Haight Street Voice: Alright, so here we are, we are with the one and only Dr. Dave Smith, Dr. David E. Smith, founder of the Haight-Ashbury Street Organization – Sorry!!! The Haight-Ashbury Free Clinic, excuse me folks! And I’m in his office and we’re here to find out what’s going on with the clinic because I walk by it to go to the post office all the time and I’m not sure what’s going on there …
Dr. David E. Smith: Well, the Haight-Ashbury Free Clinic, whose original motto was “health care is a right not a privilege” – has merged with Walden House and it is now part HR360 (HealthRight360), which is the largest non-profit treatment organization and located over in the Mission. It’s primary focus is the people coming out of the criminal justice system, they have health and education groups for people that have an addiction and have gone to jail and are coming out, and the homeless.
The original site at 558 Clayton, which is a historic site, it has now a needle exchange.
HSV: Yes, I’ve seen that.
DD: So individuals come in, get a clean needle so they don’t get infections and HIV and all that. And then they get bibinorphan? which is the new medication which is being used for the treatment of addiction. And then some of them get involved in the psycho-social rehab and then they go over to Walden House. And then some of them come out the other end in recovery. But the initial part of it is harm reduction. We’ve had this huge increase in overdose deaths here in San Francisco.
HSV: Yes, the fentanyl epidemic. One of my questions to you is would you be open to – we’re just winging it here cuz this is the Haight-Ashbury …
DD: [laughs]
HSV: Would you be open to kids, if they get drugs that they can have it tested to see if it has fentanyl in it, or something like that? Somebody asked me that question cuz a lot of these kids didn’t realize they were taking fentanyl. Have you heard this?
DD: That’s a complex question because originally that’s what the Haight-Ashbury clinic did when addiction … the crime, the fence circled the area and you could do pretty much whatever you wanted in the Haight, so we tested the drugs and analyzed them – that was before fentanyl — but we had the capability. And then they wouldn’t allow that to happen. But now you’re starting to see a comeback with the fentanyl strips. I know if you go into 558 Clayton Street with Mary Howe, the Homeless Youth Alliance, they have all the drugs they brought in on the wall, and it turns out that many of them are contaminated with fentanyl. You think you’re taking methamphetamine but it’s methamphetamine with fentanyl. Even the marijuana has got fentanyl in it.
HSV: What???
DD: Yeah.
HSV: Wow.
DD: And so that contributes a lot to the adverse reactions.
HSV: I mean, this year, it’s the end of March and there’s been maybe 8 to 10 people that have died on the street. People who I have known. I mean Stumbles – god bless these kids. I mean, I’m not blaming just fentanyl – it’s also alcohol. There’s a lot of alcohol out there.
DD: And during covid, with the isolation and the difficulty getting to your recovery groups, there has been a huge increase in alcohol and drug overdoses, methamphetamine. The city is in a city-wide crisis. The worst though is in the Tenderloin.
HSV: Yeah.
DD: It’s bad here but it’s much worse in the Tenderloin.
HSV: And the condition of Haight Street now since the covid and all these shops that have closed. I mean we’ve still Amoeba Records, you know, we’ve got Sunny at Love on Haight, we’ve got a few and sundry places. But how do you feel about these places and the closed windows and shops. Thank god for the SF Heritage who is taking care of the corner right there and another couple shops down. So that’s great. We’re going to have art and the history is still there. Did you see stuff like – you did! You lived through the whole early ‘70s when everything got really ugly, right? I mean, you were there. Was it very similar to this when things were boarded up?
DD: It’s worse now.
HSV: It’s worse now …
DD: Yeah. It’s very sad because as I’ve shared with you I’m working on an autobiography, “Healthcare is a right, not a privilege”, and I walk down there and I have memories of the Grateful Dead playing on a flatbed truck and developing their music in the Panhandle and that was the era that the Haight Street Free Clinic started and it was just vibrant! It was crazy but it was vibrant with art and culture, there were psychedelic sounds and everything. And now you go down there and it’s just sad.
HSV: Well, rest in peace Brian Rohan, who I mention earlier, he and Michael Stepanian were helping all those kids getting arrested and all of that.
DD: Oh yeah, I have memories of them with HALO. They busted so many kids that then they, the lawyers, Stepanian and Rohan, decided to defend them through the Haight-Ashbury Legal Organization, and they said we’re going to try every case. And a lot of it was just jam up the courts. They arrested so many people then and the war on drugs just was so unnecessary and a total failure. And so they were the ones that developed … Brian, you know, termed the coin “dope law.” They really started the legal defense for [inaudible]. It’s interesting because there are these narratives now where all these interviews are coming out. That’s why, like your project, history is adding some light on what happened. And they had this interview with John Erlichman from Nixon in the ‘60s and they said, “We can’t arrest hippies for anti-war. And we can’t arrest blacks for being black, so we’re going to equate hippies with marijuana, and we’re going to equate black with heroin, and we’re going to use the drugs to crack down. In other words, there was a political motive behind the police sieges. And it was dangerous. I know that they had a big siege in ’68 when they were actually beating up kids on the street. And they actually came into our detox program. I mean what police force comes into a treatment program. And I remember, we came out and …
HSV: Yeah, what was your reaction?
DD: “You can’t do that!” We were kind of out on the street fixing up bloody kids and I got whacked on the butt and it was in the Chronicle. That was ’68 when basically things were the worst.
HSV: Yeah.
DD: And the drug epidemic really hit and the Haight-Ashbury was devastated. There was a lot of – I don’t know. I don’t know if it was worse then or now. I think it was probably worse then.
HSV: I feel like the police on Haight Street – I don’t know if you know Lily (Prillinger)…
DD: Yes.
HSV: Hi Lily, we love you! You know, in 2017, maybe it was because it was the Summer of Love 50th Anniversary, but it seems like there were cops on every block, and now, well, with Covid, it’s different. But I just feel like there’s really not as much presence, and I don’t know if that’s good or bad. They’re not beating the kids off the street like they were as much, so now they’re conglomerating more on the corner there at Haight and Ashbury. Is that okay? How do you feel about kids hanging out, with their dogs – not even the covid, just hanging out? I mean, some of them have to sleep in tents on the Haight-Ashbury or in the area, but area can get very clustery.
DD: Right.
HSV: Is that okay? What do we do? Is it happy or …?
DD: Those are social policy issues to reflect on because it’s not a healthy lifestyle. I hate to see that unhealthy lifestyle.
HSV: Drinking, getting drunk …
DD: We’re big dog people as you can tell. My wife buys dogfood and goes down there on that corner where they all congregate with the dogs, and the people on the street thank us. But one of the things I found out at 558 [HA Free Clinic] in dealing with the homeless, is called “sympathetic engagement” where people from the clinic and some people in the Haight treat them like human beings.
HSV: Yeah! Oh yeah. I mean, like I said, I don’t just step over them, I mean I’m like, “Hey!” I know their names. Yeah, of course.
DD: Yeah.
HSV: So that’s wonderful.
DD: I also, as a physician, I think it’s a public health hazard to not have toilets and stuff for the street. I think also it hurts the businesses.
HSV: The merchants, yes.
DD: For us, we’re just used to it: “Hi, how ya doin’?” Give them some dog food. But tourists come in that patronize the businesses and it freaks them out. And of course Sunny would be a better one to talk to about that. You know, the online businesses are very happy. Sunny is a real community leader and she and I have talked a lot about what’s going to happen with the Haight. People like her and Christin at Booksmith. I mean me, I lived on Frederick Street for 60 years. There are some old stalwarts.
HSV: Michael Xavier, who runs the Haight-Ashbury Street Fair.
DD: Right. There’s a culture and a vibrancy there and you transmit it to the next generation. So I hope what will happen is that will continue on and things will come back. But that’s a hope.
HSV: I know. That’s one of my questions is … my magazine is “hyper-local with a global perspective” about people taking care of their own communities no matter where they are.
DD: Yes. I love it. I love it. I read your stuff and I think it’s a great idea.
HSV: Thanks babe! Thank you, Dr. Dave, I’m honored. But, you know, I can’t keep doing this. The print stopped during covid but I’m really aiming to get a summer edition and do it four times a year. Probably have a story about what’s going on with the Doolan-Larson building, what that’s going to be become, for real. The merchants are going to move into those two shops next door that used to be t-shirt shop that was there for 48 years, that one right on the corner
DD: And you know Peggy Caserta?
HSV: Yeah! I’ve already interviewed her.
DD: She’s such a historic figure here.
HSV: Oh yeah, huge, with Mnasidika, yeah. She even said, “Shout out to Dr. Dave at the Haight-Ashbury Free Clinic.” She said, “We had food” I forgot the name of the shop, “We had safety, we health care, and clothes” … her! [laughs]
DD: Right. [laughs]
HSV: And of course music. But I can’t keep doing this for nothing. I mean I have to go out and sell my ads, you know, but who are people in the neighborhood that – how can we help, how can I help keep the spirit and health of the community alive? Who are the allies? I guess like you said, HANC (Haight Ashbury Neighborhood Council).
DD: Sunny at Love on Haight. SF Heritage. I think preservation of the culture and the history.
HSV: Stories, and the history! Even today, which why I started out how you feel about today. And you’re writing a book about your famous quote: “Healthcare is a right not a privilege.” When that’s out I’ll give you a little shoutout on the Facebook page and the magazine. When’s it coming out?
DD: I’m almost done with it and I’m going to try to have it ready by – we’re having a 54th anniversary of the Haight Ashbury Free Clinic on the 6th.
HSV: Of April?
DD: June. Yeah, anniversary of the clinic. And Sunny is the chair, and we’ve got some of the old bands together because our clinic was built on rock and roll. We were too radical for traditional funding so there’s going to be this celebration
HSV: As Bill Graham did with you.
DD: Exactly. And then I’ll have a friends and family version and then go to the publisher and they’ll mess with it. Probably the version available for the general public will be more like a year. What I’m going to do is have a poster and a commemorative edition for donations to HR360. That’s the stage in my life where I am now. I’m going to train the next generation and help with the community, try to keep things going. I think – what’s amazing to me is how much interest there is in this area. I get these interview requests from around the world. People are very interested in this culture.
HSV: Aren’t you one of the first free clinics in the country?
DD: Yeah. The free – the concept of free came from the Diggers. You had the free city, the free store, and this, that and the other thing. But they wanted to have medical and all they had was – they wanted to have like barefoot doctors and I said, no, that isn’t going to work. Doctors won’t do. They want a building and they want malpractice insurance, so the Haight Ashbury Clinic was the first of the nationwide free clinic movement, and I’m honored to be known as the father of the free clinic movement. And it’s amazing how much stuff started in this little area at that time. My free clinic movement, addiction medicine, addiction as a disease and has a right to treatment.
HSV: That kind of leads to the next question which is: rock and roll is always associated …
[Dr. Dave’s dog Wilson has to get off my lap]. Cute little dog taking care of me we talk to Dr. Dave. Kind of looks like Dr. Dave, the other dog [laugh].
But, I mean let’s face it: Rock and roll is all about drugs, hallucinogens and all of that. Psychedelics being legalized – let’s talk about that a little bit. Are you excited about how psychedelics can help treat people medicinally?
DD: Yeah, we’re into the 3rd psychedelic revolution and that’s kind of the last part of my research or my life now is I’m partially retired and I still treat addiction but my kind of my research, late stage area there with psychedelic psilocybin and we’re learning why psilocybin works. There’s an area in the brain called the “default-mode inter-neural network” and that’s way down in the primitive area of the brain, a little band of neurons and it’s the neural biology of ego.
HSV: Wow.
DD: It is the psychedelics like psilocybin that reduces activity in this default mode and that’s what helps produce the desolution of ego and the spirituality. I’m part of a paper called “the neurobiology of spirituality” and lot of it comes out of an understanding of spirituality and recovery from addiction. So they looked at why LSD and psilocybin helps people recover from addictive disease. I mean it doesn’t make much sense.
HSV: Is marijuana clumped in there too?
DD: Well, marijuana is a psychedelic but it’s really – studies with marijuana are more of the CBD for pain.
HSV: Right.
DD: What this is, is they don’t take it every day, so it’s not like — it suppresses. But what you do is … like LSD or psilocybin — that’s why it’s potent – you take 1 to 3 doses at high dosages. You don’t take a little bit, you take a lot. That’s what seems to produce this mystical and spiritual experience, and then it’s transformative. It’s like the bottom of AA – Bill Wilson, co-founder of AA — said that his bottom and how became involved in the spiritual program of AA is in the middle of DTs, he was hallucinating. And it turns out that that was his bottom. I have a whole lecture on psychedelics and the treatment of substance abuse disorders, and every one of the studies: LSD, psilocybin, ibogaine, ayahuasca. When it works, it is this high-dose, mystical experience – that’s what makes it work. And the high-dose mystical experience dampens tone. in that default-mode network. And then it also looks like the high dosage helps rewire that area of the brain. That’s why they’re so long lasting. I was very – I was a laboratory scientist and I was a local drug expert, and then this whole thing developed, and I lived right over here, two blocks from here, on Frederick Street and this whole thing was happening. And I saw Hippie Hill, and I saw all these people doing this and I thought, “Hmm. I’m sticking this in my lab animals up at UC … why don’t I try it myself?” And I did, and I had a high-dose mystical transformative experience and that’s what made me take the risk to start a free clinic.
HSV: Wow.
DD: Because at that time, you know, when I started the clinic or to get my malpractice insurance cancelled I was at risk for arrest. I mean it was so out of character for me …
HSV: Are you saying you were a square, Dr. Dave? [laugh]
DD: I was a square! My grandparents were farmworkers from Oklahoma.
HSV: Yeah, I was reading about that – from Oklahoma, yeah. You grew up in Bakersfield.
DD: Yeah.
HSV: And your parents died when you were young.
DD: Yes, when I was young. And I was driven for financial and professional success, and I would be the last one that you would think that would do something like this. So I just got involved in the psychedelic culture and I had a transformative experience and I took all this risk except it just seemed like the thing to do.
HSV: Yeah. Well, having survived a parent, my mom died when I was young, but I’m sure, I mean I would imagine that the psychedelics trips for you helped you heal that in some way? Am I projecting that or is that true?
DD: No! It’s totally accurate. What they’re doing now is finding that that psychedelics help deal with traumatic experiences. Trauma is encoded and trapped in an area of the brain called the “singular” gyrus and it just keeps going around and around and around and it’s subconscious until something triggers a memory of it. And what the psychedelics do is – they have these ayahuasca rituals with a shaman and I know there are some vets that have done it and out of the consciousness comes the memories of, you know, their friends being blown up, and then it can process it. If it gets trapped it doesn’t get processed in the areas of the brain — you don’t grieve it, you don’t deal with it in a healthy way in the brain.
HSV: And then you mix that with alcohol …
DD: Yeah – that’s why the area that I’m working on is recovering people because I’m very involved in AA and recovering people that have trauma. So they’ve stopped drinking and using and a significant part of their life is going okay, but the trauma memories persist.
HSV: It’s the elephant in the room still, right? It just happens not to be drunk anymore, right?
DD: Yes. So they have these spiritual awakening groups that combine psilocybin and AA, which seems very controversial.
HSV: Yes.
DD: Yeah. It’s a new world. And that’s the area that I’m looking at: the people that I’m working with, including me, is a spiritual awakening to deal with individuals who are in AA, interested in spirituality and residual trauma memories that impact on their lives. Because remember, Bill Wilson, cofounder of AA, took LSD for depression and had a real spiritual experience.
HSV: I did not know that.
DD: Yes. And he went to the big board of AA and said, “This is something…” but they didn’t want to have anything to do with drug-induced spiritual experience.
HSV: Right.
DD: And then it all went south when Timothy Leary when he got into his whole scene – not that it wasn’t interesting stuff but what it did was compromise legitimate studies. Well now there are all these controlled studies. This is – what I’m tell you now, this is not opinion.
HSV: Right.
DD: This is science-based research where they have a hypothesis, they have a population and the key to this population is the traditional stuff hasn’t worked. And then it starts making sense out of a lot of what happened in the ‘60s except it didn’t – it made sense out of psychedelic music and the good stuff, but it also kind of makes sense out of the bad stuff.
HSV: Right.
DD: This is powerful stuff. You don’t mess with your brain in an uncontrolled setting.
HSV: Right. So it’s always under a controlled setting so if the person starts to have some sort of freak out or whatever then there’s a person to sort of talk them off the cliff or whatever?
DD: Yes.
HSV: Okay. I mean, I’m very interested in it all, too. I’ve had this conversation with Sunny too and it was in the first edition I believe, but how, like I said earlier, alcohol is . really far more a problem on Haight Street than psychedelics.
DD: Yes.
HSV: I mean psychedelics aren’t the problem. I mean the methamphetamine I’m sure …
DD: That’s, by the way, what I have on my wall – that interview you did with Sunny. I have that picture of her on my wall.
HSV: Yay, oh good! I think that was the first edition.
DD: Yeah, that was cool.
HSV: Thank you, Dr. Dave! And [holding up first edition of HSV with Jerry Garcia on cover]: Did you ever work on Jerry?
DD: Oh yeah [looking at photo of Jerry on cover]
HSV: That was the first one, walking down Haight Street, 1968, March 3. That’s before it got bad I guess, huh?
DD: Yeah, it was that period of time. [holds up photo of Jerry]. See, that’s the memories of it.
HSV: That’s what it looked like, huh? The fire was still there. And the guy who took that picture is this guy, Steve Brown, dear friend, who was in Vietnam during the Summer of Love and was bringing Jimi Hendrix music to the ships overseas. Isn’t that beautiful? And yes, he did bring a little bit of acid too and brought it to the ships.
DD: [laughs]
HSV: He said it helped! I’m going to keep looking at my notes here. Thank you for believing in my magazine. That means a lot. That means so much to me.
DD: Yeah!
HSV: And Rohan – people such as you two.
DD: Let me keep one of these so I can reference it for my book.
HSV: Okay. Let’s finish this. Okay, which one do you want to keep? You can have whichever one you want! We’ll figure out which is the best one.
DD: Okay.
HSV: So I guess the final words, again – the back light is getting bad so I keep moving around, but who cares. It’s all about the conversation rather than … [panning to photos on his office wall] There’s Jerry.
DD: Yeah, Rock Medicine and [inaudible] Kaiser Deadhead and he did all the medical and I was involved in a couple of his treatments. That’s when the drug scene went bad [inaudible].
That one wasn’t [pointing to Jerry in Captain Trips hat]. That’s when it was cool. And there’s …
HSV: Ram Das …
DD: And there’s Mountain Girl, way up there, and Ken Kesey …
HSV: Oh yeah! Aww! And now are you involved with MAPS? I’m sure you must be.
DD: Oh yeah. We had an annual conference – Rick Doblin chaired it and we have a journal on new psychedelic research and that’s a lot of the studies that I’ve been quoting to you. In fact, Michael Pollen said when the history of the third psychedelic revolution is written, Michael Pollen will be the leader of getting it started with MAPS.
HSV: Wow. I should probably do an interview with them as well. That’s David Wills [pointing to HA poster]. I just interviewed him last week.
DD: Yeah, I love that history.
HSV: It’s wonderful. He said that he was told that the water was going to rise and that’s why he’s in a boat in the foreground.
DD: [Big laugh] I didn’t know that!
HSV: It was a theory one year I guess in the ‘70s they said the elevation of the water was going to go up and we’re going to need boats! But it might’ve been the psychedelics! [laugh]
DD: [laughs]
HSV: So what would you like to say to the hyper-local Haight Street Voice with a global perspective. What would you like to say to the communities of the world, to our beautiful community here?
DD: Preserve our history and culture, remember all the great things that came out of it but learn from the mistakes. There were a lot of mistakes made and particularly the hard drugs. Preserve the good, beware of the bad. I want the Haight to come back very badly. It is such a special place. And I want historians, like yourself, and the cultural institutions like Love on Haight and The Booksmith and Amoeba Records to be preserved. You know, right up the hill at UC Medical Center where I’m on the faculty …
HSV: That’s where you went to school, right?
DD: That’s where I went to school, some of the best research that’s going on on all these neurological issues, they have psilocybin trials. They’re going to have a – they’re going to legalize psilocybin counseling centers. In fact if that evolves and lives long enough and my book comes out that space down below I want to have a psychedelic book store.
HSV: Cool!
DD: And I’ll have you there with your history …
HSV: Absolutely! That’s cool!
DD: We’re going to have a podcast and …
HSV: And you can sit around and read these cool books.
DD: Right! [laughs]
HSV: That’s great! That’s wonderful! I had a thought when were giving an homage to all the place, supportive. This is – I don’t know if this is the right question to ask but what about places like Zam Zam, which is an old institutional, you know, it’s one of the oldest bars on Haight Street.
DD: Right.
HSV: You can’t close down the bars if we’re worried about alcohol.
DD: No.
HSV: That’s just an issue with alcohol, right? I just want to clarify that it’s not that it’s anti-alcohol …
DD: No.
HSV: I think that’s a very important distinction to make.
DD: Oh yeah.
HSV: Because a lot of people think, “Oh I have a couple glasses of wine on the weekend, am I a bad person?”
DD: Well, that’s a misunderstanding with alcoholism as a brain disease. You can take a lifetime of alcohol — you can have a couple of glasses of wine a night for the rest of your life. And then you can take an individual who’s an alcoholic and he’ll drink a whole bunch at once and then he will detox and stay sober for a while and then have another bender and then detox. At the end of the lifetime, the social drinker that drinks a couple glasses of wine will have drank as much as the alcoholic. But alcoholism is what’s bad for the brain. So it’s not the drug, it’s not even the amount that you drink, it’s how your body reacts. It’s called a “brain stress hypothesis”. In AA, we always say we are not Carry Nation. We’re not trying to rid …
CUTS OFF
Part 2 in Closing:
HSV: Here’s Dr. Dave in closing, journal of psychoactive drugs, thank you for all you do …
DD: [smiles, laughs, nods head]
HSV: And we’re running out of steam here on the machine! But we’re so happy you’re here and we’re going to get to see you at this … what is it, 40 … what is the anniversary?
DD: 54th. Sunny Powers …
HSV: Sunny Powers and there’s going to be some music, and I’ll be there to —
DD: Wonderful!
HSV: I hope! If I’m invited!
DD: Of course you are!
HSV: I’d love to be live from Haight Street Voice.
DD: You’re a very historical figure in the Haight with the Voice and everything.
HSV: Thank you, Dr. Dave! We’ll see you down the road then! And thanks so much for your time today!
