Drug Users Face Extra Health Challenges With Uptick in Homeless Sweeps

Narcan saves people’s lives. The drug reverses the effect of opioid overdoses, when administered by injection or nasal spray.

But people who use drugs need to actually have Narcan — also known as naloxone — on hand in order to reverse a friend or neighbor’s overdose, something that’s been increasingly difficult as the city has upped its homeless sweeps.

Those who work at drop-in centers have noticed this trend. Glide — a social service provider in the Tenderloin — provide a multitude of services, from hot meals to medical care to harm reduction supplies that help ensure people who use drugs in San Francisco can do so safely. Staffer Amber Sheldon spends most of her day in the syringe access office, handing out clean supplies to people who use drugs, such as sterile needles, alcohol wipes, saline — and Narcan. In the wake of the sweeps, she’s noticed that not everyone can keep hold of the valuable items they receive at a drop-in center like Glide.

“I had a man come in [earlier this month] and report that he was across the street from Glide around 9 a.m. when the police came around and asked who his bags belonged to,” Sheldon says. “He was afraid to speak up because he was worried he’d go to jail … so his bag was taken and thrown away. It was all his worldly possessions, and five vials of Narcan.

“People don’t know it’s totally legal for them to carry harm-reduction supplies,” Sheldon explains. “They still believe that it’s going to be considered paraphernalia and they can get arrested. Part of my job is educating people that it’s legal and fine.”

Sheldon’s encounter isn’t unique; more than 150 people have reported incidents of police or Public Works employees taking their Narcan during a homeless sweep since the start of 2018. The sweeps, part of an effort to reduce the visibility of homelessness citywide, have increased in frequency since former-Mayor Mark Farrell asked Public Works and the San Francisco Police Department to ban tents on sidewalks “in a more aggressive way.” It’s a practice Mayor London Breed has continued, through the creation of the Healthy Streets Operation Center — who the police who swept Sheldon’s client’s supply of Narcan worked for. 

According to frontline workers like Sheldon, the sweeps are causing a plethora of health issues and additional problems for people on the streets.

“I hear stories like this every single day,” Sheldon says. “It can be very difficult to hold onto things with these sweeps happening. Life-saving supplies and medications are incredibly important.”

The Department of Public Health estimates that there are more than 20,000 intravenous drug users living in San Francisco. Providing Narcan to this community to reverse overdoses helps them stay alive: 1,658 overdoses were reversed in 2018, according to the Drug Overdose Prevention and Education (DOPE) Project, a San Francisco program from the national Harm Reduction Coalition. In contrast, SFPD only reversed 53. 

The DOPE Project monitors all of the Narcan given out across the city — be it from the AIDS Foundation, Glide, or Homeless Youth Alliance — and every time someone refills their prescription, they’re asked why. Was it used? Lost? Stolen? In 2018, 102 people reported that their Narcan had been confiscated by either Public Works or police.

This year’s data has only been crunched through March, but still proves this trend hasn’t slowed down: from January to March 2019, 62 people refilled their Narcan because it had been taken by authorities.

“If someone tells officers that they have medications, including Narcan, or other important items that they need, we will always allow them to retain that property,” SFPD spokesperson Joseph Tomlinson tells SF Weekly, while also asserting that SFPD does not perform homeless sweeps. “We do not seek out Narcan, nor do we refuse to allow them to take Narcan with them.” 

DOPE Project Manager Kristen Marshall says that claims from frontline workers that their clients have had Narcan and survival supplies thrown in the trash have been met with skepticism from officials who authorize these sweeps.

“In June, I stood in front of a room full of police officers and city workers to explain that during these sweep operations, Narcan and other items essential to people’s survival are taken,” she says. “I was met with defensiveness and dismissiveness, and outright accusations that I, as a provider, and other homeless advocates, and all the people we serve are liars. That we are making up these reports. That they would never do something like that. But this isn’t a one-off thing, this isn’t isolated. We have been receiving increasing numbers of these reports over the last two years.”

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Public Works Director Mohammad Nuru stands in one of five containers filled with homeless people’s belongings seized by city workers. (Photo: Kevin N. Hume)

During a recent tour of the storage yard where homeless people’s belongings are kept after being removed from the streets, Public Works Director Mohammad Nuru acknowledged that medication and needles are sometimes seized by city workers during homeless sweeps.

“There are things we discard: needles, paint cans, soiled stuff, mattresses, food, trash,” he told SF Weekly — though it’s unlikely the needles are examined to see if they were used or sterile. “All the other things like medicine, flashlights, things that look valuable, we will keep here and store.”

But he also says that unless a prescription bottle is in plain sight, Public Works wouldn’t be aware that they’re storing it.

“We would never open a suitcase,” Nuru said.

In the meantime, the cost of these lost supplies is adding up. The DOPE Project — which receives some funding from the San Francisco Department of Public Health — spent $80,005 on naloxone in 2018 alone. Based on their reports, at least 102 of those Narcan prescriptions handed out that year were then allegedly seized back by the city.

This isn’t new. For those who work on the front lines to provide medical care to homeless people who use drugs, evidence of the health issues homeless sweeps cause arrives on their doorstep daily.

At the Sixth Street Harm Reduction Center, run by the San Francisco AIDS Foundation, Associate Director Ro Giuliano says she’s heard innumerable stories of people having their Narcan taken.

“We often hear the narrative that Narcan has been lost,” she says. “ ‘During a sweep, all my stuff was taken. DPW took my stuff. They went through our encampment.’ That I hear all the time. Or, ‘They came through and told me to get out of there and I had no time so I left my Narcan.’ ”

In addition, Giuliano has noticed an increase in a specific health issue more commonly seen in geographic areas that don’t have a plethora of needle exchanges.

“We know there’s a link between [an increase in soft tissue infections] and the sweeps — even if we don’t have the numbers to prove it,” she says.

Five blocks away, Dr. Andrew Desruisseau of the Tenderloin Health Services, a program of HealthRight 360, says that he’s also seen a rise in soft tissue infections.

“In general, anything they have or are struggling with is magnified and intensified and made much worse by the sweeps,” he says.

Frontline workers are adapting as best they can, as are the unhoused people being shuffled from one street corner to the next by authorities. But the disconnect between the Department of Public Health’s commitment to offering Narcan and safe consumption supplies to its residents who use drugs — and the subsequent seizure of those items by Public Works and police — is exacerbating health issues San Francisco long ago learned how to manage. 

“In the midst of a continuing overdose crisis, San Francisco leadership chooses to take the things from people that keep them alive, thereby actively contributing to their deaths,” Marshall says. “Instead of looking at evidence, our city leadership places moral weight on the decisions people make for survival —while doing little to actually uplift them or address the root cause of homelessness in this city.”

[This story was originally published by SFWEEKLY.]