LOS ANGELES — Gavin Newsom, the governor of California, hasn’t been shy about testing his power to advance progressive causes, most notably in 2004 when, as mayor of San Francisco, he allowed same-sex marriages in defiance of a voter-approved ban.
Fellow Democrats in the state legislature have now sent him a bill that would allow the nation’s broadest experiment with supervised drug-injection sites, in the hope of reducing a deluge of opioid overdoses. Local governments that serve more than 11 million residents — including San Francisco and Los Angeles — could authorize centers that offer clean needles and have staff who can intervene quickly when an overdose occurs.
But it’s not clear whether Mr. Newsom will allow the bill to become law, and his imminent decision is being closely watched as a barometer of his national ambitions. Opponents of the legislation have argued that the proposal goes too far in normalizing illicit drug use.
“I feel like Gavin Newsom is the most and least likely governor in America to sign this bill — most likely in the sense that he likes to be ahead of the curve,” said Jessica Levinson, a political analyst who teaches at Loyola Law School in Los Angeles. “But if he signs this, the ads kind of write themselves: He becomes ‘Governor Heroin.’”
Mr. Newsom is running for re-election, and is heavily favored to win after quashing a recall attempt last year, while Republicans are more focused this fall on the competitive midterm congressional elections in the state than on the governor’s race. The favorable momentum has given him greater license to turn his attention elsewhere.
He drew presidential speculation this summer when he purchased ads in Florida and Texas criticizing Republican governors there over laws related to guns and abortion. He sparred this week on Twitter with another Republican, Gov. Kay Ivey of Alabama. (Mr. Newsom’s targets have responded by pointing to California’s recent population declines.)
While Mr. Newsom may feel the gravitational pull of Washington politics, bill-signing season will keep him occupied at home for the next several weeks. Other bills will also test him, like the proposal to strictly regulate the fast food industry, but none may prove to be as difficult a political decision as the supervised injection site proposal.
Mr. Newsom’s office did not respond to requests for comment on the bill.
New York City opened the nation’s first supervised drug-injection sites in November, and other American cities from Seattle to Philadelphia have plans to follow suit. But the California law would make the nation’s most populous state home to a much larger-scale experiment with the sites over the next five years.
The legislation would allow three cities — San Francisco, Los Angeles and Oakland — and Los Angeles County to open facilities where people could use illegal drugs in a supervised environment. Participants could receive supplies like clean needles and get connected with treatment services. Crucially, trained staff members could watch for signs of overdose and be able to intervene. The state would study the sites, which could remain open through 2027 as part of an overdose prevention pilot program.
When Mr. Newsom campaigned for governor in 2018, he said he was “very, very open” to an injection site pilot project, according to The San Francisco Chronicle. But he has not signaled his position on the current bill.
The issue is one on which California has watched other places take the lead. In 2018, Mr. Newsom’s predecessor and fellow Democrat, Jerry Brown, vetoed a similar bill, saying that he didn’t believe authorized injection sites would reduce drug use without a requirement for treatment. California cities need state legislation to shield the drug users and medical professionals at the sites from criminal laws.
Mr. Brown wrote in his veto message that “enabling illegal and destructive drug use will never work” and that the proposal was “all carrot and no stick.”
But some volunteers who work with drug users see the approach as crucial to saving lives. On the sun-beaten streets of Skid Row, where Los Angeles’s most destitute residents live, Soma Snakeoil pulled a collapsible wagon past encampments.
“Needles! Pipes! Clothes!” she called out to the inhabitants, many of them drug users who have struggled with addiction and homelessness for years or decades. “Water!”
Then, as some people approached, she offered, “Narcan?” She held out white boxes filled with the nasal spray that reverses opioid overdoses, while her colleague biked ahead, pausing to staple Narcan packages to trees.
Ms. Snakeoil, co-founder and executive director of the nonprofit Sidewalk Project, which helps people living on the streets, said Mr. Newsom had a unique opportunity to respond to drug overdoses by signing the bill on his desk.
“We’re really on the front lines here,” said Ms. Snakeoil, an activist, artist and sex worker.
“I’ve done many reversals,” she added, referring to reviving users from an overdose using Narcan or another method, “but I’ve also watched people die in the midst of a response to an overdose, because we got there too late.”
Republicans in the state legislature urged Mr. Newsom to veto the latest bill, saying it would effectively create government-sanctioned “drug dens” and could leave workers vulnerable to federal prosecution. Under the Trump administration, the United States Department of Justice sued a Philadelphia nonprofit over a plan to open a supervised injection site; Biden administration officials are now discussing a settlement of the suit.
Tom Wolf, co-founder of the California Peace Coalition, a nonpartisan group of people in recovery and family members of current or former drug users, said that California cities — and those across the nation — do not have robust systems that include the transitional housing and mandatory treatment that are needed to make supervised sites effective in the long term.
For a time several years ago, Mr. Wolf was severely addicted to opioids and lived on the street in San Francisco’s Tenderloin district. He said he had seen conditions deteriorate further since then, with drug deals taking place essentially in the open.
“In Los Angeles and San Francisco and Oakland, the situation is out of control,” he said. “What’s to stop an open drug scene from populating around the safe consumption site?”
State law enforcement groups have also opposed the California proposal. In a statement, Sheriff Alex Villanueva, who leads Los Angeles County’s sprawling law enforcement agency, said that safe consumption sites would “bring havoc to our communities.”
Advocates say that while supervised injection sites are not a silver bullet, it is clear that law enforcement has not been able to stop the flow of illicit drugs into communities, and that forcing people into treatment doesn’t work.
Sam Rivera, the executive director of OnPoint, which operates the New York consumption sites, said that since the centers opened, staff members had intervened in more than 400 overdoses and called ambulances five times for other health emergencies. He estimated that the initiative had saved taxpayers about $12 million that would have been spent on ambulance trips and emergency-room treatment. But he said the potential monetary savings were a secondary purpose.
Mr. Newsom, he said, “literally has the power to save thousands of lives in California.”
In San Francisco, overdoses killed more than twice as many people as the coronavirus in 2020. The squalor and open drug use in the Tenderloin have become synonymous with the crisis on the West Coast.
In Los Angeles County, overdoses killed 773 more people in 2020 than in 2019, an increase of almost 47 percent. Among homeless people, overdoses were the biggest contributor to a 78 percent increase in deaths in the year after the onset of the pandemic, according to a study by the county’s Department of Public Health. Overdoses have remained the top cause of death among people experiencing homelessness in the county.
“When you look at the trajectory, the lines are not plateauing,” said Gary Tsai, director of substance abuse prevention and control for the county’s public health department.
Service providers say that a deadly mix of fentanyl, opioids and methamphetamine is contributing to a terrifying upswing in overdoses. Fentanyl is 50 times as potent as heroin, and drug cartels use it as a filler because it can be made cheaply with chemicals. People often don’t realize that their drugs are tainted with the substance, which causes them to overdose quickly.
Back on Los Angeles’s Skid Row, Ms. Snakeoil greeted Gene Calmese, who recently moved into his own place indoors after living on the streets nearby for years. She handed him a Narcan package to keep in case he sees someone in need.
Mr. Calmese stood in a bike lane looking at the community where he still felt at home. He estimated that he had helped resuscitate 10 to 15 people who had overdosed.
“I’m getting tired of it,” he said.