Gov. Gavin Newsom speaks to the press during a visit to Ruby Bridges Elementary School in Alameda on March 16, 2021. Photo by Anne Wernikoff, CalMatters

(CALMATTERS) – Gov. Gavin Newsom has a big decision to make — one that could have equally big implications for his national profile.

Heading to Newsom’s desk is a controversial bill that would allow Oakland, San Francisco and Los Angeles to launch trial supervised drug injection sites through Jan. 1, 2028. The sites — which are currently not authorized under federal law — would permit Californians to use illegal drugs under the supervision of medical professionals, who would supply them with clean needles, connect them with substance abuse services if requested, and administer overdose reversal medications if needed.

As Newsom elevates his political profile by contrasting California with Republican-led states such as Texas and Florida — a strategy that suggests he may be building the foundation for a future presidential run — he’s no doubt aware that greenlighting the safe injection sites would give his GOP critics plenty of fodder for attack ads.

“This is one of the most dangerous pieces of legislation that I’ve seen sent to the governor,” state Senate Republican Leader Scott Wilk said in an Aug. 1 statement. “Instead of focusing on a strategy to help people get their lives back, get off drugs and into treatment, California Democrats focus on giving people free needles and a safe place to shoot up.”

But pressure is also mounting on the governor to sign the bill. On Wednesday, the Los Angeles Times and Sacramento Bee editorial boards and San Francisco Chronicle columnist Heather Knight urged Newsom to approve it, citing a massive surge in fatal overdoses — many of them caused by the powerful synthetic opioid fentanyl — that killed a record 10,000 Californians in the year-long period ending April 2021.

(Also Wednesday, a federal judge ruled that Walgreens can be held liable for causing much of San Francisco’s opioid epidemic, noting it distributed more than 100 million prescription pills to the city’s pharmacies between 2006 and 2020 without taking reasonable steps to curb their misuse.) 

  • Knight wrote in an open letter to Newsom“You’re clearly pondering a run for president and explaining this one to a national audience that’s far more conservative than California could be tricky. … (But) you may remember, governor, a righteous act of civil disobedience that you spearheaded as mayor on Feb. 12, 2004 — one that turned City Hall into a same-sex wedding chapel and ultimately helped your political prospects.”
  • The Sacramento Bee editorial board wrote“Signing the bill would require Newsom to put facts, principles and vulnerable Californians ahead of political concerns, which would be a compelling demonstration of progressive leadership indeed.”

If Newsom were to sign the bill, it would reverse the decision of his predecessor, fellow Democrat Jerry Brown, who vetoed a similar bill in 2018. “Fundamentally, I don’t believe that enabling illegal drug use in government-sponsored injection centers — with no corresponding requirement that the user undergo treatment — will reduce drug addiction,” Brown said at the time.

But rejecting the bill would also be a repudiation of California’s values and vision, lawmakers and advocates argued at a Wednesday press conference.

Politics aside, how exactly do supervised injection sites work, when would they be open, how would they be funded, and what does research show about their effectiveness? CalMatters health reporter Ana B. Ibarra has the details.