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San Francisco’s drug problem is in your face. Walk around long enough and you may well kick a used syringe or see someone shooting up in plain view.

The visibility of the scourge is one reason city leaders are starting to move seriously toward creating so-called supervised injection sites. It would be among the first American cities to do so.

Supervisor London Breed has been a champion of the idea. In an interview, she recounted some of the efforts so far to address the drug problem: outreach, a needle exchange program and cleanup crews that collect thousands of syringes a month.