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Homeless men sleep on Larkin Street in June 2019. (Gabrielle Lurie/San Francisco Chronicle via Getty Images)

Slow-Motion Suicide in San Francisco

The city is carrying out a bizarre medical experiment in which they are helping homeless drug addicts use drugs. ‘It’s handing a loaded gun to a suicidal person.’

At this point all I can say is: go and see it. 

Over the past two years, more than 1,360 people have died from drug overdoses in San Francisco. That is more than double the number who have died from Covid.

But you don’t need more stats. You don’t need more numbers about how the tent encampments are exploding. Or about the amount of money that the city is paying for each person doing drugs on the sidewalks. You need to see it.

I’m serious. Everyone in San Francisco should make a trip downtown. Walk around. And do not avert your eyes to the people dying slowly on the streets.

The politicians that run my hometown are relying on you not noticing what’s going on because it’s been bad for so long and who cares if it gets a little worse. Don’t let them. Go see it.

The city is using intimidation. They used it on me when I went to see what was going on at a new addict-services facility, which they’d set up in a public plaza. And they tried to intimidate my friend Michael Shellenberger, as you’ll read below. 

The people in charge of homelessness and addiction want to bully people into giving up public streets and parks. They want to take your tax money and let your suffering neighbors die gentle, stoned deaths while they watch and call it justice. They think the mothers who want to get their sons out of the jaws of death are suspect. (It’s conservative to want your kid to live, don’t you know?) The city would like a little privacy please. Fentanyl use is an intimate moment between our officials and our addicts.

Do not listen to the propaganda. Skip Golden Gate Park. Bring your friends downtown instead. Stand in UN Plaza and just watch. Use your eyes, those great weapons. 

— Nellie Bowles

A sanctioned and fenced-in homeless encampment across from City Hall in May 2020. (Jane Tyska/Digital First Media/East Bay Times via Getty Images)

When San Francisco Mayor London Breed promised last month that she would “put an end to all the bullshit destroying our city,” everyone breathed a sigh of relief. Over the past decade, the city had come to resemble “Night of the Living Dead,” with Covid accelerating its decline. At last, someone was promising to take charge. Finally we would see a crackdown on the open-air drug use and drug dealing that is fueling an epidemic of slow-motion death by the bay.

I praised Breed and defended her from skeptics who claimed hers was an empty promise. I was wrong to be so naive.

Right now, in the heart of downtown San Francisco, “the bullshit” the mayor spoke about is worsening by the day. The city is running a supervised drug consumption site in United Nations Plaza—just blocks away from city hall and the opera house—in flagrant violation of state and federal law. (Two weeks ago, my colleagues and I broke the story. The San Francisco Chronicle confirmed our reporting.) There, city-funded service providers supervise people smoking fentanyl and meth they buy from drug dealers across the street. 

The police do nothing. Indeed, the mayor, through the Department of Emergency Management and the Department of Public Health, is running the site. 

Tom Wolf, a recovering homeless addict who served on the city’s drug-dealing task force, compared the department to “the mafia.” Everyone sees that the situation is untenable, he added, but “nobody wants to go on record” because “everyone is afraid of the backlash.” 

Let me say off the bat that I am not a drug prude. I support the decriminalization of marijuana and psychedelics for medical and spiritual purposes. I have favored needle exchanges since the late 1990s, and I have always strongly supported using Narcan to reverse overdoses, and methadone or Suboxone as opioid replacement.

I am also not completely opposed to supervised drug consumption sites. In my new book, San Fransicko, I praise Portugal, which has decriminalized drug use, and the Netherlands, where there are 28 drug consumption rooms. (In some, addicts are even given heroin.)

But both of those countries condemn hard drug use and intervene when addicts break laws, including laws against public drug use and public camping. “There’s a clear sign of disapproval in our society to the use of drugs,” the head of Portugal’s drug program, João Goulão, told me. 

They are also not opposed to coercion. In Portugal, someone caught using heroin in public is arrested, brought to the police station, and either prosecuted for drug dealing or forced to appear before something called a Commission for the Dissuasion of Addiction comprised of a combination of social workers, psychologists, psychiatrists, and family members who confront addicts in a formal intervention.  

Something very different is happening in San Francisco. The city is carrying out a bizarre medical experiment whereby addicts are given everything they need to maintain their addiction—cash, hot meals, shelter—in exchange for . . . almost nothing. Voters have found themselves in the strange position of paying for fentanyl, meth and crack use on public property. 

You can go and witness all of this if you simply walk down Market Street and peek your head over a newly erected fence in the southwest corner of United Nations Plaza. You will see that the city is permitting people to openly use and even deal drugs in a cordoned-off area of the public square.

The city denies that they are operating a supervised drug consumption site. “This site is about getting people connected with immediate support, as well as long-term services and treatment,” a spokesperson for the city’s Department of Emergency Management told the Chronicle. 

The official line is that they are running what they call a “Linkage Center” in a building next to the open drug market in the plaza. The idea is that the center is supposed to link addicts to services, including housing and rehab. When Mayor London Breed announced it, she promised it would get people into treatment so they could stop using drugs, not simply hide their use.

But city officials have told me that in the 19 days that the site has been open, just two people total went to detox so far. And they serve some 220 people per day. 

“In that tent on Market Street everyone is shooting dope,” complained a senior employee of a major city service provider, speaking of the scene at the plaza. “It’s insane. All the staff standing around watching them. It’s fucking ridiculous. I don’t know how anybody thinks that helping a drug addict use drugs is helping them.”

“What’s happening is that everyone that comes in gets a meal, can use the bathroom, gets drug supplies (needles, foil, pipes) and signs up for a ‘housing assessment,” a person with firsthand information about the operation told me over text message. “But there’s no housing. So nothing happens. They just get added to a list.” 

The parents whose children live on the streets are adamant that the status quo is broken. “I agree with the Linkage Center,” Gina McDonald told me. Her 24-year-old daughter Samantha is a heroin and fentanyl addict who has been on and off the streets for the last two years. “But allowing open drug use does not help. It’s handing a loaded gun to a suicidal person.”

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Last Thursday I returned to the Linkage Center to find out what, if anything, had changed since I first visited. I saw (and video recorded) much more drug use within the supervised drug consumption site, and much more drug dealing around it, than I had two weeks ago.

I counted at least 30 drug users crowded together and sitting on a cement stoop or on outdoor tables. Many were gaunt, stooped over, and had open wounds consistent with substance use disorder, from meth, fentanyl, or a combination of the two, which has become increasingly common. There were also more employees on site than when I had first visited; they were watching as people smoked fentanyl and meth. 

The security guards at the site work for a new, fast-growing nonprofit contractor called Urban Alchemy. Urban Alchemy is composed of ex-cons and “lifers” released early, many of whom have gone through recovery from addiction themselves. Their first contract was to clean and police the public toilets that, without security guards, are used for drug consumption and prostitution.

I admire the organization’s ethos, which emphasizes self-control, discipline, and turning past mistakes into something positive. One morning in early December I shadowed Urban Alchemy employees, known as “practitioners,” as they told street addicts in the Tenderloin to pack up their tents and cleaned up after them. 

But the practitioners did not appreciate my presence in the consumption area and asked me to leave. After I pointed out that the site was public property, and therefore open to the public, they said I could stay if I registered at the front desk. Within seconds they changed their mind and threw me out of the site. 

My last visit to the site had frightened me, so I was wearing a body camera clipped to my jacket. They grabbed my body camera and another camera from my hand and rushed me outside of the facility. Eventually the police came and returned my property to me.

Urban Alchemy is not just paid by the city to provide security for the Linkage Center. It also oversees a city-sponsored homeless tent village, which the city has dubbed a “Safe Sleeping Site,” just one block away. There, late-stage addicts living in tents spend their days smoking fentanyl and meth. Meantime, Urban Alchemy practitioners bring them three hot meals a day, provide them with clean clothes, and even clean their toilets. 

The Safe Sleeping Site, which was created in 2020, is one of six similar sites throughout the city with about 250 tents between them. The city’s taxpayers spend about $57,000 per tent per year—or twice the median cost of a one-bedroom apartment in San Francisco.

Addiction experts—and I spoke to dozens for my book, including senior officials in Europe— are appalled by San Francisco’s radical drug experiment. 

“If you’re coming into a place that’s supposed to guide you toward the end of seeking treatment and recovery, and there are people using drugs around you, that becomes an incentive to keep going,” said Stanford University School of Medicine addiction expert, Keith Humphreys. “It’s like trying to have an AA meeting in a bar.”

Wolf, the recovering addict who is the founder of The Recovery Education Coalition, told me that “some service providers are refusing to go to the [supervised drug consumption] site because they don’t feel safe.” He added that “a lot of workers for these nonprofit service providers are in recovery and they don’t want to be around the drug use.”

In obeisance to woke ideology, the official position of the Department of Public Health and progressives on the San Francisco Board of Supervisors is that police should not be involved except perhaps to revive people with Narcan after they overdose. Many on the Board of Supervisors and the District Attorney believe that drug dealers—who the latter refers to as victims—should not be prosecuted.

The result is that the city is spending roughly $100,000 per year per homeless person, or over $1 billion annually, to maintain a large, unemployed, and very sick addict population in San Francisco’s public squares at the cost of human life and the loss of peace, walkability and livability—the very qualities that have long attracted so many to San Francisco.

For decades, San Franciscans have been fed the line that people are not on the street primarily because they are addicts, but because of high rent and lack of housing. The most powerful proponent of this view is Jennifer Friedenbach of the San Francisco Coalition on Homelessness. She blocks the closure of open drug scenes, calls people who disagree with her fascists and racists, and organizes protests at the homes of politicians. “They’re screaming for housing,” she has said of the city’s homeless population.

But that is not what addicts on the street tell me. On Saturday, I talked to a 37-year-old heroin addict originally from Alabama who has been living on San Francisco’s streets for seven years. He told me that for the majority of homeless people “addiction is the main driving force.”

It makes good sense. Homeless shelters have rules, like no drug use. The streets do not. 

And simply giving addicts and the mentally ill their own apartment units—the so-called “Housing First” approach pioneered in San Francisco—doesn’t even keep people housed long-term. In the spring of 2021, a team of Harvard medical experts found that after 10 years, just 12 percent of the previously homeless remained housed. 

In 2018, a National Academies of Sciences review of the scientific literature of Housing First concluded that there was “no substantial evidence” that the policy of Housing First “contributes to improved health outcomes.” This shouldn’t come as a surprise given that it doesn’t deal with addiction.

But in the name of Housing First, San Francisco’s elected leaders have deliberately chosen to leave a significant portion of the homeless unsheltered on the logic that anything short of a permanent apartment, no strings attached, for any addict who wants one is immoral.

It didn’t have to be this way. “New York has made the decision that everyone should have an exit from the street,” noted Rafael Mandelman, one of the city’s 11 supervisors. “San Francisco has consciously chosen not to make that commitment. And the conditions on New York’s streets versus San Francisco streets are somewhat reflective of what that means.”

It seems like it cannot get worse. But it can. 

In Canada, taxpayer-funded service providers have been delivering fentanyl directly to addicts living in homeless drug encampments. This is where many fear the San Francisco program is headed.

The backlash is building, though. It is made up of fed-up city residents, addiction experts, and the relatives of addicts. 

On Saturday morning, mothers of homeless addicts and mothers of kids killed by drugs gathered to protest the supervised drug site in front of the Linkage Center. They call themselves Mothers Against Drug Deaths, and they are part of the California Peace Coalition, which I co-founded last May.

Gina McDonald, Samantha’s mother, was there. She opened up to me about her own past addiction. She was an alcoholic, then turned to opioids, then to meth. “Within six months I was in a psychiatric ward with meth-induced psychosis.” In May, she will have been sober for 10 years.

“I don’t want to know what she has to do to survive out there,” McDonald said of her daughter. “I know because I was an addict. But I don’t want to hear it from her. Can you imagine what those girls have to do out there to not be dope sick?” 

I no longer believe that change in the city will come from Mayor Breed. If it comes, it will come from mothers like Gina McDonald. When she took the microphone on Saturday she didn’t hold back. “Mayor Breed,” she said, “I’m tired of the bullshit, too.”

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