Sonia Jenkins carefully folds sheets of foil. One by one, the folded pieces of aluminum pile up. They will be handed out to people that will use them to smoke fentanyl — a much safer way of consuming the drug, experts and advocates say.
The foil is part of a larger harm reduction strategy.
Throughout the day, people trickle in at the Gubbio Project for free cups of coffee, sleep, foot care, massages and overdose training in Mayan and Spanish languages led by the Department of Public Health. The patio area is a place for people to connect with healthcare specialists, or to just rest and distance themselves from the harsh street life for a while. In the corner, others line up for smoking supplies. Jenkins grabs a paper bag and tends to each person. One by one, she goes through the bins, grabbing rubber mouth pieces that attach to smoking pipes, bubble pipes, straight shooters, foil, needles, wound care, test strips and hygiene products.
Jenkins, a substance-use-disorder and de-escalation specialist at the Gubbio Project, grew up around family members and neighbors that were drug users. She was raised in the Tenderloin and went to school in the Mission District. So, helping people battling addiction hits close to home, inspiring her to become a social worker for more than 10 years now. For Jenkins, part of the job is building trust with people.
“Once people come and grab supplies, we start building a rapport and engaging with them about treatment, which can mean anything to anybody. This is bigger than harm reduction.”
Recently, Jenkins has seen increased police presence around the neighborhood, and it’s made it difficult to work with the usual clients that come in for harm reduction services. Many of the people she helps have misdemeanors and warrants for minor infractions.
“And a lot of the time that’s how they end up being trapped in the criminal system,” she added.
In an analysis by Mission Local, nearly a third of the city’s drug arrests and citations happened near the 16th BART Plaza corridors in March, where the San Francisco Police Department deployed a recreational vehicle-sized ‘mobile command unit’ to combat crime and drug dealing.
In May, El Tecolote encountered the arrest of two unidentified men near the plaza’s vicinity on Julian Avenue. A pipe and a small bag with a white substance was confiscated. The two men were handcuffed and taken into custody. SFPD officers on the scene declined comment. The reason for the arrests were unclear.
“Sometimes it’s sad, because it looks very militarized. The way they come in vans and how they start taking pictures of the clients,” Jenkins said.
Gail D’Onofrio, an emergency medicine and addiction specialist at Yale New Haven Hospital, believes that communities of color are always hit the hardest when it comes to the criminalization of drug use and overdose deaths. According to D’Onofrio, harm reduction strategies like test strips, allow users to test substances for fentanyl and can help prevent fatal overdoses. “So, all these things contribute to that de-escalation in opioid overdose.”
But harm reduction services have seen a shift from local leadership at City Hall. Some residents staged a protest on 16th and Mission, denouncing the open-air drug market in the Mission, and calling for aggressive abstinence-only approaches to drug use. The moderate Democratic mayor, Daniel Lurie, has already started to scale back on publicly-funded harm reduction programs that provide users with pipes to smoke, straws, clean foil and wound care.
These shifts can have severe implications, with human lives at stake, experts and advocates say. Amidst the city’s directives on the drug crisis, an uptick in confirmed overdose deaths reached more than 200 in the first four months this year, according to data from the SF Office of the Chief Medical Examiner. Arrests for drug possession, loitering and public intoxication have skyrocketed, too.
“We’ll have an increase in opioid related deaths. Pure and simple,” D’Onofrio said, citing San Francisco’s rollback harm reduction services.
Stephanie Clavijo, a primary care physician and addiction medicine specialist who works in communities of color around the city, hopes that the city will continue to strongly consider research-based studies on harm reduction, and assess the potential consequences of abstinence-only methods.
“Forcing folks [abstinence-only] doesn’t work, even for just general medicine. Criminalization has been used as a tactic for substance use, and we know that it impacts communities of color. And we know that it hasn’t worked.”
With the city getting tougher on drug use, Jenkins and her colleagues at the Gubbio Project insist that every individual needs to be met where they are, with dignity and humanity.
But this is a job that hardly anyone wants to do: keeping drug users alive, and hopefully, leading them into a treatment program one day. Jenkins looks back at her upbringing in the Tenderloin. She believes her empathy and hospitality have been radicalized in guiding her into this work, despite the recent negative push back.
“Society sees drug users as the worst of the worst. But I will always see the need and the empathy there.”
