San Francisco crackdown on open-air drug use intensifies

SAN FRANCISCO — San Francisco has been getting tougher with open-air drug use and, in July, enforcement will intensify.

Although police initially focused on dealers, users are now finding themselves in custody. Critics have blasted the use of law enforcement, saying it’s the wrong approach to deal with addiction and could even increase overdose deaths.

Between May 30  and June 18, 53 people were arrested for public drug use. Eleven were cited for misdemeanors and 42 were booked into jail for temporary detention. The mayor’s office said none of them accepted offers of treatment upon their release.

KPIX spoke with a man who was arrested for smoking fentanyl on a Tenderloin sidewalk and also with an expert on what law enforcement might mean for those placed in custody.

“Went to the dope dealer,” Rob, as he asked to be identified, said of his arrest. “Got some dope for the morning time. Jones and Ellis (streets). I just loaded up my foil and then I took one hit and then I loaded it up again and then I saw a shadow behind me and I knew it was a police officer just by the way he was standing.”

Just like that, Rob became one of the drug users picked up by San Francisco police during recent enforcement efforts.

“He said, ‘face the wall!’” Rob continued. ” (I) faced the wall. He said ‘put your hands behind your back.’ He put the handcuffs on me and he said ‘you are under arrest.’ They took me to 850 Bryant Street. I would say almost 12 hours.”

The city’s evolving use of law enforcement to address public drug use has drawn criticism so what are the risks? We asked Stanford addiction researcher Keith Humphreys.

“Whether or not an arrest puts a person at greater risk for an overdose depends entirely on what you do after the arrest,” Humphreys explained. “If the policy is — for people who are addicted to opioids — we’re going to hold them in a cell for 48 hours and then release them, that will probably increase overdose. What’s going to happen is people go through withdrawal — which, by the way, is both unpleasant and dangerous — and they will come out with a lower tolerance for the drug. If they use the drug again they will be at higher risk of overdose. So that would be a destructive way to do it.”

“Oh that was my biggest fear because I really thought I was going to stay for a day or two, you know, or like a week,” Rob said. “I didn’t know what was going on until they told me ‘you’re going home.’”

Tolerance was a concern, he said of his 12 hours. Fentanyl users often need the drug several times a day or every couple of hours. While there is risk, an encounter with police or an arrest isn’t necessarily dangerous.

“An alternative way to do it would be to have the sentence in jail be longer but couple it with immediate enrollment in good medication like buprenorphine or methadone that people would have so they wouldn’t lose tolerance and engage them in treatment,” Humphreys said. “And,  when they’re out, monitor them regularly, give them drug tests, give them positive and negative consequences for their use or non-use. That kind of thing can be helpful. So it all depends on what you do on the back end.”

Starting next month, those arrested a second time will be sent to a drug court that can refer people for treatment. Right now, those arrested are being offered voluntary services.

“After they arrested me, one of the S.F. officers asked me questions,” Rob said of the treatment discussions. “Like, have you thought about getting into treatment? Yeah that’s a thought, of course.”

He says he’s not sure he’s ready for that or how he would respond to some kind of court-ordered treatment. As for a brief time in police custody like he experienced, he doesn’t think it will deter much on-street drug use.

“No. Because all they’re gonna want to do is get out and use,” Rob predicted. “Because that’s all that’s on an addict’s mind, you know? I need to feel well. I want to feel well, you know?”

The district attorney’s office initially discussed sending people to drug court after five arrests. Now it will be done after two. The new policy is set to begin July 3.