Are Wellness Hubs the Most Effective Way to Spend San Francisco’s Opioid Settlement Money?
Ever since Mayor London Breed released her proposed budget, TogetherSF Action’s team of policy experts and recovery advocates have been combing through the draft. We’ve been pushing City Hall to end San Francisco’s open-air drug markets this year, and many of our requests are funded in the proposal. We’re grateful the Mayor listened to our community’s calls for action.
But one item that stood out was the proposal to spend $18.9 million to open up three Wellness Hubs over two fiscal years. This money comes from over $290 million in settlement funds San Francisco received from pharmaceutical companies and retailers for their role in creating the opioid crisis, and we’re not sure if this is the most effective way to spend this money.
The proposed budget describes these hubs as low-to-no-barrier “safe and supervised spaces to get drug use off the streets and connect people to services,” with the aim of improving the health of people with substance use disorder and reducing public drug use. Planned services for Wellness Hubs will include overdose prevention services, along with resources and connections to outpatient and inpatient residential treatment.
These are good goals, and implementing Wellness Hubs is a “cornerstone” of the San Francisco Department of Public Health’s Overdose Prevention Plan. Our concern is that Wellness Hubs, in practice, will actually function as safe consumption sites, similar to the Tenderloin Center that closed late last year. Safe consumption sites are illegal at the federal level, so the proposed budget specifically notes that safe consumption drug services in these hubs will be privately funded.
In fact, the SFDPH explicitly notes in their Overdose Prevention Plan that the Wellness Hubs will build upon the successful elements of the Tenderloin Center. Unfortunately, the data on the effectiveness of the Tenderloin Center is mixed to downright negative.
One of the primary goals of the Tenderloin Center was to link those suffering from substance use disorder to treatment and recovery services. While nearly 50,000 visits were logged to the center between its opening in January 2022 to May 2022, only 163 people were referred to substance use treatment programs, and only 38 had actually been connected to substance use treatment, resulting in a linkage rate of just 0.076 percent. By the time the Center closed in December 2022, the Center reported a linkage rate of less than 1 percent to mental health or drug treatment programs.
Needless to say, this wasn’t effective. Mixing active drug use with resources to connect people to drug treatment services has been criticized by experts, like Stanford University School of Medicine Addiction Medicine Specialist Keith Humphreys. “If you’re coming into a place that’s supposed to guide you toward the end of seeking treatment and recovery and there are people using drugs around you, that becomes an incentive to keep going,” Humphreys said. “It’s like trying to have an AA meeting in a bar.”
Many have praised the Tenderloin Center for its work in saving lives during its existence, and the center did reverse 333 overdoses from January 2022 to December 2022. Overdose prevention and reversals are critical, but other city services already offer these more efficiently. In the same time period that the Tenderloin Center was active, there were 2,711 overdoses reversed citywide by San Francisco’s Emergency Medical Services, meaning the 333 overdoses reversed at the Tenderloin Center accounted for 12.28% of all overdoses reversed citywide.
Instead of replicating an imperfect solution, this opioid settlement money should be directed to programs that will help people get healthy and sheltered, like additional intake centers and more drug treatment beds. One good example is SoMa RISE, which connects drug users to services and offers them care during the sobering process.
Ultimately, San Francisco’s past experience with the Tenderloin Center calls into question how effective Wellness Hubs will be. There is a valid concern that these Wellness Hubs could end up repeating some of the failures of the Tenderloin Center. With an anticipated $780 million budget deficit, San Francisco needs to ensure that limited funds are spent on treatment programs that have a real impact.
TogetherSF Action is making advocating for an end to the drug epidemic in San Francisco a top priority this year. Our first step? Flooding inboxes at City Hall. We need thousands of concerned San Franciscans to send letters to their leaders demanding they end open-air drug markets in 2023. Are you in?