“I know you don’t believe me, you have valid concerns, and I’m going to do it anyway”

QA with Supervisor Hillary Ronen about proposed drug use sites. Why, despite objections, she's committed to opening them.

Scenes from outside Vancouver’s Downtown/Yaletown drug use site. photo credit @SeedyVancouver

On April 17, 2023 I sat down with San Francisco supervisor Hillary Ronen to discuss the proposed drug use sites. The city’s Department of Public Health (DPH) is calling them wellness centers, and Ronen is one the plan’s most devout evangelicals.

That the community at large isn’t so taken with the idea of a drug use site opening on their block is a hurdle she’s willing to clear. If she can help it, they’re going in. And if they don’t work out… well, read on.*

I was at the Tenderloin Center [which turned into a drug use site] constantly, and drug dealing outside was rampant. 

We would not allow that. 

How would you not allow that?

We would have police and community ambassador presence making sure that doesn’t happen.

What would be the perimeter?

I mean, we'd have to build it in. My guess is a circular two block parameter across, but we have to plan that. 

So people would go in, use, then have to go out to purchase again, multiple times a day.

Well, no. From what I hear, people generally purchase their use for the day. And I could be wrong, but from talking to DPH, from talking to the moms, from talking to different people, they say it’s about $15 a day to have your fentanyl needs met for that day if you’re a severe addict. And I’ve heard lots of crazy ways that people get their $15 every day, that are disturbing. But they get their $15 worth for their day's use.

I don’t know this for a fact, but I don't think people do a hit, leave, score again, do a hit, leave, score again. I think they have their portion for the day, but I could be wrong.

The majority of Fentanyl addicts do score throughout the day. Given that, doesn't that leave the outside area more prone to a thick concentration of dealers?

Very fair question. I’ve talked to a lot of supervisors about this. it is a concern for us as well.

Three supervisors in the neighborhoods that are plagued with open air drug use and overdoses, do not want a center that creates worse community conditions than they are today. We have to plan.

Number one is that the conditions are horrendous today. Could they actually get worse? I don’t think so. We would love to open all three at the same time, in the Mission, SOMA, and the Tenderloin. Because we don’t want people coming from different neighborhoods into the other neighborhoods. We don’t want to attract more of the behavior or the problem into the neighborhood that’s already there. We want to address what’s there, not attract more.

Number two, we all want to have really robust safety plans. And we can’t sustain these if they become hell-holes. If they create hell-hole conditions around the neighborhoods where they exist, it won’t work. Our constituents will demand we shut them down, and we will be voted out of office.

It’s really important for an elected official to maintain. We care about the community we represent. We want to be represented well. We want to improve the conditions, not make them worse. So we’ve talked about partnerships with the police and creating community ambassadorships to ensure that this behavior doesn’t take place…. it’s something that we have to get right if we want these centers to last in our communities. 

I put up a poll on Nextdoor, asking if residents would want drug use sites close to them and 79% said absolutely not. What they did say, is that it would be fine if it was in somebody else’s neighborhood. People don’t want them next to them. So basically you would be going against the desires of the people. How do you respond to that?

City-wide polls on safe injection sites show that the vast majority of people are in favor of them. [I looked for the polls and could only find this, from 2018. They were called Supervised Injection Sites at the time because most people were shooting heroin. The far stronger and more deadly Fentanyl, which is typically smoked, had not yet entered the picture.]

But yes, I do agree with you that there is this phenomenon of the closer you are to the center, the less you want them.

We’re not yet at a place where we’re opening the wellness centers because the city attorney is stopping us. So we’re in a planning phase, in kind of show down.

But before I would ever say OK we’re ready, I would have to be convinced, because it would be me putting myself on the line. I have to look neighbors who oppose this in the eye and say, “I understand your fears; they’re valid. Because they are. I can say that right now. And I have to prove to you that we’re going to do this right. You don’t have faith in the city, for understandable reasons, we have horrible conditions.”

Precisely because the conditions are so horrible, I’m fighting so hard. That’s why I’m opening the center, because I believe we can improve conditions with the center. And the proof is going to be in the pudding. You’re never going to believe it until I prove it to you. I’ve got to be able to prove it to you if you’re ever going to support anything I do again.

So we have a mutual interest in doing this right, and I take everything I do extremely seriously.  I’m willing to look my constituents in the eyes, and say, “I know you don’t believe me, you have valid concerns, and I’m going to do it anyway.” 

You’re going to do it anyway?

Yes, I mean in the future we will go ahead to open these centers, when we have the budget, the planning, and we do community outreach.

If the community is against the center, we have to open it regardless of the community. I have to be able to say, “We’re going to open this, we’re going to do it responsibly, and conditions are going to improve in the neighborhood.”

And if they don’t improve, you hold me responsible for it. 

What does that mean?

Well, I’m out of office in two years, but you know, don’t support the person I’m supporting for supervisor.

I find that so concerning: “I’m going to do it anyway.” That’s kind of scary.

Before you quote me out of context, please don’t quote me out of context, I’m saying in a situation where it’s 50/50. I have been in the District 9 position for 13 years. I know the Mission inside and out. I have opened navigation centers. I have opened Hummingbird. I have done dozens of meetings, and it’s usually 50/50, or 60/40 in favor of these sites.

So if you have 50% of your constituents saying yes to something, and 50% saying no to something, you have to take a side and 50% of the people are going to be angry with you. This is the story of my life. This is the story of every politician's life.

The repercussions are you don’t support them in the next round. Or you turn around and say, “they really cared about me, they had my best interests at heart and they worked hard to meet their promises.”

My promise will always be that I am not going to put something in the middle of my community unless I think it will improve neighborhood conditions. [The drug use sites] will save lives, it will serve the needs of my constituents. So I will make that promise, and I will suffer the consequences. I have to look my constituents in the eyes and say, “We disagree. I’ve been elected by the whole to make decisions for the community. I hear your concerns, and they’re valid.”

I don’t think they have much trust in the city right now, which is also valid. The conditions are horrible on the streets, but how are we going to improve those conditions if we don’t do something new and different? And this would be one of those things that we would do to try and change the conditions on the street.

We can’t keep doing the same thing and expect different results. One thing we have not tried in San Francisco in a real, responsible way, is opening robust overdose prevention sites with a whole host of other services, with ample security and neighborhood safety plans, that have worked in over 200 cities in the world.

And it’s not the same, many of them have socialized medicine, which is very different from San Francisco. But it’s something we could try to address these equally horrendous twin crises that we’re facing: death by overdose, in the hundreds, shocking numbers, and open-air drug use, which is absolutely unacceptable in our neighborhoods.

I take the responsibility very seriously and I will take ownership for it so there is someone to blame if something goes wrong. Because I think someone needs to stand up and take ownership. And I haven’t seen enough of that in this city. I haven't seen enough politicians say, “I have a solution to the problem, and if it doesn’t work, it’s on me.” I’m willing to do that.

But in order to do that, I have requirements. I need these three centers to open at the same time, not opening one in the Mission alone, I won’t do that – it would be a disaster, I really believe that. And number two, to have a top-notch safety plan that the police and community and safety ambassadors truly staffed. And I need that agreement with the chief of police, I need that commitment with the community ambassadors, I won’t open them without it. 

-end-

Ronen strikes me as a kind and passionate person, but also naive. It was immediately clear that she is genuinely disturbed by the state of the city and would like to be a force for good. However I found her shockingly uninformed about the habits of fentanyl addicts and their relationship with drug dealers. She imagines these sites as a sort of Shangri-La, despite evidence to the contrary in places they’ve been tried, such as Vancouver and New York, and is unwilling to explore alternatives.

Although Ronen requested that I not quote her, the “doing it anyway” comments must remain.

*The transcribed conversation weighs in at just over 4,000 words, so too long for this article. I start at mid-point since it’s where we get to the practicalities of the plan, edited slightly to omit vocal disfluencies and redundancies. I recorded the interview via video, so for a copy, please contact me.