[BBC video clip]

69 SIFs worlwide : 8 countries, 27 cities as of 2009

intelligence 2
DEBATES
THINK TWICE.
 intelligence2 : Think twice.

Dirty Reused Shared Reused

needles needle they needle Someone
used before after use else’s needle

Motion:
A Safe Injection Facility (SIF) for
injection drug users (IDUs) needs to be
piloted in San Francisco.
 intelligence2 : Think twice.

FOR:
• Hang – Drug Policy Alliance
• Judy – San Francisco Hep C Task Force
AGAINST:
• Dina – Office of the San Francisco Mayor

PRELIMINARY VOTE

YES

NO

UNDECIDED
intelligence2 : Think twice.

Dirty Reused Shared Reused

needles needle they needle Someone
used before after use else’s needle

OPENING STATEMENTS
 intelligence2 : Think twice.

Salient Points from the SF Hep C Task Force

- Hep C prevalent among SF IDUs, HIV co-infection

- HCV prevention costs < HCV Tx (lifetime cost est.
$100,000-300,000).
- HIV prevention costs ($39/life-year saved) < HIV Tx
(>$2,000/life-year saved)
- SIF can generate incremental net savings of >$18 million,
help IDUs gain >175 life-years over 10 years.
- SIFs offer Hep/HIV counseling, STD & TB screening,
referrals to Tx & rehab.
- San Francisco: nation’s model of courage & leadership
in social justice issues
 intelligence2 : Think twice.

Salient Points from the Drug Policy Alliance

- Harm reduction: a comprehensive approach to drug abuse

and policy.
- Secondary prevention vs. tertiary prevention: 
possibility of changing behavior, leads to better quality of
life
- Reduces incidence of OD, traffic in the ED
- Ability to reach highest risk groups who do not have
access to healthcare (sex workers, homeless)
- Protects the public from accidental puncture d/t
improperly disposed needles
 intelligence2 : Think twice.

Salient Points from the Office of the SF Mayor

- SF already spending for NEPs, Naloxone distribution,
Methadone clinics, outpatient/inpatient drug rehab
programs, street outreach programs.
- SIFs will violate 2 Sections of Federal Controlled
Substance Act:
- Sec 844: prohibits drug possession q SIF client can be
arrested
- Sec 856: “Crack House Statute” makes illegal to knowingly
open or maintain any place for the purpose of unlawfully
using a controlled substance.
- SIF: a complex legal battle that takes SF away from
pressing matters: city budget, pension reform, job
creation
intelligence2 : Think twice.

Dirty Reused Shared Reused

needles needle they needle Someone
used before after use else’s needle

DISCUSSION
intelligence2 : Think twice.

Dirty Reused Shared Reused

needles needle they needle Someone
used before after use else’s needle

CLOSING STATEMENTS
 intelligence2 : Think twice.

Salient Points from Closing Arguments

FOR:
- Do we continue to waste money & resources or do we
follow clear evidence & invest in something that works?
- SIFs are not just science – also about healthcare reform
and human rights, compassion and dignity.

AGAINST:
- SIFs—a legal mess that will require changes from all
branches of the federal government.
- Are you willing to risk your healthcare provider licenses
to violate federal law?
 intelligence2 : Think twice.

BEFORE AFTER

YES

NO

UNDECIDED
 REFERENCES
www.hepcsf.org
www.drugwarfacts.org
www.stopthedrugwar.org
www.drugpolicy.org
www.who.int/hiv/topics/idu/en/index.html
The San Francisco Chronicle & Bay Area News Group
California Department of Public Health
American Journal of Public Health
E-mail us if you want a detailed list of bibliographical references.

intelligence 2

DEBATES
www.intelligencesquaredus.org  Bloomberg TV  National Public Radio