. 2 and Feb. 4.

One of the alleged transactions took place Dec. 22 near Seventh and Mission streets. The undercover officer purchased 61.1 grams of fentanyl for $1,000 and 59 grams of methamphetamine for $500 from Archaga-Reyes, according to the complaint.

The transaction which occurred in the undercover officer’s vehicle was recorded, according to the complaint.

If convicted, Archaga-Reyes could face five to 40 years in prison, a $5 million fine and four years to life of supervised release for each of the charges.

Archaga-Reyes remained in custody Friday. He is scheduled to appear in court Feb. 28 for a detention hearing.

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Sampling and recruiting

Survey data from PWID living in San Francisco and Los Angeles were collected for the Change the Cycle (CTC) study, a United States National Institute on Drug Abuse-funded randomized controlled trial performed between 2016 and 2017 to assess the efficacy of a behavioral intervention on injection initiation among PWID. Participants were recruited using targeted sampling of participants from previously identified street, community, and program sites, a method developed by Watters and Biernacki to sample populations who are difficult-to-reach with traditional sampling methods [22,23,24]. Targeted sampling involves the synthesis of secondary data, such as drug treatment and arrest data, and direct community observation (ethnography) to map out target neighborhood blocks for recruitment. Based on estimates of relevant population size of people who inject drugs, a representative number of individuals are recruited from each area by an outreach worker familiar with the neighborhoods and population. Inclusion criteria for this study required participants to be 18 years of age or older, to self-report injecting drugs in the past 30 days, and to have the evidence of recent drug use confirmed by staff inspection [25]. The interviews were performed at private field sites leased by RTI and USC, which were easily accessible by foot or public transport. After providing written informed consent, survey participants completed a computer-assisted personal interview (Questionnaire Development System, Nova Research, Bethesda, MD) in which trained interviewers spent 40–60 min reading questions aloud and recording the answers on a laptop computer. Participants were reimbursed $15 for their time and participation. The six-month follow-up survey for CTC introduced questions concerning housing and relocation, thus it was the dataset for this cross-sectional analysis. The last six-month interview was collected on June 10th, 2018 and the analysis was performed from June 2018 to October 2019. The CTC intervention conducted at baseline included no content that would influence the exposures or outcomes of this analysis. The baseline sample for the CTC study included 979 individuals, of whom 601 participated in the 6-month follow-up survey (316 in San Francisco and 285 in Los Angeles) which included questions about housing status and residential relocation. All protocols were approved by the Institutional Review Board at the University of Southern California.

Study measures

The main exposure variable was if study participants experienced residential relocation in the last 30 days. We asked each participant “In the last 30 days, how many times did you sleep in a different place or location (same type of place but different location)?” We created both dichotomized (those who moved in the past 30 days compared to those did not move in the past 30 days) and categorical distributions of our relocation variable. The categorical distribution was created by generating approximate quartiles based on frequency of residential relocation, yielding the following move categories: did not relocate, relocated< 3 times, relocated 3–9 times, and relocated >9 times in past 30 days.

The main outcome variables included exposure to violence, health outcomes, health behaviors, criminal legal system involvement, and access to services. Participants’ exposure to violence was assessed by asking whether they had their belongings stolen (“In the past 6 months, have any of your belongings been stolen?”), experienced physical assault (“In the last 6 months has anybody punched, slapped, kicked, or physically hurt you?”), experienced weaponized assault (“In the past 6 months, has anybody used a knife, gun, club, or other weapon against you?”), or had experienced sexual assault (“In the past 6 months, has somebody used physical force or threats to make you have vaginal sex, anal sex, or oral sex with them?”). The responses to these items were all coded as binary (yes vs. no).

We assessed participants’ health outcomes, health behaviors, and access to services by asking about overdose, injecting with syringes used by others, severe food insecurity, and access to substance use treatment. For overdose, we asked participants “In the last 6 months, have you overdosed?” and coded participant responses as binary (yes vs. no). For injecting with syringes used by others, we asked “In the last 6 months, how many times did you inject using syringes/needles that you know had been used by someone else (including a close friend or lover)?” Responses were coded as binary (whether participants had any injecting with used syringes vs. no injecting with used syringes in the past 6 months). To assess food insecurity during the prior 30 days we used a 10-question scale utilized by Schmitz et al. that consisted of questions about skipping meals, losing weight because of inability to access food, and concern about access to food [26, 27]. Participants were assigned one point for each food insecurity question they endorsed. Participants with 0 to 5 points were designated as not severely food insecure, while participants with 6 to 10 points were designated as severely food insecure. We assessed participants’ access to substance use treatment by asking the following question: “In the last 6 months, have you participated in any type of substance use treatment program (including methadone or alcohol treatment, but excluding NA, AA, or other self- help programs)?” Participant responses were coded as binary (yes vs. no).

Criminal-legal system involvement was assessed by asking participants if they had been arrested (“Have you been arrested in the last 6 months?”), or if they had been incarcerated (“In the last 6 months, have you been held overnight in jail?”). Both outcomes were operationalized as binary (yes vs. no).

We also included several demographic variables as potential confounding factors. These included gender (cismale, cisfemale, transgender, or other), sexual orientation (heterosexual, gay/lesbian, or bisexual), race/ethnicity (White, Latinx, Black, Asian/Pacific Islander, Native American, Mixed Race/Other) , homelessness (If respondents considered themselves to be homeless or unstably housed, or not), education (less than high school diploma or high school diploma or more), age (18–29, 30–39, 40–49, or 50 or older), relationship status (single, in a relationship but not living as married, or married/living as married), and monthly income (Less than $1,400, or $1,400 or more).

Statistical analysis

Descriptive statistics, including means and frequencies, were generated for all study variables. We analyzed the relationship between our relocation variable and our three aggregate outcome variables which were grouped a priori: exposure to violence, health (including health outcomes, health behaviors, and access to services), and involvement with the criminal legal system. Bivariate analyzes consisting of odds ratios and χ2 tests were conducted to assess associations between the relocation variable and outcome variables. Potential confounding by demographic variables (eg self-reported race/ethnicity, gender, income, age) was assessed with two-way χ2 tests (p<0.05) for each outcome variable. Variables found to be associated with both the explanatory variable (residential relocation) and outcome variables were included as potential covariates in multivariable logistic regression models generated for each outcome variable. Covariates not statistically significantly associated with the outcome in the models at p < 0.05 were removed in the final models. Data was analyzed in R, version 3.5.3 [28].

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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

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