See the opioid crisis plaguing San Francisco

Homelessness and the opioid epidemic are plaguing San Francisco streets. CNN's Dan Simon reports on how the city is fighting back.

Posted: Dec 29, 2018 1:50 AM
Updated: Dec 29, 2018 1:50 AM

Outside the Ninth Circuit Court of Appeals in downtown San Francisco, a woman urinates on the sidewalk and smokes a crack pipe.

Inside her purse are about a dozen used heroin needles. She shoots heroin up to 10 times per day, she says.

About 50 yards away, a man injects another woman in the neck with a needle. She puts her thumb in her mouth and blows on it to make her vein more visible. Her right arm is caked with dried blood.

This San Francisco neighborhood is home to the headquarters of Uber, Twitter and Salesforce. But stroll around here, and you're also likely to find used drug paraphernalia, trash, and human excrement on the sidewalks, and people lying in various states of consciousness.

Public drug usage and homelessness are not new problems for the city of San Francisco. But residents say the situation has gotten worse in recent years. As of October, 7,500 complaints about discarded needles have been made this year, compared with 6,363 last year. In 2015, the number was less than 3,000.

It's moved some locals -- so-called "video vigilantes" -- to document the mess they see, in an attempt to get the city's attention.

Adam Mesnick, a restaurateur who lives and works in the South of Market (SoMa) neighborhood, started posting daily photos and videos of people using drugs in public, urinating near his restaurant, or lying passed out on the sidewalk.

"More mrsa and staph on the streets of San Francisco," Mesnick wrote in one post, accompanied by photos of angry sores on people's backs, hands and legs.

One photo shows a man planted face down on the sidewalk, his shorts pulled down exposing his rear. In another, human feces lies nestled in front of a doorway. In a video apparently taken from inside Mesnick's restaurant, a man can be seen urinating in a doorway across the street.

Mesnick isn't trying to shame homeless people with his Twitter posts, he says, but "to actually find help for these people." He's been giving leftover food from his restaurant to the homeless for the past ten years, he said.

Over the past five or six years, Mesnick says, visible homelessness and drug use on the streets have seemed to spread from areas of San Francisco where they were once concentrated, like the Tenderloin.

"It's like third world squalor," Mesnick said. "I'm a small business (owner) trying to exist, and basically surrounded by decay that continues to get worse and worse and worse."

Others fear that the situation will impact tourism. "If we can't find a solution to this problem," said Joe D'Alessandro, CEO of the San Francisco Convention and Visitors Bureau, "it will tarnish the city's brand."

Another longtime resident tweets about the state of the neighborhood using the handle @cleanupwestsoma. He asked to remain anonymous because his friends don't know he runs the account, and says he's lived in San Francisco for 21 years, 12 of them in SoMa.

"I post as I go to work. I'll sometimes come home from lunch and see a giant drug deal going on," he said. "I'll leave and go back to work and see someone going to the bathroom in the street. It blows me away that this continues to happen in the city."

Mesnick and @cleanupwestsoma want to send a message to city officials about what's happening in their neighborhoods. They often tweet at San Francisco Mayor London Breed, who took office in a special election in July after the death of Mayor Ed Lee.

"You know what? I already had the message, as a native San Franciscan, as someone who's been here all my life," Breed told CNN. "It isn't acceptable."

Breed, 44, made tackling homelessness and drug addiction a signature of her campaign platform. She says the city has been making changes since she took office, and that they're slowly starting to have an impact. "It's not an unsolvable problem," she said.

Last week, the mayor announced a detailed plan to direct a $181 million cash windfall the city received from the state to homelessness, affordable housing and related problems. The proposal includes nearly $20 million to be spent on beds for patients who have addiction and mental health problems. An additional $4 million would go toward expanding street cleaning.

And Breed says visible progress has already been made.

"If you walk with me right now, you will see the difference," she said. "You'll see more police officers. You'll see the homeless outreach team. You'll see people power-washing on a regular basis and picking up trash." Tent encampments are down by 27% since she took office, she said.

Kevin Schwing, who works in SoMa, said that despite the city's efforts, he doesn't see a change in the numbers of people on the streets.

"I don't really know what the city can do," he said. "The city cleans up sidewalks every day. But I don't see any difference in terms of the amount of people."

"I see human waste. Injections. Probably 10 times per day," he said. "Sometimes people look like they're dead."

Breed says the city is cracking down on drug dealing, and aims to open at least 1,000 new shelter beds by the end of 2020.

And she's looking at new ways to approach these entrenched problems, she says. Breed supports safe injection sites -- facilities where people can inject heroin in a private setting and under the supervision of health care workers. The sites would "not only be a way to get people off the streets and get the needles off the streets, but to get people into treatment," Breed said. California Gov. Jerry Brown vetoed legislation earlier this year that would have allowed safe injection sites in the state.

She also supports conservatorship programs for the severely mentally ill, which would allow the state to "make decisions for them in order to place them into mental health stabilization beds, instead of our criminal justice system." Gov. Brown recently signed a bill that would allow such action to take place.

Breed says she hopes the "video vigilantes" tag 311, the city's non-emergency complaint service center, in their posts. The information they're putting out helps the city address challenges in specific neighborhoods, she said.

The city's Department of Public Health recently partnered with the San Francisco AIDS Foundation, essentially hiring contract workers to fan the streets and collect used needles.

Crisis intervention teams have also stepped up their efforts to provide addicts with the drug buprenorphine, a narcotic to help reduce a person's addiction to heroin and other opioids.

"We go to people that are using drugs and offer them treatment instead of the traditional model which has people coming into a clinic," said Dr. Naveena Bobba, the department's deputy director of health.

The city has also launched the so-called "poop patrol," a team that responds to complaints of feces on city streets.

SoMa resident Alesia Panajota said she sees an impact. "They're doing the best they can," she said. "I think things are getting better under London Breed."

San Francisco may also see an influx of cash to help solve the crisis, after a controversial ballot measure passed in November. Known as "Prop C," the measure is viewed as a "homeless tax" -- it aims to raise $300 million a year to spend on homeless services by taxing big businesses.

Salesforce Chairman and Co-CEO Marc Benioff spent at least $7 million of his own money to help ensure Prop C's passage. "We have to say enough is enough," he recently told CNN.

But legal challenges could prevent the city from receiving the funds for several years.

In the meantime, Mesnick keeps posting. He recently put up a video interview with a homeless man talking about how difficult it is to find a place to go to the bathroom after dark.

"Help this guy," Mesnick wrote. "Keep the restrooms open at night? Perhaps we change usage of our space and make it a bathroom share? Better than on our front stoop..."

"We are in a severe epidemic here," he told CNN. "My angle may seem to be a little rough around the edges, but it's really about compassion."

Mississippi Coronavirus Cases

Data is updated nightly.

Cases: 350070

Reported Deaths: 7590
CountyCasesDeaths
Hinds24512449
DeSoto23513283
Harrison21172335
Rankin15798293
Jackson15735254
Madison11171227
Lee10903180
Jones9223169
Forrest9027163
Lauderdale8087244
Lamar724890
Lowndes7199152
Lafayette6631125
Washington5661140
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Oktibbeha503198
Bolivar5004134
Warren4817128
Panola4812112
Marshall4739106
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Union438979
Monroe4369138
Lincoln4228116
Pike3739114
Leflore3676125
Alcorn355374
Tate354988
Sunflower351094
Adams347490
Scott346677
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Copiah330869
Simpson327191
Itawamba317281
Coahoma315685
Tippah312869
Prentiss302563
Covington302384
Marion289882
Leake288676
Wayne280945
George277351
Grenada272188
Newton266864
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Stone235338
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Attala228674
Chickasaw221460
Holmes202574
Clay201954
Clarke189580
Tallahatchie185642
Calhoun183232
Smith183036
Yalobusha173641
Walthall150449
Lawrence145426
Greene141935
Amite139144
Noxubee137235
Perry136138
Montgomery133944
Carroll127031
Webster124332
Jefferson Davis119834
Tunica116127
Benton107825
Claiborne105931
Kemper104429
Humphreys102333
Franklin88424
Quitman86319
Choctaw83119
Wilkinson79332
Jefferson72228
Sharkey51918
Issaquena1746
Unassigned00

Alabama Coronavirus Cases

Cases: 592417

Reported Deaths: 11542
CountyCasesDeaths
Jefferson861091591
Mobile49771865
Madison37714533
Shelby27501259
Tuscaloosa27344465
Montgomery26343628
Baldwin25860329
Lee17336181
Calhoun15498334
Morgan15225291
Etowah15060370
Marshall13198236
Houston12191293
Elmore10977219
St. Clair10852252
Limestone10816158
Cullman10610206
Lauderdale10305254
DeKalb9594192
Talladega9005188
Walker7840288
Autauga7615114
Jackson7431117
Blount7417139
Colbert6752142
Coffee6443132
Dale5723117
Russell482243
Chilton4810117
Covington4804125
Franklin462781
Tallapoosa4571156
Escambia451083
Chambers3987125
Dallas3751163
Clarke372263
Marion3470107
Pike334079
Lawrence3277100
Winston300773
Bibb292865
Geneva288383
Marengo262967
Barbour253761
Pickens247762
Butler242472
Hale236778
Fayette228165
Henry216545
Monroe204541
Randolph202844
Cherokee200748
Washington186839
Macon171552
Crenshaw170658
Clay167159
Cleburne161845
Lamar151938
Lowndes146255
Wilcox132331
Bullock126542
Conecuh122132
Coosa119529
Perry111228
Sumter110633
Greene99337
Choctaw64425
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