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Needles, naloxone and board games: A first look inside the Tenderloin Center

After nearly six months of debate, scrutiny and a gubernatorial candidate’s attempt to trespass on the property, city officials finally allowed journalists to take their first look inside the Tenderloin Center. 

The facility opened under Mayor London Breed’s emergency declaration in December to address the city’s devastating drug crisis. Though the site’s original name—the Tenderloin Linkage Center—quickly became a misnomer since numbers on completed linkages to drug treatment remain low, site providers tout their success in attracting otherwise hard-to-reach clients by permitting drug use and offering basic services.

To date, staff at the facility have reversed 92 overdoses, supplied over 35,000 hot meals and provided nearly 5,000 showers, according to a city dashboard. 

On any other day, the seven-story building is fenced off from everyone but its clients. In the absence of accessibility to anyone beyond clientele, conflicting visions for its role in the community have led to unfulfilled expectations among some residents. 

Breed’s emergency order came on the heels of her vow to crack down on crime in the Tenderloin. The declaration sparked mixed reactions from SF residents. 

Some raised alarm that the city would double down on criminalizing drug use. Others rejoiced at the prospect of safer streets. 

Ultimately, the results didn’t quite align with Breed’s stated vision, as the facility morphed into a de-facto safe-consumption site.

“If we shame [guests], then they’re not going to come in,” Vitka Eisen, CEO of site service provider HealthRight360, said during the first-of-its-kind media tour. “That’s what they’ve experienced everywhere.”

DPH, Code Tenderloin Center, and other nonprofit services walk through the outdoor space of the Tenderloin “Linkage” Center on Market Street in San Francisco, Calif. on Thursday, June 2, 2022. | Camille Cohen/The Standard

City and nonprofit officials walked reporters through the center’s first floor Thursday morning, talking about what services are provided in each office, from securing housing for clients to signing them up for food stamps.

An outside area that allows people to use drugs has drawn the most criticism

Deep-seated blue-and-gray plastic lawn chairs were spread out across the yard, a concrete expanse enclosed by green-tarped fences and white HealthRight360-branded canopies.

During the walk-through, media observers were shown a cart holding clean needles, Naloxone overdose-reversal medication and tin foil for people to burn smokable narcotics. Across the courtyard, a table held board games: Monopoly, Scrabble, chess, checkers, Connect 4.

Donna Hilliard, executive director of homeless service nonprofit CODE Tenderloin, which works at the site, compared the outdoor plaza to “grandma’s backyard.” 

“We want folks to come to a place where no one’s going to judge them,” she explained. “We have a game center, we play chess with folks—but really what that is, is sitting down and saying, ‘I care about you.’” 

Blue storage bins with medical supplies, labeled with numbers and percentages.
Tools and resources available to guests of the Tenderloin “Linkage” Center on Market Street in San Francisco, Calif. on Thursday, June 2, 2022. | Camille Cohen/The Standard | Source: Camille Cohen/The Standard

In interviews with The Standard, early guests praised the site as a relatively safe place to get high in private. But some clients said they were unaware they could seek drug treatment there. 

After Breed’s winter announcement, emails obtained by The Standard through a public-records request depicted a scramble to pull the center together. And from the onset, many of those involved primarily viewed the facility as an “overdose prevention site.”

Experts in addiction medicine argue that overdose-prevention sites make neighborhoods safer and save lives. Many residents in the city aren’t so sure. 

Only 32% of San Francisco voters said they approved of opening a safe consumption site, according to a recent poll commissioned by The Standard. In the South of Market neighborhood, another group of recovery-minded officials is preparing a different vision for a harm-reduction rehabilitation facility—one that doesn’t allow drug use. 

Juliana McNeil, a Tenderloin Center guest who spoke on the tour, said staff at the site had helped her with housing applications. 

“When I line up in that line, I feel embraced,” she said. “They don’t care where you come from. They treat you like a person, not a number. Nobody else is going to embrace you like San Francisco.” 

David Sjostedt can be reached at david@sfstandard.com