What should San Francisco solons do to respond to the epidemic of hypodermic syringes littering public parks and streets or thrown into residents' yards?
While some residents want to curb city-funded needle-exchange programs, the harm-reduction community has suggested that The Special City set up America's first medical-supervised injection center.
Call it: Let's create another pander-to-lawbreaker government-funded program to make up for the unintended consequences of an older pander-to-lawbreaker government-funded program.
Let me be clear. I support needle-exchange programs. They curb the spread of communicable disease among drug users and save lives. I do not believe that needle-exchanges encourage kids to shoot up -- not with all the squalor connected with needle-shooting addicts.
I visited a city needle-exchange program a decade ago and saw the value in having a place where users could not only bring in bundles of used needles to exchange for clean needles -- back then, users had to return a dirty needle to receive each clean one -- but also visit volunteer medical workers who drained their abscesses, gave them flu shots or pregnancy tests, and could provide referrals for drug treatment.
Defenders of the exchanges argue that there are fewer littered needles today than could be found in public before. Harm Reduction Coalition Western Director Hilary McQuie called for more needle drop boxes, "more city staff to clean up public spaces and programs to remind clients to properly dispose" of used needles -- as well as "safer injection sites."
OK, but needle-exchange programs owe it to the public to find ways to clean up the mess drug users leave behind. Those programs, after all, receive public money. They are supposed to promote public safety -- not public blight.
Even if the chances of contracting HIV after being pricked by a littered needle are .035 percent -- as one activist told me -- taxpaying San Franciscans should not be exposed to that risk.
Not to mention the yuk factor.
Over the phone last week, McQuie said of injection centers, "I wouldn't say we should open one tomorrow." But, "I think it merits a serious exploration."
McQuie noted good reviews on the Vancouver's injection center, opened in 2003. (No surprise. Canadian junkies are probably the most polite addicts in the world, eh?) A study found that there were fewer discarded syringes and less public drug use in the weeks just after the clinic opened than just before.
My experience hails back to a brief visit in 2001 to the Medically Supervised Injecting Centre in the King's Cross neighborhood of Sydney, Australia. Today, the news from Sydney is not good.
The Daily Telegraph in Australia has reported that MSIC referrals for drug treatment and rehabilitation services fell from 10 percent in 2001 to 1 percent this year. A selling point for the MSIC had been that the centre would work to steer users away from drugs.
Supporters point to a reduction in heroin overdoses -- but that's because Australia experienced a dramatic heroin drought starting in 2001.
Which points to the misguided focus of the harm-reduction movement: Its goal is to minimize harm for the most risky and self-destructive behavior, which is impossible, so programs keep evolving to accommodate anti-social dysfunctional behavior.
So San Francisco expanded one-on-one needle exchanges until the exchange element is gone. Users can go to an SF needle "exchange" and receive free needles without providing dirty ones. They can get free needles, despite the fact that, thanks to a new state law, they now can buy syringes at Walgreens.
It's not enough that the state passed a law that allows San Francisco pharmacies to sell syringes. It's not enough that users can exchange dirty needles for clean ones. The do-good mentality transformed needle "exchanges" in order to spare addicts from having to pay for clean needles -- which go for about $3 for 10 needles, according to Homeless Youth Alliance Chairman Peter Davidson -- at a drugstore.
This is not a treadmill of good intentions leading nowhere. It is a spiral of decay slowly unraveling.