By Brian Rinker
A safe injection site for intravenous drug users has attracted more attention than other, possibly more important recommendations released last month in a report by the San Francisco Hepatitis C Task Force in an effort to curtail the epidemic of the virus.
The injection center would be safe place where users could go and inject whatever they wished in a legally, medically-monitored and city-funded environment.
“The safe injection site is a sub, sub, sub recommendation,” said Hepatitis C Task Force member and City College health educator Robin Roth. She was diagnosed with hepatitis C, but went through treatment and is now cured.
The two main recommendations, she added, are electing a public health coordinator and creating a public health community planning committee.
The issue on whether San Francisco should implement a safe injection site became public on Jan. 24 when the task force released a report urging city officials to begin taking the necessary measures to combat the spread of hepatitis C.
Roth said one line in the 50 page report was dedicated to the safe injection site. However, once the San Francisco Chronicle and the Associated Press picked up on the line, everything was blown out of proportion, she said.
“But the task force certainly stands behind a safe injection site,” Roth said. “We think it’s a great idea. Prevention is always the best way to treat disease and is also more cost effective than treatment.”
The San Francisco Department of Public Health recognizes chronic hepatitis C as a significant burden to the people of San Francisco and the disease still remains a “silent epidemic,” but the department believes there are many recommendations in the hepatitis C report that are more important than a new injection center.
The DPH will convene a working group to review, prioritize and implement selected task force recommendations. The working group will include task force representation and will be a multi-year commitment, according to Director of Health Barbra Garcia and health officer Tomás J. Aragón.
San Francisco has an estimated 12,000 people infected with the disease. Within the U.S., one out of 50 people have hepatitis C, the report said. Hepatitis C is a blood-borne disease, meaning it is only transmitted through blood-to-blood contact.
“It affects everyone in San Francisco,” Roth said. “Ask someone about hep C, and if they don’t have it, they know someone who does.”
Yet hepatitis C testing isn’t readily available, perhaps because of the stigma of being associated with intravenous drug users. The lack of symptoms also contributes to why most people don’t seek testing, Roth said.
“I have students with hepatitis C in every one of my classes,” Roth said. “But the scariest part is there are way more people who have it that don’t know it.”
However, intravenous drug users are still the most at-risk: 90 percent over the age of 30 have contracted the disease, according to the report.
“Hep C disproportionately affects drug users and is probably why there isn’t enough money put towards it,” said Alexandra Goldman, coordinator for the San Francisco Drug Users’ Union. The union is a member-based organization that provides a voice for drug users who are often characterized as uncaring about their communities.
“I think the safe injection site is a wonderful idea,” Goldman said. The union has wanted safe injection site for some time now and also would like to decriminalize all drugs.
Hepatitis C is spread through shared drug paraphernalia such as needles, cottons, cookers and tourniquets. The safe injection site would not provide drugs to clients, but would provide clean equipment and monitor the injection process, which would help prevent the transmission of hepatitis C. The site would also prevent abscesses and overdoses, Roth said.
“The safe injection site is not about making it easier to obtain drugs, but to see the humanity of drug addicts and help them into treatment,” she said.
The injection center would be a safe place for homeless drug users and would help rid the streets of used needles, said Issac Jackson of the drug users’ union. He is a peer counselor and also identifies as a drug user.
“It can be an entry point for treatment,” he said.