San Francisco mayor plans to drug screen those who want houseless services

Nov 16, 2023

Earlier in September, Democratic San Francisco Mayor London Breed announced a plan to require individuals receiving welfare to receive mandatory drug screening and treatment programs. This measure is aimed at mitigating San Francisco’s homelessness and toxic overdose crises.

“San Francisco is a city of compassion, but also a city that demands accountability,” Breed said in a statement. “We fund a wide range of services, and we want to help people get the care they need but under current state law, local government lack tools to compel people into treatment. This initiative aims to create more accountability and help get people to accept the treatment and services they need.”   

Mayor Breed made the announcement with Supervisor Matt Dorsey, a recovering addict and former spokesperson for the San Francisco police department. “I strongly support Mayor Breed’s initiative, which will better incentivize treatment and recovery for a population that’s at wildly disproportionate risk for drug addiction and overdose fatalities,” said Dorsey. “We’re facing an unprecedented loss of life in San Francisco, and we know coercive interventions can work.”

According to the proposed legislation, all individuals who apply for or receive benefits from the County Adult Assistance Programs (CAAP) will be required to undergo screening for substance use disorder and participate in a substance abuse treatment program if the results of the screening determined that it was necessary. Moreover, the legislation also needs to be approved by the Board of Supervisors.  

“In our pursuit to address the opioid crisis, let our message be clear: the City isn’t going to give you money to buy drugs. If you are ready for help, we are ready to help you,” said Supervisor Catherine Stefani in a released statement. “I believe that requiring individuals with addiction issues to be in a treatment program to receive county monetary assistance is not just a policy but a compassionate pathway towards recovery and stability.” 

The proposed treatment programs will include a range of interventions such as residential treatment, medical detox, medically-assisted treatment, outpatient options, and abstinence-based treatment, and will be selected based on the needs of each individual. However, people who refuse or do not complete treatment will not be eligible to receive CAAP cash assistance and their application will be denied, or their cash assistance will be discontinued. 

Recent data from the 2022 San Francisco Homeless Count and Survey demonstrates that 52% of individuals experiencing homelessness also reported drug or alcohol use as a disabling health condition, which corresponds to a 10% increase since 2019. Furthermore, Accidental Drug Overdose Reports released by the Office of the Chief Medical Examiner have also shown that at least 25% of individuals who died from drug overdose over the period of 2020-2022 have no fixed address. 

“In recent years, San Francisco has earned a reputation as a destination for people who use the most toxic drugs to come, and eventually die,” said Supervisor Rafael Mandelman. “I support this effort to make San Francisco the City where people are able to get sober and build a better life.”