San Francisco inches closer to adopting drug policy with abstinence as
its primary goal
[April 25, 2025]
By JANIE HAR
SAN FRANCISCO (AP) — Reeling from drug overdose deaths and scenes of
people smoking fentanyl on sidewalks, San Francisco moved closer
Thursday to adopting a “recovery first” drug policy that sets abstinence
from illicit drugs as its primary goal, a proposal that has prompted
heated debate in the city that pioneered harm reduction.
Opponents of Supervisor Matt Dorsey's proposal say its emphasis on
stopping drug use alienates those who are not ready to quit, while
proponents say the city has been far too permissive and making drug use
safer does not help break the cycle of addiction.
Dorsey, himself recovering from alcohol and drug addiction, amended the
proposal in his public safety committee to clarify that distributing
safer-use paraphernalia and linking people to social services regardless
of whether they are using remain critical to the city's response.
But more than an hour of public comment with cheers and boos from both
sides underscored just how touchy the issue remains.
“No one dies from harm reduction,” Patt Denning said. “People die from
conventional abstinence-based treatments because they’re either left out
or kicked out if they don’t comply with abstinence.”
Brendan Harris, who said he has been clean for six years, countered that
harm reduction tactics cannot go on forever and people need a firm if
compassionate push into treatment.
“We can’t just keep enabling drugs over and over again,” he said.
In recent years San Francisco's public health department advised people
who use drugs to do so with friends to try to prevent overdose deaths.
Critics said that sent the wrong message.
Mayor Daniel Lurie, who took office in January, has vowed to solve the
city's fentanyl crisis. Last year more than 600 people died from
accidental overdoses.
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Supervisor Matt Dorsey is shown during a San Francisco Board
of Supervisors meeting in San Francisco, Tuesday, Jan. 9, 2024. (AP
Photo/Jeff Chiu, File)
 He ordered city-funded nonprofits to
offer treatment or counseling options before giving out certain
paraphernalia such as foil and pipes, and they will no longer be
allowed to distribute those items in parks and on sidewalks.
As amended, Dorsey's proposal states that the “long-term remission
of substance use disorders for individuals, with the help of fully
supported and staffed evidence-based recovery and behavioral health
services, shall be the primary goal.”
It also defines recovery as “the process by which an individual
suffering from substance use disorder strives to make positive
changes that become part of a voluntarily adopted healthy
lifestyle.”
Dorsey said aspiring to live a healthy life free from illicit drug
use should not be a controversial goal, and abstention can mean
receiving methadone as part of a medication assisted treatment
program. San Francisco offers an array of services to help people
addicted to drugs, but many residents only see the free foil and
pipes, he said.
“We're losing the battle on harm reduction when people think that’s
all we’re doing,” he said after the hearing.
The San Francisco Marin Medical Society, which represents more than
3,500 physicians, proposed the amendments.
The full Board of Supervisors votes on the proposal next month. It
is expected to pass, with seven of the 11 members sponsoring or
cosponsoring.
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