German Lopez has an opinion piece in todays NY Times arguing that San Francisco seems to be “sobering up” when it comes to dealing with drug use on the city’s streets.
Generally, I’m skeptical about articles like this, i.e. ones that suggest a blue city synonymous with urban chaos is doing well. Compared to what? In this case, Lopez makes the comparison explicit. He says SF is doing better than it was 2 years ago when he visited and saw first hand some of the dysfunction that I and many other conservatives have written about. Here’s what he said about it back in January 2024:
For some San Franciscans, a drug crisis is just part of city living. They see people shooting up in front of their homes and businesses. They often find someone dozing on a sidewalk, high. Sometimes, they check for a pulse. “That’s how I found my first dead body,” said Adam Mesnick, owner of a local deli.
But the city’s drug crisis is relatively new. In 2018, San Francisco’s overdose death rate roughly matched the national average. Last year, its death rate was more than double the national level.
The line about the dead body is shocking but Lopez seemed to avoid much of a his personal encounters with the problem, but he did go on to say that the problem in SF wasn’t just policy, it was cultural. It was a kind of permissive progressive culture, though he didn’t phrase it exactly that way at the time.
Culture can sound like an abstract concept, but it matters for drug policy. Consider smoking. In 1965, more than 42 percent of American adults smoked cigarettes. In 2021, less than 12 percent did. The country did not criminalize tobacco. And while policy changes like higher taxes played a role, much of the drop happened through a sustained public health campaign that led most Americans to reject smoking.
In San Francisco and other liberal cities, the opposite shift has happened with hard drug use. The culture has become more tolerant of people using drugs. When I asked people living on the streets why they are in San Francisco, the most common response was that they knew they could avoid the legal and social penalties that often follow addiction. Some came from as close as Oakland, believing that San Francisco was more permissive. As Keith Humphreys, a drug policy expert at Stanford University, told me, San Francisco “is on the extreme of a pro-drug culture.”
So give him some credit for stating the obvious a couple years ago, though some of us were noticing the drug/homelessness problem a lot earlier than that.
In any case, Lopez is back today arguing that things are improving. And his summary of his previous tour of SF is much more directly focused on failed progressivism than it was when he wrote about it in 2024. Maybe that’s partly because now he’s writing for the opinion section but the language is more direct.
When I visited San Francisco in 2023, parts of the city looked like open-air drug dens. Users made homes in tents that lined block after block. They bought, sold and smoked fentanyl, crack and meth in public. They used drugs in front of a police station, visibly undeterred by the threat of the law. I once saw four people hunched over, in what’s called the “fentanyl fold,” along a sidewalk in sight of City Hall. It was a startling vision of what had gone wrong with West Coast progressivism.
This year, I went back to find San Francisco in the early stages of recovery. The tents were gone. I spotted public drug use much less frequently. Officials didn’t ignore the remaining addicts. Community ambassadors, as the city calls them, patrolled the streets and tried to persuade users to get into treatment. At a minimum, they made sure that people didn’t treat sidewalks as campgrounds. I could move through the city without having to walk in the road — something most of America mercifully takes for granted.
His take on how SF got to this state is also pretty direct and on target. Again, the problem all along was big city progressives with bad ideas.
In 2000, the San Francisco Health Commission unanimously approved a resolution adopting “harm reduction,” as the concept came to be known, as city policy. By 2020, harm reduction was in effect the city’s only drug policy. Treatment and recovery became secondary goals, if they were goals at all. During my 2023 trip, one harm reduction provider, Michael Discepola of the social services program GLIDE, told me his group had recently dissuaded a client from quitting drugs cold turkey because the goal was unrealistic. Harm reduction providers did not want to push users into treatment. They worried that doing so could hurt their ability to help clients by scaring them away. The approach was all carrot, no stick.
This failed to acknowledge the realities of drug use. Addiction is not a disease like diabetes or cancer. Diabetics and cancer patients typically want treatment. Many addicts, because of the nature of addiction, do not. This is why people struggling with addiction often need an outside push — from a family member, a friend or ultimately the government — to seek help.
When fentanyl reached San Francisco in the mid-2010s, the city’s policy did not keep people alive by making their drug use safer. Instead, annual accidental overdose deaths spiked to more than 800 at their peak in 2023, triple the national rate. Public drug use soared. And as addicts sought money to pay for drugs, shoplifting increased, too, buoyed by voter-approved changes to state law in 2014 that reduced penalties on property offenses. Some businesses fled, including about half of CVS stores and pharmacies. The city’s illegal drug problem made it harder for San Franciscans to get their legal drugs.
Eventually, the army of fentanyl addicts on the streets and riding the trains, the spike in overdose deaths and the publicization of the city’s much needed poop patrol to clean human waste off the city’s streets led to a downturn in tourism. That finally seemed to get the city’s attention that it needed to do more than power wash the sidewalks every morning.
Keith Humphreys, a drug policy and addiction expert who lives in the Bay Area, described the old policy as “almost the addicted person’s fantasy: ‘I can do whatever I want to do. I have no responsibilities. The damage I do, you all have to clean up, and you can’t ask me to do anything.’”
He continued: “Cancer isn’t fun, depression isn’t fun, but drugs and alcohol are. So people often need pressure to get out of it.”
So the number of overdoses is down a bit. The streets have improved and the culture may have improved a bit as well. People are less tolerant of the chaos and that’s a good thing. But there are still plenty of leftist ideologues who oppose everything the new mayor is trying to do. But Lopez argues that part of the ongoing problem isn’t just the city it’s the state and the judiciary which still bends over backwards to insulate the addicts and even the dealers from any meaningful consequences.
The biggest problem is the state’s enforcement of drug laws. In theory, possession is a misdemeanor punishable with jail time — the kind of leverage a prosecutor could use to push a user into treatment. In practice, lax and conflicting state laws in combination with liberal judges and juries have made it nearly impossible to get a conviction, let alone jail time, for simple drug possession or public use. The San Francisco district attorney, Brooke Jenkins, told me it can be difficult to get prison time even for drug dealers. She estimated it takes two to three arrests to persuade a court to hold someone in custody. That’s an improvement from the four to five cases required when she started the job in 2023.
In other words, some of the city’s residents and elected officials may be sobering up but the city’s judges continue to live up to their reputation as some of the most permissive in the nation. Until that changes, SF is only one bad election away from the chaos returning in full force.
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