Just about everyone at City Hall has come out in support of safe-injection sites, where drug addicts can use under medical supervision. Data from around the world shows that these facilities save lives, reduce open-air consumption, and lead people into treatment more effectively than most other models.
Mayor London Breed appeared with state Sen. Scott Wiener and then-Assemblymember (now city attorney) David Chiu to endorse the idea.
But now Sup. Matt Dorsey, who as press secretary urged former City Attorney Dennis Herrera to get on board, is calling on the mayor to divert all the money earmarked for a wellness center in his district to jail-based treatment programs.
His five-page letter to Breed has created a furor, with Sup. Hillary Ronen writing a sharp critique and Public Defender Mano Raju denouncing the approach as a dangerous failure that could lead to more overdose deaths.
Breed’s Office hasn’t responded, but moving the funding would be to defy the supervisors, who voted for a budget including wellness center money.
It’s also connected to a larger strategy that the mayor and the district attorney are employing to arrest not only dealers but people who are simply under the influence of drugs.
And it’s part of what may be a campaign to replace some San Francisco judges.
Dorsey argues that it’s better to focus on treatment for a population that is held against their will than to work with people to seek voluntary help:
It makes little sense to fund and staff limited services for voluntary drop-ins by drug users at a time when we’re endeavoring to engage a growing involuntary population of drug users, whose lawless conduct suggests a far greater need for lifesaving care and treatment.
From Ronen:
Once again, a politician, this time District 6 Supervisor Matt Dorsey, seeks to advance his political career by using vulnerable populations and press releases to gain attention while accomplishing nothing for people living in poverty and dying on our streets everyday.
Instead of working with health experts, his colleagues, and the Mayor, Supervisor Dorsey has made it a habit to tweet out sexy press releases moving the goalposts on years of carefully crafted work that he supported just weeks earlier. Politicians like Supervisor Dorsey are why we can’t make headway on the overdose crisis in San Francisco.
Over the last few years the Department of Public Health and Mayor’s Office have been involved in – SEVEN – well researched and vetted plans to address the drug crisis on our streets: Mental Health SF, the Overdose Prevention Plan, Treatment on Demand, Supervised Injection Task Force, Methamphetamine Task Force, Drug Dealing Task Force, and the Tenderloin Emergency Center.
Each of these laws, task forces or emergency interventions have implementation plans – not one of which has been completed. All of these plans have involved time, expense, and most importantly significant expert input to create. Yet not one of these plans has been given the time or resources to fully implement.
The Department of Public Health continues to slowly but surely implement Mental Health SF and the creation of a network of Wellness Centers carefully crafted in the City’s Overdose Prevention Plan. Both programs are meant to create the infrastructure necessary to provide treatment immediately when needed for anyone who voluntarily or forcibly enters care. Supervisor Dorsey supported this plan when he voted for the Budget just weeks ago and never attended one hearing to register his concerns when the Board’s Budget Committee discussed the plans for a month in day long hearings.
Had Supervisor Dorsey paid attention at the appropriate times, he would know that the request for voluntary services at the one Harm Reduction Center that currently exists have risen from 150 people a day to 500 people. These are 500 individuals with a drug addiction illness seeking voluntary help every single day from just one center in his District that cannot meet the demand. The funded Wellness Centers are designed to meet this demand.
Instead Supervisor Dorsey urges the Mayor to move the Wellness Center money to jail health services. Supervisor Dorsey wants to arrest and jail the way out of the overdose epidemic – a strategy used during the drug wars in this country that have been widely discredited. Additionally, if Supervisor Dorsey had been listening to the actual people doing the work he would know that the Director of Jail Health Services presented recently at the Health Commission explaining her inability to fill the dozens of funded but vacant positions in Jail Health.
The Mayor with the support of the Board of Supervisors funded three Wellness Centers in the Budget very thoughtfully. We funded those Centers as part of the implementation of a holistic system of care delineated in Mental Health SF and the Overdose Prevention Plan. Both plans have the full support of the Health Department whose leaders helped design these interventions after following decades of evidence about how to best help individuals with drug addiction disorders.
Political antics allow two people a day to continue dying from overdose in San Francisco. It’s time for politicians to step aside and let the doctors, psychiatrists, and social workers fully implement the half dozen solutions they have already created to address this crisis. As a City we need to have patience and persistence to back our health department. San Franciscans are losing faith in politicians like Supervisor Dorsey who are good at working the media with fancy press releases but bad at rolling up their sleeves, collaborating without fanfare, and doing the hard grueling work behind the scenes that truly saves lives. San Francisco has been governed by press release for years and it has consistently failed us.
From Raju:
The city’s latest program of arresting and detaining individuals for public drug intoxication has been an utter failure by all accounts, and calling for increased funding of this cruel program defies all logic. These sweeps ignore evidence-based solutions to our city’s public health crisis and have not been successful in connecting people who have been arrested to treatment.
The coordinated law enforcement sweeps have arrested and detained 191 individuals since late May. Many of these individuals are detained for a day or less, and are forced to suffer from withdrawal in a cage and often in lockdown conditions. It is not surprising that many do not accept treatment, if any is offered, in these deplorable conditions and in this state of mind. Even if they were to receive treatment, studies have shown that forced treatment can have negative effects. These individuals are then released back to the streets without supportive housing, where they are at a greater risk of overdose.
These sweeps are politically motivated, War-on-Drugs tactics, and amount to state-sponsored harassment of vulnerable individuals. These detentions are more concerned with sweeping people struggling with substance use disorder temporarily out of sight than with helping them get well. Drug policy experts and decades of research have demonstrated that drug prosecutions are ineffective and harmful. Over the last year, the overdose crisis has only worsened, and these renewed arrests for public intoxication are only putting people struggling with substance use disorder more at risk.
The last 50 years of the War on Drugs have targeted and criminalized the poor and communities of color. This law enforcement approach has fueled mass incarceration and drained public resources away from evidence-based public health solutions. It has squandered one trillion dollars nationally and millions in San Francisco. The millions of dollars the city is pouring into the ineffective and harmful policing and prosecution of drug-related crimes would have a better return on investment if they were being used on Wellness Hubs, treatment on demand, overdose prevention centers, housing, and employment training. If the city is serious about reducing overdoses and saving lives, our resources should be invested in evidence-based public health solutions, and not in causing more harm and suffering to vulnerable communities.
I spoke to Dorsey today, and he told me that he still supports the idea of safe-injection sites. But he said that he doesn’t think the city will be able to get away with following that approach until the second term of President Joe Biden, since the threat of a second Trump presidency makes it too legally risky.
He said he supported a series of wellness centers, which offer drop-in services but are not specifically designed for safe drug use, but changed his mind when he learned from the Health Department that there’s only one center in the works now, and it’s in his district.
The debate is much larger than one wellness center, or one district supervisor. It’s about whether the politics of the city are moving toward the mayor and the DA’s approach, which is to lock people up first and ask questions later, or if the city is still willing to resist the concept of incarceration as a solution to the public-health issue of substance abuse.
The public pressure coming from not only national right-wing media claiming a lawless city (a narrative Breed and DA Brooke Jenkins started for their own political purposes) but from tech billionaires trying to oust progressives from the Board of Supes is relentless.
Unfortunately, we have more than 40 years of evidence that criminal-justice approaches to substance abuse are racist and don’t work. But that’s not the line we keep hearing when people talk about the crisis of Fentanyl overdoses.
(We don’t hear much talk either about how radical income inequality, created by some of the same policies that Breed and her allies, especially in the tech industry, support have created the conditions for homelessness, drug abuse, and misery on the streets. I was here in the early 1980s; homelessness wasn’t a big problem until the Reagan era.)
Instead, what we are now hearing from Jenkins (and I am hearing from other sources) is that the Tech Right wants to go after the local judges, saying they are releasing drug users instead of keeping them locked up in jail. Never mind that there isn’t room in the jail for all of these folks, and that state law and rules determine who can be held for how long on what charges.
Superior Court judges in California are elected, in theory, although most are actually appointed by the governor. If a judge resigns before the end of their term, as many do, the governor fills the position.
The judges don’t have to appear on the ballot unless someone files to challenge them, which is relatively rare.
But if the Tech Right wants to fund challenges, we could see a new attack on progressive (or even reasonably liberal) policies in San Francisco.
There is so much money on the right, and so much bad news media, that it’s getting scary in this city.
