By Gil Duran
Holding a metal chain and posting photos of their adult children, a group of five mothers staged a small protest outside the Tenderloin Linkage Center on a Saturday morning. Calling themselves “Mothers Against Drug Deaths”, they rallied against supervised drug use at the center, which has become a controversial flashpoint in the city’s efforts to stem rising overdose deaths.
Their protest illustrated the escalating debate over how best to handle a nationwide fentanyl overdose crisis. The Tenderloin facility allows supervised drug use within a fenced area as a form of harm reduction that has already prevented multiple overdoses. But the mothers – most of whom have adult children struggling with addiction in The City – have accused city officials of chaining people to opioid addiction.
They blasted supervised drug use as a “facilitating” and “normalizing” addiction. Yet they also voiced support for a European-style treatment model known for framing addiction as a health condition, decriminalizing drug possession, and allowing supervised drug use.
“We’ve been asked by several reporters what we think the solution is,” said Michelle Leopold, a Marin County resident whose 19-year-old son overdosed in Sonoma County in 2019. that the solution worked in Lisbon, in Amsterdam, in Vienna, in Zurich. People call it the ‘Portuguese model.’ It’s comprehensive services that are rolled out across the community. That’s the solution.
The statement was surprising because most of these cities allow overdose prevention sites, also called safe drinking sites. Lisbon has even deployed vans equipped with mobile injection sites. Zurich and other cities in Switzerland, which legalized prescription heroin in 1994, have opened injection rooms as part of an effort to shut down outdoor drug scenes and prevent death. San Francisco’s approach is conservative by comparison.
No one can deny the anguish of these mothers. Unfortunately, they didn’t seem very familiar with European-style harm reduction models. They voiced their support while simultaneously protesting the city’s efforts to enact one key element: overdose prevention.
As offensive as the concept of supervised drug use may seem, overdose prevention is a moral course of action in a city where drugs kill an average of two people a day. It’s not a perfect solution, but perfection is not an option at this point.
The mothers’ own stories underscored the complexity of the opioid epidemic.
San Lorenzo resident Gina McDonald said she became aware of her daughter’s addiction after she started hoarding parking tickets on Golden Gate Avenue in the Tenderloin.
“I found the heroin and took her to Highland Hospital in Oakland and put her on Suboxone, but then she got addicted to it,” McDonald said. “So it was a cycle of in and out of treatment. I finally had to say, ‘I can’t do this anymore. We can’t do that anymore. We took his car. We canceled her phone and left her…it was heartbreaking.
Her daughter is currently in a program in Alameda County. It’s her fourth attempt at a treatment program, McDonald said, adding that she herself had struggled with alcohol, opioids and methamphetamine for years.
“The Alameda County Sheriff picked me up off the street in the midst of meth-induced psychosis and sent me for treatment,” McDonald said. “It saved my life. I had no choice. They put me in a mental institution, which probably wasn’t the right thing to do because they didn’t know if it was drugs or if I was crazy. When I woke up four days later with a clear mind, I was able to make a decision.
The idea of locking people up to force them to undergo treatment was a common refrain.
“Please stop my son,” said Jacqui Berlinn, an Alameda County resident whose son struggled with addiction for years.
Berlinn criticized city officials for not providing more treatment options and said a lack of health care resources, coupled with open-air drug markets, prevented his son from quitting drugs. . She said red tape and a lack of resources made it difficult for her to help.
While she is right that we urgently need more treatment beds and services, her son’s case also proves that treatment is not a silver bullet. Last year, Berlinn said, District 6 Supervisor Matt Haney helped his son find a place at a Walden House facility. Her son agreed to leave.
“He said, ‘Mom, this is going to be like jail,'” Berlinn said, explaining that COVID rules meant he had to endure a 10-day quarantine.
“It was the week before Christmas,” Berlinn said. “I said to him: if you succeed, then at Christmas, we will be together and you will feel so much better.”
He left after three days.
Another woman, a Marin resident who declined to be named, said her son also started using drugs again after a stay in a treatment center.
These mothers are clearly desperate to help their children, but their stories also illustrate a major flaw in abstinence-only treatment. Most people relapse when they try to quit, and relapse can end in death when the drug is fentanyl. Harm reduction models reflect this reality by meeting people where they are and prioritizing survival over abstinence.
A stay in prison can help some people get treatment, but incarceration can also work against them. This is because enforced abstinence reduces drug tolerance, which increases the likelihood of an overdose upon release. Drug overdoses are a leading cause of death among recently incarcerated people.
Not all mothers are opposed to overdose prevention. San Francisco’s Nurit Baruch was at the Tenderloin facility as part of a counter-protest in support of overdose prevention. She said prison helped her son get treatment, but she doesn’t think it’s the right solution for most people.
“The prison is there because there is nothing else,” Baruch said. “Who wants to traumatize people who are already sick?
Like other mothers, Baruch has touted the success of harm reduction efforts elsewhere.
“I’ve read about Vancouver, I’ve read about Portugal and I see they have a really good success rate,” Baruch said. “And I know that’s counterintuitive because you’re thinking ‘we’re allowing them,’ but at the same time we’re also talking to them maybe about a place where they can dry out.”
Critics of the San Francisco effort say it’s not the Portuguese model. They’re right. Portugal decriminalized personal drug possession in 2001. It has also invested heavily in treatment and in creating a system designed to compel drug addicts to get help. The United States is decades behind when it comes to dealing with the horrific reality of addiction. The city is trying to catch up by hiring hundreds of workers to expand mental health and addiction treatment options, but there’s still a long way to go.
The Tenderloin center is a small step forward. He’s attracted a few vocal detractors, but that’s no surprise. Most harm reduction measures – such as needle exchange and condom distribution programs – meet with fierce opposition before they are accepted. The City’s down-to-earth approach upsets these suburban white mothers, but our overdose crisis is disproportionately killing black men. We need to value their lives whether or not they suddenly stop using drugs.
Onnie Broussard, a 41-year-old black man who walked out of the Tenderloin Center and accidentally found himself standing with the mothers at their press conference, had mostly positive things to say about the facility.
“Everything is fine,” Broussard said in an interview. “They don’t have a hot breakfast, though.”
He said he didn’t see any drugs inside, but dismissed criticism of The City’s approach.
“I don’t think there’s really anything wrong with that,” he said. “How can they hurt people if people start working with them?”
Gil Duran is editor-in-chief of The Examiner’s editorial page. @gilduran76