SECTION 1.
The Legislature finds and declares all of the following:(a) Overdose deaths in California are an urgent public health crisis. Overdose has been the leading cause of accidental death in the United States and in California each year since 2011.
(b) The COVID-19 pandemic has been associated with a rapid increase in drug overdose deaths. According to data published in the article “Drug “‘Cries
for help’: Drug overdoses are soaring during the coronavirus pandemic” by the Washington Post, overdoses increased every month in fall of 2020 compared to the prior year. In May 2020, the increase was 42 percent compared to the prior year.
(c) Overdose prevention programs (OPPs) are an evidence-based harm reduction strategy that allows individuals to consume drugs in a hygienic environment under the supervision of staff trained to intervene if the individual overdoses. OPPs also provide sterile consumption equipment and offer general medical advice and referrals to substance use disorder treatment, housing, medical care, and other community social services.
(d) There are approximately 165 overdose prevention programs operating in 10 countries around the world.
Numerous peer-reviewed studies have confirmed that OPPs are effective in reducing overdose deaths and HIV transmission, and in increasing access to counseling, treatment, and other risk reduction services. Research has also demonstrated that OPPs decrease use of emergency medical services, reduce public drug use, reduce syringe debris, and do not increase crime or drug use.
(e) In July 2020, the American Medical Association (AMA) joined several associations representing health officials and public health, drug policy, and substance use disorder treatment specialists, in an amicus brief supporting an OPP in Philadelphia, Pennsylvania. The AMA and others wrote that, “Supervised consumption sites are an evidence-based medical and public health intervention with the potential to improve individual and community health.”
(f) On July 8, 2020, the New England Journal of Medicine published a study on the outcomes of an unsanctioned OPP operating in the United States from 2014 to 2019, inclusive. The study and supplemental material show that not only were there no deaths resulting from over 10,000 injections, but that it was not once necessary in five years to call for paramedic services or use an outside medical facility. The authors conclude that, “sanctioned safe consumption sites in the United States could reduce mortality from opioid-involved overdose. Sanctioning sites could allow persons to link to other medical and social services, including treatment for substance use, and facilitate rigorous evaluation of their implementation and effect on reducing problems such as public injection of drugs and improperly discarded syringes.”
(g) An analysis published in the Journal of Drug Issues in 2016 found that, based on the experience of an OPP in Vancouver, a proposed program in San Francisco would reduce government expenses associated with health care, emergency services, and crime, saving $2.33 for every dollar spent. It is estimated that one OPP would save the City and County of San Francisco $3,500,000 in other costs.
(h) As demands for reform of the criminal justice and legal
system reverberate around the country, OPPs offer an alternative framework for addressing both drug use as well as the enforcement of drug laws that disproportionately injures communities of color. OPPs bring people inside to a safe and therapeutic space, instead of leaving them vulnerable to police intervention, arrest, and incarceration.
(i) In July 2020, California law enforcement leadership, including district attorneys of the Counties of Los Angeles, San Francisco, Santa Clara, and Contra Costa, signed onto an amicus brief in support of an OPP in Philadelphia, Pennsylvania, writing, “The issues are particularly acute at this current moment, with a global pandemic and fractured relations between law enforcement and communities. There is an urgent need to fortify trust in the justice system. Failing to address the loss of life
resulting from drug overdose-and criminalizing a community based public health organization working to save lives-will further erode trust. If there were ever a time to demonstrate that the justice system values the dignity of human life, that time is now.”
(j) Also in July 2020, California Attorney General Xavier Becerra joined an amicus brief with eight other states and the District of Columbia, in support of an OPP. In the brief, the attorneys general wrote, “After studying SIS [safe injection services] interventions in other countries, many states and cities are considering them as a means of saving lives. The studies predict that the sites will reduce deaths, the spread of bloodborne diseases, and costs. And they are a unique solution to the common problem in many urban areas of rapid, unintended overdoses of
heroin or fentanyl.”
(k) It is the intent of the Legislature to promote the health and safety of communities by evaluating the health impacts of OPPs in San Francisco, Los Angeles, and Oakland.
(l) It is the intent of the Legislature to prevent fatal and nonfatal drug overdoses, reduce drug use by providing a pathway to drug treatment, as well as medical and social services for high-risk drug users, many of whom are homeless, uninsured, or very low income, prevent the transmission of HIV and hepatitis C, reduce nuisance and public safety problems related to public use of controlled substances, and reduce emergency room use and hospital utilization related to drug use, reserving precious space, including intensive care beds for treatment of COVID-19 and
other life-threatening conditions.
(m) It is the intent of the Legislature that OPPs should be evaluated in California cities that authorize them, as OPPs show great promise to save lives, enhance public safety, improve access
to substance use disorder treatment, medical care, and related services, reduce emergency department and hospital utilization related to drug overdose, and reduce the human, social, and financial costs of the triple epidemics of drug misuse, homelessness, and COVID-19.