Two bodies a day continue to arrive at the San Francisco Medical Examiner’s Office, laid waste by drug overdoses, usually fentanyl. This year through the end of September, 516 people had died. The city might hit 700 deaths from overdoses by the end of this year, up from 441 last year and 259 the year before.
And the misery created by the city’s lax approach to open-air drug markets in the Tenderloin and South of Market extends far beyond the devastating deaths. Families report being unable to leave their apartments because of the crush of dealers outside and repeated harassment when they do venture out.
But despite the crisis growing so much more dire, the discussions at City Hall and in San Francisco’s criminal justice system sound like the same old scratchy broken records. There’s a lot of blame, bickering and endless debate. And on the rare occasion a new, worthwhile idea is agreed upon, it often leads nowhere.
The model, as I’ve written before, is Portugal, where small amounts of drugs are decriminalized, but people addicted to them are urged into treatment and people who sell them face real consequences. Neither of those commonsense approaches exists in San Francisco, where treatment is hard to access and drug dealers have the run of the sidewalk.
Before Portugal decriminalized drugs, it saw an average of one overdose every day. By 2016, the annual total had plunged to 27. In an entire country of more than 10 million people. We’re seeing the same number in our little city every two weeks.
San Francisco officials have said they like Portugal’s model, too, but they’ve never moved to replicate it. They seem to prefer talking about smaller solutions and then forgetting about them.
Remember the much-discussed meth sobering center planned for Turk and Jones streets? It never opened, largely because of the pandemic. Remember the safe injection site that has been widely supported at City Hall for at least four years? It still doesn’t exist because the Trump administration threatened to arrest those who participate.
Remember that much-debated conservatorship law to make it a little easier to compel people who are severely addicted to drugs and who create a danger to themselves or others to accept treatment? It was enacted last year, and guess how many people the city has helped with it? Zero.
Officials are still calling for drug treatment on demand 23 years after then-Mayor Willie Brown promised it. People addicted to drugs in the city still can’t access treatment as soon as they’re ready to accept it, and there are too few incentives to push them into it.
The criminal justice system hasn’t changed either. District Attorney Chesa Boudin said in an interview on The Chronicle’s “Fifth & Mission” podcast that he prosecutes just over 80% of drug-dealing cases brought by police, a little less than the 88% claimed by his predecessor, George Gascón.
Boudin, like Gascón, usually supports releasing defendants with stay-away orders banning them from the area where they were arrested. It’s common for the defendant to return to the same corner, get arrested again and perhaps be put on probation, Boudin said.
Drug dealing cases hardly ever go to trial or end in prison time. San Francisco Superior Court judges and juries have no appetite for that, Boudin said. And neither does he, noting his “constant condemnation of the failings of the war on drugs.”
Instead, he pointed to three initiatives he says would make a real difference. They might sound familiar. Safe injection sites. Treatment on demand. And police investigations that lead to seizures of large quantities of drugs rather than the small amounts his office usually gets.
“They’re almost exclusively crumbs — a few pills, a few rocks, very low-level dealers who are essentially fungible to the networks that are bringing drugs into our city,” Boudin said.
The Police Department did not respond to requests for comment.
The drug networks traffic people from Honduras, and they sell drugs in the open-air markets in the Tenderloin. Boudin said he talked to Superior Court judges this year about creating a new special court for people who’ve been trafficked and are arrested — including drug dealers and sex workers — so the city can help pull them away from their traffickers. The idea hasn’t advanced because of the COVID-19 pandemic, Boudin said, and it’s unclear whether there would be funding or staff for it anyway.
As for another new initiative — City Attorney Dennis Herrera’s plan to seek civil injunctions banning known dealers from a 50-block area of the Tenderloin and South of Market — Boudin said he’s skeptical it’ll work any better than his stay-away orders. Herrera has served 10 of the planned 28 defendants so far, and the Public Defender’s Office has until Nov. 23 to is find legal counsel for them.
“I don’t really see any added value from this approach,” Boudin said.
Boudin said the U.S. attorney’s focus on the Tenderloin — initiated in August 2019 — also has made no real difference. David Anderson, U.S. attorney for the Northern District of California, disputed that claim. He said the operation has led to 200 arrests for attempted murder, robbery, child pornography, drug trafficking, drug conspiracy, the use of firearms in connection with drug crimes, sex trafficking, mail fraud and other crimes. No charges have been filed for using or possessing drugs.
About half of those arrested have been sentenced by federal judges so far with jail time ranging from a month to seven years, depending on the crime.
Anderson said a main reason the Tenderloin has become one of the largest open-air drug markets on the West Coast is that dealers know the criminal consequences will be light, and that keeps prices abnormally low. It costs money for traffickers to bail their workers out of jail or to replace those locked up with new staff, but that’s not usually an issue in San Francisco.
“It is hard on the federal level alone to deliver enough volume of prosecutions. Certainly more prosecution pressure would raise drug prices in the Tenderloin and would decrease the level of drug trafficking that you see and certainly would save lives,” he said.
In truth, we need to try all of this: safe injection sites, treatment on demand, sobering centers, conservatorship and real consequences for people repeatedly picked up for selling deadly drugs.
Some of this can happen with the freeing up of Proposition C money to help fund a better system of drug and mental health treatment and with the passage of Proposition A this month to fund the city’s Mental Health SF program. One encouraging sign is the launch this month of a street crisis team to respond to 911 calls about people in distress.
But if the city’s leaders talked about these issues together instead of sniping at each other, they could create a model program that encourages people addicted to drugs to get better and gives real consequences to those who sell.
That’s how it works in Portugal, considered the world’s progressive model for addressing the drug crisis. After heroin addiction erupted in the 1980s and 1990s, the country decriminalized the possession of any type of drug in a quantity that would last one person 10 days. If police find someone with that amount or less, the person must report to a noncriminal commission within three days.
That commission may refer the person to treatment — always readily available — or a psychologist. If the person declines and is caught with drugs again, the commission may assign community service or stay-away orders. Failure to comply can eventually lead to police involvement.
Police also arrest dealers, who can face lengthy prison sentences. Now, overdose deaths have plunged, the number of people using illicit drugs has dropped, and it’s rare to see open-air drug use on the streets.
Doesn’t that sound like a dream?
The city’s Street-Level Drug Dealing Task Force should have its recommendations to help improve the city’s drug nightmare soon. Member Curtis Bradford, a community organizer with the Tenderloin Neighborhood Development Corp., said there’s a “sense of urgency” considering this year’s shocking rise in overdose deaths.
“The conversation is really leaning toward this idea that it’s not either or,” he said. “It’s not policing and enforcement or no enforcement and just programs.”
That’s exactly right. Bradford supports tough prosecution for drug dealing when it’s associated with violence or threats of any kind. Plus he wants far more street outreach and safe injection sites.
Bradford speaks from his own experience. In January, he’ll celebrate a decade of being sober after struggling with a crystal meth addiction and homelessness. He stopped using on Jan. 10, 2011 — the same day his partner, John, died of a drug overdose.
He remembers lining up for food at Glide soon after that and following the music into the church sanctuary, where he signed up for its recovery programs.
“I was shooting up three times a day just to function. Half my teeth had fallen out of my head. I was 30 pounds too thin and looked like a skeleton,” he recalled. “I’m grateful and amazed that I’ve been given this second opportunity at life.
“Any one of those times I put a needle in my arm could have been my last,” he added. “I dodged a bullet.”