San Francisco: Is saving a few people from HIV worth the consequences of needle-sharing programs/injection sites?
San Francisco has decided to hand out needles to drug users. And now, San Francisco wants to defy Federal Law and open up injection sites. (https://www.sfchronicle.com/bayarea/matier-ross/article/Federal-drug-laws-could-stand-in-the-way-of-safe-13074350.php) Is San Francisco on the right path?
The main argument for enabling drug users with needle sharing programs appears to be that it lowers HIV infections from sharing needles. According to statistics, the number of new HIV infections among people who inject drugs in San Francisco dropped from about 106 new infections per year in 2010 to 38 in 2016 because of the needle-sharing program. (https://www.sfchronicle.com/bayarea/matier-ross/article/Those-needles-littering-the-streets-The-city-12898656.php) So it appears that enabling injectable drug use in San Francisco possibly prevents approximately 68 people a year from getting infected by HIV.
But the program appears to have several consequences such as:
Opiod Death and Near Death
In 2016 there were 105 deaths from opiod abuse and 883 near deaths reversed with naloxone in San Francisco.(https://www.sfdph.org/dph/files/newsMediadocs/2018PR/DPH%20Release-Three-deaths-suspected-fentanyl-poisoning.pdf)
So in exchange for approximately 68 people not getting HIV per year, the city of San Francisco has possibly enabled the near-death 883 people, and the death of 105?
Increased Needle Use Indicates Increased Drug Abuse and/or Attracting Drug Abusers
I've repeatedly seen pro-needle sharing program advocates argue that the program doesn't encourage drug abuse. But statistics show that needle usage is way up.
-During Spring 1989 (92 day period), 7,821 syringes were exchanged in San Francisco (approximately 2607 a month) .
-During the 92 day period of Spring 1992, 343,883 syringes were exchanged (approximately 114,627 per month)(https://www.ncbi.nlm.nih.gov/books/NBK236639/)
-Now, about 400,000 needles are handed out per month. https://www.sfchronicle.com/bayarea/matier-ross/article/Those-needles-littering-the-streets-The-city-12898656.php)
How does the city explain the increase in needles handed out unless drug abuse is increasing and/or the city is attracting drug abusers?
Needle Sharing Programs Appear to Correlate With Increased Homeless Encampments and Human Waste
A SF Chronicle article has a timelapse image of 311 calls in San Francisco. Over the years, reports of homeless encampments, discarded needles and human waste have exploded. Is there a correlation between enabling drug use with needle programs and homeless encampments/feces/discarded needles?
Homeless encampments:
2011: 611
2016: 22608
Human Waste:
2011: 5685
2016: 18211
Needles:
2011: 285
2016: 4154
People Pricked by Discarded Needles
"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"
(https://www.sfchronicle.com/bayarea/matier-ross/article/Those-needles-littering-the-streets-The-city-12898656.php)
San Francisco is covered in needles. People are getting pricked. It's entirely possible that people will contact HIV or another disease by being pricked by a discarded needle as a result of the needle-sharing program.
Police say that people report being pricked a couple times a month. Here is a story about a woman who was pricked by a needle on BART:
https://www.kron4.com/news/bay-area/woman-says-she-was-pricked-by-needle-while-taking-seat-on-bart/1199906996
Financial Cost
Needles alone cost over half a million a year: "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." (https://www.sfchronicle.com/bayarea/matier-ross/article/Those-needles-littering-the-streets-The-city-12898656.php)
California is also paying for opiod overdose antidotes (https://www.sfchronicle.com/business/article/California-orders-opioid-overdose-antidote-12979129.php)
Cleaning up the feces and needles cost approximately $30 million a year:
https://www.dailywire.com/news/27348/san-francisco-spends-30-million-cleaning-feces-paul-bois
Medical care for opiod users averages about $92,400 per opiod user. (https://www.statnews.com/2017/08/11/opioid-overdose-costs/)
Tourists have reported that San Francisco is a terrifying place to visit. How much has the tourism industry lost? https://www.sfgate.com/local/article/is-san-francisco-dangerous-visit-sf-safe-crime-12995294.php
Moral Cost
Is it moral to encourage/enable somebody down the path of injectable drug abuse? Is this a good lifestyle that it should be supported with taxpayer dollars? How many of these drug users are suffering mentally and physically because of injectable drug abuse? How many human trafficking victims are being forced onto injectable drugs with needles paid for by taxpayers? How many people will die from opiod overdose? How many people will contract diseases from being pricked by discarded needles?
In every article I've read, needle-program advocates ignore the immorality of enabling drug abuse, as if saving a few people from HIV infection makes this moral quandary go away. And if saving people from HIV is so important, then why did California lower the penalty for knowing exposing people to AIDS and donating AIDS tainted blood? In fact, "Democratic state Sen. Scott Wiener and Assemblyman Todd Gloria, coauthors the legislation, argued that modern medicine has changed the lifespan of HIV-infected persons and nearly eliminates the chance of transmission." (https://townhall.com/tipsheet/leahbarkoukis/2017/10/09/unreal-california-lowers-criminal-punishment-of-those-knowingly-giving-hiv-tainted-blood-n2392514)
Conclusion:
Is:
- opiod deaths and near deaths
- increased homeless encampments
- increased human waste in the streets
- increased needles in the streets
- being poked by disease-ridden needles
- millions upon millions of taxpayer dollars for needles, cleanup and hospital visits
- the immorality of enabling destructive drug-abuse behavior
Worth:
- possibly preventing approximately 68 people a year from contracting HIV?
Wouldn't it be more economical and moral to end the needle exchange program and put drug abusers who use injectables in free/affordable drug rehabilitation?