At 9am in San Francisco’s Tenderloin district, sleeping bodies line the sidewalks as Felanie Castro sets out in Glide Foundation’s harm reduction van. Along Ellis Street, hungry people queue for a daily breakfast, while down the block a fire department truck awaits the first drug overdose call of the day.
The Tenderloin and adjoining South of Market district have become ground zero in an opioid crisis that has killed more than 1,300 people in San Francisco over the past two years. Nearly half of those deaths occurred in these two neighbourhoods, driven by fentanyl, a synthetic opioid 50 times stronger than heroin.
Castro and her team are fighting to keep people alive by distributing clean syringes, glass pipes, alcohol wipes and water, alongside Narcan – a nasal spray containing 4mg of naloxone. Castro says she has reversed 50 overdoses herself. Laura Guzman, of the National Harm Reduction Coalition, said the aim is to have Narcan available everywhere.
On a stop under a freeway overpass, Castro and her partner Rizzy Spoer call out to tents and tarps. A young man emerges, asking for syringes in two sizes. Castro loads a paper bag, offers water, and asks if he has Narcan. He gratefully takes a single-dose dispenser.
The Tenderloin, roughly 50 square blocks built after the 1906 earthquake, has long been known as the city’s seedy underbelly. Supervisor Matt Haney, who lives there, described it as a refuge for people who have fallen through the social safety net, but added that soaring rents and the rise of fentanyl have intensified the challenges.
