Those needles littering the streets? The city gave them out

Michael Lopez, with the Central Market Community Benefit District, picks up a needle and other debris lying on the sidewalk on Market Street near Seventh Street in San Francisco, Calif. on Tuesday, March 6, 2018. less Michael Lopez, with the Central Market Community Benefit District, picks up a needle and other debris lying on the sidewalk on Market Street near Seventh Street in San Francisco, Calif. on Tuesday, March 6, ... more Photo: Paul Chinn / The Chronicle Buy photo Photo: Paul Chinn / The Chronicle Image 1 of / 1 Caption Close Those needles littering the streets? The city gave them out 1 / 1 Back to Gallery

For all of City Hall’s tough talk of late about getting needles off the streets, the city itself is responsible for helping fuel the problem — handing out millions of syringes a year with little or no controls over their return.

And while the easy access to clean syringes is intended to protect public health, the city’s residents are not happy with the situation.

“The status quo on our streets today is simply unacceptable, and we’re not going to stand for it,” Mayor Mark Farrell said the other day as he stood on Natoma Street to unveil his new needle cleanup team.

Standing by his side, Director of Public Health Barbara Garcia said, “No needles on the streets — that’s our goal.”

No doubt that goal is well-intentioned, but what wasn’t mentioned is that the health department is the biggest source of the needles — it hands out an estimated 400,000 syringes a month through various programs aimed at reducing HIV and other health risks for drug users.

The program began under Mayor Frank Jordan in 1993. It was originally billed as a “needle exchange,” but there never have been strict rules for returns, and the number handed out has steadily climbed.

In fiscal 2013-14, for example, health department records show the city handed out 3.3 million needles at a cost of $400,397. Two years later, it handed out 4.45 million needles at a cost of $523,363.

Garcia said the program’s goal of ensuring access to sterile syringes is intended “to eliminate the transmission of blood-borne pathogens among people who inject drugs and their sexual partners.”

Health department statistics show the program appears to be working, at least on one level: The number of new HIV infections among people who inject drugs in San Francisco dropped from 106 in 2010 to 38 in 2016.

And while the city sees the public health benefit for users, the math on retrieving the free syringes and keeping them off of the streets has come up short.

Of the 400,000 needles distributed monthly, the health department estimates that about 246,000 come back though its 13 syringe access and disposal sites.

That leaves more than 154,000 needles a month still circulating. No one knows how many are tossed into garbage cans or into private needle retrieval boxes — but thousands wind up on streets and sidewalks, in tent camps, and in parks and playgrounds.

“It is hard to arrive at an exact number,” said health department spokeswoman Rachael Kagan. “That said, there is clearly needle litter on our streets, and we are working hard to address that.”

To combat the problem, the health department sends out crews who pick up about 8,000 needles per month off the streets.

San Francisco’s public works department also reports collecting an average of 12,640 needles per month when it cleans out homeless hot spots and encampments.

“Those are just the encampments crews,” said DPW spokeswoman Rachel Gordon.

How many of the remaining 133,000 or so needles are picked up by regular street cleaning crews is unknown, but walking some streets shows that the retrieval efforts are falling short.

Health officials maintain that the unlimited syringe access actually lowers the risk that a used needle on the street carries disease.

“When clean needles are available, there is less sharing, less disease transmission, and the discarded needles are less likely to be infectious,” Kagan said.

And there are no known cases of disease from needle sticks in San Francisco.

Still, in recent years the visible proliferation of needles on streets and in parks has become both a growing political and public relations problem for City Hall, as residents point to the problem when they call for cleaner streets.

The public clamor is one of the chief reasons Farrell announced a plan to spend $750,000 a year so the San Francisco AIDS Foundation could hire 10 people just to collect used needles.

“People are, quite frankly, fed up with the conditions of our streets, and so am I,” Farrell said at the news conference announcing the cleanup team.

But there was no mention of changing the policy of handing out unlimited numbers of needles.

“There are no changes to our syringe access programs,” Garcia said. “Research shows that reducing access to clean syringes increases disease and does not improve the problem of needle litter.

“Syringe access is part of a bigger picture,” she said.

The mayor agrees.

“My investment in a dedicated syringe clean team will tackle one of the unintended consequences of this program,” Farrell said. “But I will not walk back our health policy back to the stone ages.”

In the last half of 2017 alone, needle handouts grew to 3 million, meaning, if the rate continues, it will hit 6 million by the close of the fiscal year on June 30.

So, watch your step.

San Francisco Chronicle columnists Phillip Matier and Andrew Ross appear Sundays, Mondays and Wednesdays. Matier can be seen on the KPIX-TV morning and evening news. He can also be heard on KCBS radio Monday through Friday at 7:50 a.m. and 5:50 p.m. Got a tip? Call (415) 777-8815, or email matierandross@ sfchronicle.com. Twitter: @matierandross