On Wednesday, April 6 Project Homeless Connect hosted a panel discussion about working with and advocating for people with substance misuse disorders. The panelists represented several organizations, including UCSF, the DOPE Project, and the Department of Public Health. The audience was largely made up of care providers, who brought stories about clients with alcohol/drug problems to the conversation.
This conversation comes at a relevant time for San Francisco. According to panelist Katie Burk of the Department of Public Health (DPH), many homeless service organizations and nonprofits addressing substance use are being displaced and losing their locations. DPH is facing increased strain and an “uphill battle” to maintain services that can address the needs of the city.
The panel discussed additional challenges in helping people with substance misuse disorders:
- Panelist Eliza Wheeler, of the DOPE Project, explained that heroin use in San Francisco had been declining. However, in the mid-2000s an uptick in prescription opioid addiction created a pathway to increased heroin misuse today. She described a progression in which people start using street drugs after becoming addicted to their prescribed opioids. Prescription opioids are expensive; if an individual becomes homeless or loses a job, they may seek a cheaper street alternative such as heroin or fentanyl.
- One serious risk factor for overdose is that as people become poorer, they are forced to use dramatically lower-quality drugs. In some cases, buyers do not even know what they are using. Drugs sold on the streets are often misrepresented, and synthetic drugs and pills are often sold under the wrong names.
- Panelist Caycee Cullen runs the VIP Study at UCSF, a long-term survey of people with substance misuse disorder. Caycee said that before the study launched, she had worried about getting actively-using participants to stick to appointment times and treatment schedules. Since then, she has learned that the real challenge is in reimagining access and rethinking how to help people stick to their appointments.
Some of the conclusions from the panel included:
- Outright banning drugs does not decrease drug use, it simply shifts use to areas in which it will be harder to reach people. This is why providers who work with substance users advocate for needle exchange programs and safe injection sites.
- The panelists shared stories of times when they were disheartened by this work. They reminded the audience to be a guide for clients, and to trust in the humanity of the people you serve.
- Compassion is a necessary approach to working with substance users. As Caycee said, “the more kind you are, the more you build trust, and that’s what enables change to happen.”
Wisdom, Tools, & Resources
An audience member asked “What can we do when we see people suffering on the streets? How can we help?” Caycee Cullen’s immediate response was “trust your gut”. As people who work and live in San Francisco, we pass by people who seem to need help quite often. It is impossible to reach out to each and every individual. However, being armed with information can help us to recognize street scenarios where we can help.
If you are fairly certain that someone is having a medial emergency, Eliza Wheeler says don’t hesitate to call 911.
If you see someone in distress on the street, call 311 and ask for SFHOT’s Street Outreach Team.
Download the Concrn App to report a crisis on the street, and a Compassionate Responder will arrive to provide assistance.