Lee now open to safe injection sites, yet not fully convinced

S.F. Mayor Ed Lee says he could be persuaded to support safe drug injection sites if experts can show they would save lives. S.F. Mayor Ed Lee says he could be persuaded to support safe drug injection sites if experts can show they would save lives. Photo: Paul Chinn, The Chronicle Buy photo Photo: Paul Chinn, The Chronicle Image 1 of / 5 Caption Close Lee now open to safe injection sites, yet not fully convinced 1 / 5 Back to Gallery

Mayor Ed Lee said this week that he is open to the idea of safe injection sites in San Francisco, a significant shift from his earlier outspoken opposition to the concept.

“I have to say we are open. I had to kind of force myself to be open to the idea because it doesn’t come as a natural thing,” Lee said Wednesday at Seattle University in a moderated conversation about homelessness with Seattle Mayor Ed Murray.

Lee’s comments raise the prospect that San Francisco could become the first city in the United States to open a safe injection site. Officials in New York, Vermont, Maryland and Washington are also exploring the idea, according to the Drug Policy Alliance.

State Sen. Scott Wiener, D-San Francisco, said Friday he plans to co-sponsor legislation with Assemblywoman Susan Eggman, D-Stockton, that would allow San Francisco and other cities in California to open up safe injection sites on a pilot basis. Such sites are illegal under state law.

“The current situation with injection drug use in San Francisco isn’t working, and we need to be willing to try new things, and it makes a lot of sense to try a safe injection site and see if it works,” Wiener said.

Open drug use is a common sight in San Francisco, where people living on the streets can be seen using needles to shoot up heroin and methamphetamine. The number of complaints to the city about discarded needles skyrocketed from 440 in 2012 to more than 2,565 to 2015, according to the city’s 311 portal, which records citizen complaints.

At a public appearance Friday when he was asked about his comments in Seattle, Lee reiterated that he was open to safe injection sites but remained unconvinced.

“If the medical experts that I engage with are telling me that there is both data and medical practice to suggest that a safe injection site could save lives on the long run as well as the short run, could allow people to make better decisions, does not necessarily prolong the use of drugs, which I’m obviously against — I have to be open to that idea,” the mayor said. “They have not convinced me thus far. But I have to suggest that if the health department is saying there is a better alternative, then I’ve got to be open to that very fact. That’s all I was saying. Thus far, that persuasion isn’t there.”

Even so, his openness to the idea is a marked difference from the full-throated opposition he expressed almost a year ago, when asked about former Supervisor David Campos’ proposal to open up a safe injection site at a homeless shelter.

“We have a vigorous disagreement over allowing people to inject heroin and meth, to literally destroy their bodies and their minds, in a city-funded shelter, as some have proposed,” Lee said at the time.

There are now about 100 safe injection sites open in nine countries: Switzerland, Germany, the Netherlands, Norway, Luxembourg, Spain, Denmark, Australia and Canada. But the idea has met widespread resistance in the United States because of the criminalization of drugs and a fear that the centers will enable addiction.

That resistance is softening somewhat in light of research showing that safe injection sites save lives and money.

In December, Barbara Garcia, the city’s top public health official, for the first time publicly endorsed the concept, telling The Chronicle she believed the sites were a good idea. Garcia also said that to make a real difference, the city would need to open up at least six sites, at a cost of around $3 million to $3.5 million annually.

A study published in the Journal of Drug Issues in December concluded that every dollar spent on a safe injection site in San Francisco would generate $2.33 in savings because of fewer trips to the emergency room and a reduction in the number of people who contract hepatitis C, HIV and soft-tissue abscesses.

The number of opioid overdose deaths — the leading cause of deaths from drug overdose — in San Francisco has stayed constant at around 100 people a year over the past decade, according to city statistics. Opioids include heroin and morphine, but not methamphetamine and other stimulants.

Supervisors in City Hall praised the mayor’s evolving thoughts on the matter.

“On the one hand, I am happily surprised. On the other hand, I am not surprised because the evidence shows these sites work,” said Supervisor Hillary Ronen.

Supervisor Jane Kim said the city has a responsibility to make sure people with drug addictions are getting help.

“The alternative is untenable: No one supports having addicts self-inject on the street and in our public spaces,” Kim said in email. “Supervised sites are an idea worth exploring.”

For now, the prospect of safe injection sites will depend on what the state Legislature does. Eggman pushed a bill last year to allow pilot programs, but it failed to make it out of committee. She said she hoped that by trying again this year, at the beginning of the two-year legislative session, there would be more time to persuade her colleagues.

“To anyone, at the first mention of (a safe injection site), it sounds like why are you doing it,” she said. “The more you look at it, the data shows it makes good sense.”

Emily Green is a San Francisco Chronicle staff writer. Email: egreen@sfchronicle.com Twitter: @emilytgreen