The ninth floor of San Diego Central Library has a view of the bay and trolleys that ply the streets below. It’s also an outdoor patio where KPBS met David Houle, who is currently experiencing homelessness. A native from Phoenix, he battled addiction for more than 20 years.
“I’ve had my dry spells. I’ve had my good spells. And coming here, it just went really bad,” Houle said.
Then he saw a flier at the San Diego Central Library, telling him about a program aimed at helping people addicted to opioids with a drug called Suboxone. Its primary ingredient is buprenorphine. Houle said he responded and signed up for a Suboxone treatment at Father Joe’s Villages.
“After talking with the doctors at Father Joe’s, and taking it every day — getting to the right dose — it has really helped me a whole lot," Houle said. "I’ve had some slip-ups, but it’s never got out of control. I take my strips every morning like I’d drink a cup of coffee.”
There’s a new partnership aimed at helping people experiencing opioid addiction in San Diego. The School of Social Work at San Diego State University (SDSU) is teaming up with the San Diego Public Library and Father Joe’s Villages to provide access to Suboxone.
Houle said it’s as if the drug has mentally blocked the cravings he used to feel. He gets the medication on a small strip that he places under his tongue.
Buprenorphine itself is actually an opioid that binds to a person’s opiate receptor and can knock more dangerous and potent drugs off of it. Suboxone that’s given to people in the SDSU program includes both buprenorphine and naloxone, commonly known as Narcan.
Dr. Daniel Lasoff is an emergency physician and toxicologist with UC San Diego Health who has prescribed buprenorphine many times.
"It’s great,” Lasoff said. "We can see things like pain relief, treatment of withdrawal (and) treatment of cravings. But we don’t see so much of that euphoria that ... drives people to start abusing these drugs.”
Megan Partch, the chief health officer at Father Joe’s Villages, has also prescribed buprenorphine in the form of Suboxone. Father Joe's St. Vincent de Paul Village campus is just two blocks away from the downtown library where Houle first found out about the treatment program.
“We’ve seen people stabilize. We’ve seen people reconnect with family. We’ve seen them obtain income — housing. We’ve seen people find and obtain jobs that they were unable to prior,” Partch said.
Partch added that she has seen the problems of drug use and overdoses grow exponentially in the homeless community, due largely to the widespread use of fentanyl.
SDSU social work professor Lianne Urada said she has spoken to librarians who talked about frequent drug overdoses in the bathrooms and outside their libraries.
Urada got a two-year grant from the National Institute on Drug Abuse to find out if intervening with buprenorphine could make a difference. Two months ago they began reaching out to people with addiction who used the central library.
“So many people do want to get help and sometimes just a little bit of help,” Urada said. “Like us, just finding them the next day can make a world of difference to them and they tell us that. Just knowing somebody cares.”
“We’ve seen people stabilize. We’ve seen people reconnect with family. We’ve seen them obtain income — housing. We’ve seen people find and obtain jobs that they were unable to prior.”Megan Partch, chief health officer at Father Joe’s Villages
By promoting literacy and providing information, the old library mission of public service has evolved. The library has also become a place where those experiencing homelessness use the bathrooms, charge their phones, be dry and safe.
“Libraries have become dynamic and reflexive and respond to the needs of the community in real time as opposed to holding those traditional values and mission, and not expanding and growing with our communities,” said Jennifer Jenkins, deputy director for the San Diego Public Library.
The SDSU project sought to recruit at least 40 people to get Suboxone prescriptions and take it regularly. Urada said she hopes this will be a model for the rest of the library system and perhaps libraries in other states.
Lasoff said we also need to remember that detoxification, through use of medicines like Suboxone, is rarely enough to make a problem go away.
“Substance use disorders are chronic diseases. It’s the same way with asthma, diabetes or hypertension. These are health problems that wax and wane and people have relapses,” Lasoff said.
He said long-term treatment needs to be part of the solution to turn people away from drug abuse.
