San Francisco’s Inadequate Response to the Fentanyl Crisis

Graphic by Mariam Diakite/Graphics Center

In 2023, San Francisco saw 806 fatal accidental overdoses, 653 of which were caused by fentanyl. While fatal overdoses from the drug saw a decrease from 2020-21, the city has seen an increase again this past year. 

This new wave of drug abuse has reached the point of legislative pushback, with Mayor London Breed and Governor Gavin Newsom’s offices partnering to create a law enforcement task force, whose primary responsibility is to investigate opioid-related deaths, and to begin prosecuting drug dealers with homicide.

By charging drug dealers with homicide, San Francisco is joining the ranks of cities treating the symptom, not the cause, of drug addiction and unwittingly turning a blind eye to the growing crisis and death toll spreading within the city. 

District attorneys across the Bay Area have started using this approach in the hopes it will end the state-wide fentanyl crisis that led to more than sixty thousand pounds of the drug being seized in 2023 alone. But focusing on the real cause, addiction, and the people struggling because of the fentanyl crisis would be an ethical alternative more likely to lower the fatal overdose rate. 

The task force initiative was proposed this past October, and  is set to go into effect this spring. This would lead to opioid deaths being investigated as murders, giving city departments the time and expenditure to pursue homicide charges for deaths caused by either a single drug or a laced product. This new policy echoes another of Breed’s decisions from last year— an increase in arrests over public intoxication that attempted to crack down on open drug use and trade in the city. Receiving similar criticism, this new initiative has sparked backlash from the Fair and Just Prosecution Organization over its inefficacy in reducing overdose deaths and the potential for prosecution biases. 

Drug abuse is widely recognized in the medical profession as a chronic illness and serious disease. To tear the focus away from the illness to pursue a change in dealer sentencing ignores the underlying issue. Fentanyl overdoses have two causes: consumption of illicitly-manufactured fentanyl, and consumption of a drug laced with fentanyl. In either case, the rising dependence on illicit substances is causing a rise in deaths. The public health crisis is going unchecked by city officials. 

City resources, which are currently being used on the proposed initiative, should be dedicated to rehabilitation and safe-use programs, both of which have been shown as effective in reducing overdose deaths. 

Safe-use sites are medically sanctioned areas for people with drug addiction to use with medical supervision. They’re overseen by professionals who can step in to counteract fatal overdoses, and have grown in support among activists in the city.

In 2018, Breed backed a State Senate Bill which would have legalized safe-use sites in San Francisco, if it was not vetoed by then-Governor Jerry Brown. Another Senate Bill was proposed in 2022 to establish safe-use sites in the Bay Area, which was then vetoed by Newsom. 

Safe-use sites have had a long, legislatively challenged history in San Francisco, but are effective in solving this public health crisis. They aren’t able to be officially sanctioned under federal law, but currently, there are nonprofits operating safe-use facilities in San Francisco. Officials should continue to fight for these spaces in our city, supporting current efforts at nonprofits, as opposed to imprisoning victims of this crisis. 

There is room for expansion in laws that could open alternative paths for progress that don’t include homicide charges. If the city wants to address their fentanyl crisis effectively, then it has to start with the underlying cause — addiction.  

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