Most of Mary Howe’s Monday evenings revolve around clean hypodermic needles — the ones used for injecting heroin and other intravenous drugs — and a grimy, well-worn stairwell in San Francisco’s Haight Ashbury district; this is the perch from which Howe’s Homeless Youth Alliance runs its needle exchange program, which like many of the people it serves, is a bit of a vagabond.
Skyrocketing rents saw Howe and the HYA lose their lease on office space in the neighborhood, which moved the needle exchange to a street corner — a sensible adjustment, seeing as the street is where most of its patrons live and conduct business. But leery (housed) neighbors raised a fuss.
Howe was run back indoors, but she hasn’t been run off the block: These days, anyone who stops by the stoop where Howe is sitting can go upstairs (to the offices of the Haight-Ashbury Free Medical Clinic, a Summer of Love leftover currently hosting the HYA) for a fresh “rig,” free of charge.
Public health professionals have known for 30 years that needle exchanges work: Wherever there’s a needle exchange, incidences of blood-borne diseases like HIV/AIDS and hepatitis C go down. They also serve as an avenue for homeless people to seek other services, like counseling for mental health or drug abuse problems.
For many people living on the street, a common sense harm-reduction program (like an opportunity to discard used syringes safely and get new ones) might be the first step towards getting off the street and into housing. For these reasons, the World Health Organization and the American Medical Association both sing the praises of needle exchange programs.
But what if there were something else that might work just as well — what if there was something that could get people housed, into treatment and off of opiates entirely?
If free needles work so well, what about… free weed?
This is the solution hit upon by Amy Farah Weiss, a San Francisco-based activist, homeless advocate and onetime candidate for mayor. As she first told local news blog Hoodline, Farah Weiss believes distributing free marijuana to homeless people living in tent encampments could be a similar avenue towards getting clean and getting off the street.
“There would be a scheduled appointment with a doctor that would provide them with a medical cannabis evaluation,” she said. “So they would have a contact point to be able to talk about their health issues with a medical physician.”
Weiss’s idea is still just in the proposal phase, and she’s already encountered obstacles. For one, although California’s marijuana legalization law allows for individuals 21 and over to give away up to an ounce of cannabis for free, medical marijuana evaluations and recommendations require valid ID – something many tent encampment residents lack.
She does have a few working parts in order: She has a Santa Cruz-based marijuana grower lined up, and told Cananbis Now that she’s been consulting with a recovering heroin user to help craft the program towards the needs of those struggling with opioid addiction.
“She uses cannabis to cut down on methadone doses and for neuropathy/anxiety/insomnia,” Weiss said. “She also helps people on the path towards detoxing and wants to be part of the solution with the opioid crisis.”
If the notion of solving drug addiction or homelessness by handing out free cannabis sounds daft, take a step back: Wherever marijuana is available, America’s opiate crisis has been less severe, as the National Institutes on Drug Abuse confirmed earlier this year.
States with legal cannabis have seen drops of up to 31 percent in opiate overdose deaths and 35 percent in opiate-related hospitalizations.
From the NIDA report:
“[Cannabis] could reduce a population’s exposure to opioid medications and the associated problems of overdose and addiction.”
This could go a long way towards explaining why heroin and fentanyl overdoses are a leading cause of death in places like Ohio — which is just now allowing for medical-marijuana access — and has thus far been kinder to California, where over-the-counter cannabis has been available for more than 15 years.
This could also explain why abuse of hard drugs persists among low-income communities: As anyone who’s been inside a dispensary recently can attest, marijuana is expensive.
Health plans for low or no-income people cover prescription drugs like opiates, but there are virtually no programs in place where someone more interested in cannabis for pain could receive subsidized pot. For them — for a homeless veteran, for a battered spouse, for a disabled worker — the choice is between taking a pill or living in pain.
Last winter, as San Francisco grappled with a growing number of homeless encampments encroaching on homes and businesses — 75 by one count — which in turn fueled an outcry from the citizenry about trash, open-air defecation and other issues endemic to tent living in urban areas, Weiss hit upon a novel, common sense solution; toilets and trash collection. The resulting “Box City” seemed to be a cleaner, more sensible and more humane alternative to tent cities, but it was bulldozed in January and its residents were sent scattering by city workers.
Similar attitudes once foiled needle exchanges before the city establishment dropped retrograde, by-the-book attitudes and copped to the obvious — a solution is needed. Someday, we may look around at legalized tent encampments with on-site toilet facilities and medical professionals, where street people begin the transition to housing, and say, “Duh. Of course this works.”
For now, Weiss offered some Catholic wisdom.
“Francis of Assisi said: First do what’s necessary, then do what’s possible, and soon you will be doing the impossible,” she said. “I say ‘Hells yes,’ that’s my motto too, and let’s innovate for the greater good.”
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