Harm Reduction Practice and Innovation in Response to the COVID-19 Pandemic in San Francisco

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Executive Summary

Amid a significant spike in deaths among individuals experiencing homelessness in San Francisco, including a rise in overdose deaths, expanded harm reduction practices and substance use treatment during the COVID-19 pandemic have shown promising results in reducing death and harm from opioid use. The interventions include providing emergency shelters for higher-risk adults and families; lowering barriers to increase access to substance use treatment, including giving providers more flexibility in initiating and continuing care; and intensifying overdose prevention measures, including making naloxone more widely available. These measures have mitigated casualties, and should be continued even beyond the COVID-19 pandemic to address the opioid public health crisis. Polling by Data for Progress and The Justice Collaborative Institute shows strong bipartisan support for these measures:

⊲78% of likely voters, including 82% of Democrats and 80% of Republicans, support allowing temporarily housed individuals to see doctors, mental health professionals, and other treatment providers at the hotels where they are housed.

⊲77% of respondents, including 82% of Democrats and 78% of Republicans, support the city government providing food to these individuals.

⊲67% of respondents, including 74% of Democrats and 63% of Republicans, support the city government providing substance use treatment, including methadone, a non-narcotic that can help individuals with withdrawal.