I was an addict – The incentives for recovery are dead wrong
By Tom Wolf
It’s a miracle I’m alive today. Addiction caused me to go from middle-class county worker with a family, mortgage, and little league obligations to street addict hustling for the next fix. My experience resembles millions of others, revealing a dark and desperate climate where it is far too easy to get high and extremely difficult to get sober.
Just a few years ago, I was addicted to heroin and living on the streets of the Tenderloin, San Francisco’s most notorious drug and homeless district. The effort underway to recall District Attorney Chesa Boudin is due, at least in part, to his abject failure to grasp the aspects of addition and, in turn, his inability to address his city’s humanitarian crisis.
Illicit fentanyl hit San Francisco in 2018, and related overdose deaths immediately spiked. From 259 that year to 713 in 2020, the city is on pace to notch 1,000 deaths in 2021. This death toll exceeds that from COVID-19. The sharp assault on one’s senses of masses of addicts sprawled out destitute, impoverished, and comatose in their own filth should elicit mercy and support. Yet there’s no urgent response.
As of today, the San Francisco Department of Public Health sanctions only 35 detox beds for its population of 800,000, where at least 25,000 are identified with substance abuse disorder. These 35 beds are a small part of the 486 total treatment beds available for detox, residential treatment, and step-down programs.
Not only are detox beds scarce, but the process to gain access to them is extremely difficult. The San Francisco Department of Public Health’s Access Center ostensibly helps addicts, but keeps banker’s hours and is akin to the DMV. Bureaucracy and week-long waitlists there are the norm. And addicts aren’t exactly “motivated consumers” with the patience to see it through.
There still is a quick and easy way to get treatment—sometimes. An addict has to commit a crime and end up in jail. Police can fast track addicts into a variety of private or state-funded drug treatment programs within several days, but the addicts must act on the offer for treatment quickly before being released. In effect, law enforcement and the addict have to work against the system before the District Attorney gets involved.
San Francisco has drug courts whose function is to mandate people to drug treatment as a jail alternative. While the District Attorney publicly advocates for their expansion, he undermines that pledge by actively speeding the release of addicts before they get to the courts. This has caused a sharp decline in arrests for open drug use.
If the sole purpose of decriminalizing drug use is fewer arrests, it’s working. From February to April, the San Francisco Police Department’s Tenderloin Station made 60 arrests per month for drug dealing. In those same three months, the police only made three arrests for drug possession and issued one citation for drug use. Drug dealers are being released from custody by the District Attorney as fast as they’re being arrested.
In short, San Francisco’s “restorative justice” model means no addict is getting arrested, going to jail to get clean, being mandated to drug court, or being put on probation.
San Francisco is trying to address its addiction crisis with more street outreach, safe sleeping sites, and street-crisis response. However, these efforts often result in addicts remaining on the streets because volunteers and outreach workers have nowhere to refer drug abusers for treatment.
San Francisco needs more beds and, critically, lower barriers to treatment. This must be paired with a massive public outreach effort to motivate the addicted to get off the streets and seek help.
Further, the city needs mobile vans with identification and health-system access to transport overdose victims to detox. Rehab pods should be added to county jail to introduce recovery during even short stays in custody. Further, Medically Assisted Treatment (MAT), which is the use of prescription medication to treat substance addiction such as opioid abuse, needs to be available to addicts while in custody to initiate a fast track to rehab.
This response is appropriate given the incalculable number of lifeless bodies strewn across sidewalks and in alleyways. Unfortunately, it has been met with resistance from officials like Chesa Boudin, seeking to avoid the perception of an increased criminal justice element.
Forget politics. We can no longer minimize addiction’s role in the vast increase in homelessness and loss of life. Drastic measures to alleviate the suffering in our American streets must be taken, otherwise, the stream of senseless deaths will continue forever.
Thomas Wolf is a former homeless heroin addict who advocates for recovery and treatment programs. He provides tours of the Tenderloin District of San Francisco to raise awareness of the devastation of drug use. Tom can be reached at 650-822-3107 or at firstname.lastname@example.org