With San Francisco politicians and police mostly looking the other way as injection drug users shoot up in broad daylight, the official effort seems to have moved from preventing the drug use to cleaning up all those dirty needles left behind.

Remember when cigarette butts littered the city? Gross, yes. But there wasn’t the possibility of contracting a deadly disease from them. It seems the butts have been replaced in Needle City — er, San Francisco — with dirty syringes.

It may not seem like it as you two-step around the “dirties” that sprout from sidewalks like weeds, but the needle-cleanup effort in San Francisco is enormous.

And if ever there was a Sisyphean task, this is it.

The city’s Public Works crews collected an eye-bulging 17,511 needles in April alone. That’s 584 every day — and 4,178 more syringes than the department collected in March. And that’s just from the crews that focus on homeless tent camps, not from the general crews that clean other areas.

The Department of Public Health has recently installed two big black boxes the size of those blue mailboxes the U.S. Postal Service puts on street corners, but these are for used needles, not letters.

Back to Gallery SF installing syringe kiosks as disposal of dirty needles... 2 1 of 2 Photo: Paul Chinn, The Chronicle 2 of 2 Photo: Paul Chinn, The Chronicle



Cheerily called kiosks, one was installed outside the Bill Graham Civic Auditorium on May 11 and had about 1,500 needles dropped inside within 11 days. Another kiosk was placed at 1380 Howard St. in February, and it had about 1,000 syringes inside a month later. The department also has 10 smaller needle collection boxes around the city.

Eileen Loughran, the Public Health Department’s expert on syringe disposal, is so committed to cleanup, she carries a bio-box for needle collection in her purse. She said she’s proud of the kiosks and thinks most injection drug users want to do the right thing and dispose of their needles safely.

“A lot of people are frustrated with syringes on the ground and drug users using publicly,” Loughran said. “For the most part, drug users are frustrated by that, too. It’s a small population of individuals who just really don’t care about where their syringes go.”

Each of the kiosks is in a three-month pilot program, during which the Public Health Department hopes to see fewer needles on the ground around them and many syringes deposited inside. It will also monitor neighbors’ concerns about the kiosks drawing more injection drug users to their immediate vicinity.

The Bill Graham kiosk has drawn a lot of birds and a few graffiti artists, if what’s on the outside of the box is any indication.

The San Francisco AIDS Foundation also helps with needle cleanup. It collected a whopping 23,000 pounds of used injection equipment, including needles, last year.

The good news about the cleanup, however, underscores the devastating news that so many San Franciscans are shooting up. The latest estimate is that 22,500 injection drug users live in the city, Loughran said. She said that’s about 7,500 more than a few years ago.

City and nonprofit officials say the needle problem seems so much worse lately because of the growing nationwide opioid epidemic, which means more people are using needles. And development in the city has pushed drug use that used to be hidden in empty buildings and vacant lots into the open.

Also, needle-exchange programs used to require that dirty needles be turned in to receive clean ones. Now, drug users can get however many clean needles they want — no “dirties” required.

Barbara Garcia, public health director, says her staff has had many conversations about whether the current needle-giveaway approach is the right one but said she’s convinced it is. She said drug users are far more likely to use clean needles and not share dirty ones under the current approach. That means far fewer HIV and hepatitis C transmissions.

But asked whether that’s putting the health of drug users over the health of pedestrians, kids and others who might find dirty needles on the ground, Garcia paused.

“We have to do both — provide clean needles and provide the cleanup of the dirty needles,” she said. “We have to do better.”

That’s the truth.

But actually, San Francisco is doing a lot better than most of California when it comes to safely disposing of dirty needles. The state auditor recently released a report calling California’s oversight of needle disposal outside of medical centers “fragmented” and “inconsistent.”

Seventy-two percent of Californians live within a 10-minute drive of needle-collection sites, but some in rural parts of the state live more than a half-hour drive from one. The report recommends that CalRecycle take over proper disposal of needles, implement a public awareness campaign and publicize a list of collection sites.

Assemblyman Phil Ting, D-San Francisco, said he’s looking at options for streamlined needle collection. “We don’t want 58 different counties doing 58 different things,” he said.

He said he’s tired of walking through Civic Center Plaza and seeing syringes all over the place.

“What we’re doing is not deterring or stopping that behavior, so you might as well create opportunities for safe disposal,” Ting said.

Public Works Director Mohammed Nuru is even more of a, pardon the pun, straight shooter when it comes to needle talk. He wants to see the city’s acceptance of open-air drug injection end.

“I personally believe that shooting up in public should not be allowed. Period,” he said.

And he’s even more adamant that dirty needles should not be tossed aside with no consequence.

“We’re picking up thousands of needles, and that’s just not safe for anybody,” he said. “They have enough sense to go get the needles, so they should have enough sense to get rid of them.”

In the meantime, his crews are doing the job. To the tune of more than 60,000 needles picked up this year.