Is San Francisco's 'war on fentanyl' a drug war by another name? – San Francisco Chronicle

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San Francisco Supervisor Matt Dorsey says the city is not engaging in a war on drugs.
San Francisco Public Defender Mano Raju (center), during a news conference last year, criticizes Mayor London Breed’s plan for stricter enforcement of drug laws in the Tenderloin.
Mayor London Breed (right), Police Chief Bill Scott and District Attorney Brooke Jenkins discuss their approach to illegal drug dealing.
When San Francisco Mayor London Breed held a news conference this month to discuss the city’s drug crisis, two of her appointees couldn’t quite sync up on the messaging.
District Attorney Brooke Jenkins called it “a war on fentanyl.”
“What’s happening in San Francisco is not the war on drugs,” said Supervisor Matt Dorsey. “What is happening in San Francisco right now is a war on drug addicts.”
While these officials tinker with their branding, the other words they used shed light on what comes next. Collectively, Breed, Jenkins, Dorsey and Police Chief Bill Scott said the words “accountability,” “consequences” and “arrests” more than 40 times at their Oct. 5 news conference.
“Treatment” was mentioned fewer than 10 times. “Compassion” fewer than five times.
“You don’t get a pass just because you have a substance disorder,” Scott said at one point.
San Francisco didn’t always stake out such a one-sided stance.
Informed by its experiences with the AIDS epidemic and pushed by LGBTQ activists, San Francisco was an early adopter of harm-reduction policies like taxpayer-funded clean needle exchanges and making overdose-reversal drug naloxone available at local pharmacies. In 2000, the Health Commission even adopted a harm-reduction policy to shape its addiction treatment efforts going forward.
So by the time a prescription opioid epidemic emerged here in the mid-2000s, San Francisco was able to keep fatal overdoses relatively flat as they surged nationwide. That changed with fentanyl, an insidiously powerful synthetic opioid that overtook the illicit drug supply like an invasive species.
Overdose deaths soared from 259 deaths in 2018 to 711 in 2020, according to a Chronicle analysis of Medical Examiner statistics. That’s a 175% increase.
The pandemic accelerated this crisis, a San Francisco Department of Public Health report noted this month, and overdose deaths have gradually declined, to 641 last year. But those figures are still well over the city’s average, and fentanyl is the major reason, responsible for 71% of the 391 accidental overdose deaths that the Medical Examiner’s Office documented this year through August.
People who are Black, age 50 to 59, and men are the most vulnerable to this public health crisis.
While saying they are not relaunching the war on drugs, Breed, Jenkins and Scott are touting approaches that have their critics crying deja vu.
Scott said his officers have arrested more than 600 people this year so far for possessing or selling narcotics. Since July, police have issued more than 350 citations for people using drugs in public spaces. That’s compared with 89 citations total from January 2021 through June of this year.
Under Jenkins, the District Attorney’s Office has embraced sentencing enhancements and pretrial detention, and restricted eligibility for drug rehabilitation and supervision programs.
To Leo Beletsky, a professor at the Northeastern University School of Law, these approaches hearken back to the late 1870s, when the city used opium laws to target Chinese immigrants.
“That process was fueled by racism against Chinese Americans and in many ways has been the harbinger of the war on drugs,” he said during an Oct. 12 news conference that functioned as a rebuttal to the one Breed and her allies held.
Public Defender Mano Raju, who is seeking re-election in November, organized the virtual news conference. It featured health experts and criminal justice reform advocates who offered their views for what the city should be doing, but isn’t, to curb overdose deaths and drug sales.
“We need to create a truly connected safety net, not a dragnet for people with problematic drug use,” said Norma Palacios, the policy coordinator for the New York-based Drug Policy Alliance, a nonprofit that advocates for equitable alternatives to current drug policies.
Speakers such as Palacios and longtime harm-reduction activist Laura Thomas of the San Francisco AIDS Foundation urged the city to scale up initiatives that worked before but haven’t kept pace with the scourge of fentanyl, including creating more transitional housing, employment programs, voluntary treatment services that are culturally sensitive, and supervised consumption sites.
On the last one, at least, Breed and her critics are in agreement. But they were dealt a blow by Gov. Gavin Newsom, who vetoed a state bill that would have allowed San Francisco to open the safe injection site Breed had pushed for since last year. Calling the decision “disappointing,” the mayor said the city will still look to innovate.
And while Breed pledged 400 more treatment beds to the city’s current stock of 2,200 last year, public health advocates say this is where the mayor should be thinking bigger and investing more resources, not on policing and prosecution.
The closest thing to a public health perspective that Breed’s news conference featured came from Dorsey, who is a recovering addict himself. He was the only official who didn’t say “arrests” in his comments.
“We can solve this problem and do a better job than we are doing without a return to mass incarceration, without a return to the drug war,” Dorsey said.
He sounded like the odd man out up there.
San Francisco Chronicle columnist Justin Phillips appears Sundays. Email: Twitter: @JustMrPhillips
Justin Phillips joined The San Francisco Chronicle in November 2016 as a food writer. He previously served as the City, Industry, and Gaming reporter for the American Press in Lake Charles, Louisiana. In 2019, Justin also began writing a weekly column for The Chronicle’s Datebook section that focused on Black culture in the Bay Area. In 2020, Justin helped launch Extra Spicy, a food and culture podcast he co-hosts with restaurant critic Soleil Ho. Following its first season, the podcast was named one of the best podcasts in America by the Atlantic. In February, Justin left the food team to become a full-time columnist for The Chronicle. His columns focus on race and inequality in the Bay Area, while also placing a spotlight on the experiences of marginalized communities in the region.


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