Mothers highlight stark reality of SF’s drug overdose crisis

By Gil Duran

Holding a metal chain and displaying photos of their adult children, a group of five mothers staged a small protest in front of the Tenderloin Linkage Center one recent Saturday morning. Calling themselves “Mothers Against Drug Deaths,” they rallied against supervised drug use at the center, which has become a controversial flashpoint in The City’s efforts to stem rising overdose deaths.

Their protest illustrated the escalating debate over how to best handle a fentanyl overdose crisis that’s national in scope. The Tenderloin facility allows supervised drug use in a fenced-off area as a form of harm reduction that already has prevented multiple overdose incidents. But the mothers — most of whom have adult children struggling with addiction in The City — accused city officials of chaining people to opioid addiction.

They blasted supervised drug use as “enabling” and “normalizing” addiction. Yet they also expressed support for a European-style treatment model known for framing addiction as a health issue, decriminalizing drug possession and permitting supervised drug use.

“Several of the reporters have asked us what we think the solution is,” said Michelle Leopold, a Marin County resident whose 19-year-old son overdosed in Sonoma County in 2019. “The solution has been proven to work in Lisbon, in Amsterdam, in Vienna, in Zurich. People call it the ‘Portugal model.’ It’s wrap-around services that are instrumented throughout the entire community. That is the solution.”

The statement was surprising because most of those cities allow overdose prevention sites, also known as safe consumption sites. Lisbon has even deployed vans outfitted as mobile injection sites. Zurich and other cities in Switzerland, which legalized prescription heroin in 1994, opened injection rooms as part of an effort to shut down open-air drug scenes and prevent death. San Francisco’s approach is conservative in comparison.

No one can deny the anguish of these mothers. Unfortunately, they didn’t seem too familiar with European-style harm reduction models. They expressed support for them while simultaneously protesting The City’s effort to adopt one key component: overdose prevention.

As offensive as the concept of supervised drug use may seem, overdose prevention is a moral course of action in a city where drugs kill an average of two people every day. It’s not a perfect solution, but perfection is not an option at this point.

The mothers’ own stories underscored the complexity of the opioid epidemic.

Gina McDonald, a San Lorenzo resident, said she first became aware of her daughter’s addiction after she started racking up parking tickets on Golden Gate Avenue in the Tenderloin.

“I found the heroin and took her to Highland Hospital in Oakland and got her on Suboxone, but she then became addicted to that,” said McDonald. “So it’s been a cycle in and out of treatment. I finally had to say, ‘I can’t do this anymore. We can’t do this anymore.’ We took her car. We canceled her phone and we left her … it’s been heartbreaking.”

Her daughter is currently in a program in Alameda County. It’s her fourth attempt at a treatment program, said McDonald, adding that she herself struggled with alcohol, opioids and meth for years.

“The Alameda County sheriff picked me up on the street in the middle of a meth-induced psychosis and mandated me to treatment,” said McDonald. “It saved my life. I didn’t have an option. They put me in a psychiatric facility, which probably wasn’t the right thing to do because they didn’t know if it was drugs or I was crazy. When I woke up four days later with a clear mind I was able to make a decision.”

The idea of ​​locking people up to force treatment was a common refrain.

“Please arrest my son,” said Jacqui Berlinn, an Alameda County resident whose son has struggled with addiction for years.

Berlinn criticized city officials for failing to provide more treatment options and said a lack of health resources, coupled with open-air drug markets, makes it impossible for her son to quit drugs. She said red tape and a lack of resources make it hard to get him help.

While she’s right that we urgently need more treatment beds and services, her son’s case also proves treatment is no silver bullet. Last year, Berlinn said, District 6 Supervisor Matt Haney helped get her son a spot at a Walden House facility. Her son agreed to go.

“He said, ‘Mom, this is going to be like jail,'” said Berlinn, explaining that COVID rules meant he had to endure a 10-day quarantine.

“This was the week before Christmas,” said Berlinn. “I told him: If you push through this, then by Christmas we’ll be together and you’ll be feeling so much better.”

He left after three days.

Another woman, a Marin resident, who declined to give her name, said her son had also gone back to drugs after time in a treatment facility.

These mothers are clearly desperate to help their children, but their stories also illustrate a major flaw of abstinence-only treatment. Most people relapse when trying to quit drugs, and relapse can end in death when the drug is fentanyl. Harm reduction models account for this reality by meeting people where they are and prioritizing survival over abstinence.

A stint in jail might help some people get into treatment, but incarceration can also backfire. That’s because forced abstinence lowers drug tolerance, increasing the likelihood of overdose upon release. Drug overdoses are a leading cause of death for recently incarcerated people.

Not every mother opposes overdose prevention. Nurit Baruch of San Francisco was at the tenderloin facility as part of a counterprotest to support overdose prevention. She said jail helped get her son into treatment, but she doesn’t believe it’s the right solution for most people.

“Jail is there because there is not another thing,” said Baruch. “Who wants to traumatize people who are already ill?”

Like the other mothers, Baruch extolled the success of harm reduction efforts elsewhere.

“I read about Vancouver, I read about Portugal and I see that they have a very good success rate,” said Baruch. “And I know it’s counterintuitive because you think ‘we’re enabling them,’ but at the same time we’re also talking to them about maybe a place where they can dry out.”

Critics of San Francisco’s effort say it’s not the Portugal model. They’re right. Portugal decriminalized personal drug possession in 2001. It has also invested heavily in treatment and in creating a system designed to compel drug users to get help. The United States is decades behind when it comes to facing the ugly reality of addiction. The City is trying to catch up by hiring hundreds of workers to expand mental health and drug treatment options, but there’s a long way to go.

The tenderloin center is a small step forward. It has drawn some vocal detractors, but that’s no surprise. Most harm reduction measures — like needle exchanges and condom distribution programs — spark fierce opposition before gaining acceptance. The City’s realistic approach upsets these white mothers from the suburbs, but our overdose crisis is disproportionately killing Black men. We must value their lives regardless of whether they quit drugs cold turkey.

Onnie Broussard, a 41-year-old Black man who emerged from the Tenderloin center and accidentally found himself standing with the mothers during their press conference, had mostly positive things to say about the facility.

“It’s all right,” said Broussard in an interview. “They don’t have hot breakfasts, though.”

He said he hadn’t seen any drugs inside but rejected criticism of The City’s approach.

“I don’t think there’s really anything wrong with it,” he said. “How can they hurt the people if the people start working with them?”

Gil Duran is Editorial Page Editor of The Examiner. @gilduran76

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