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Breed blames harm reduction strategy for surging drug overdose deaths

A woman in a red suit gestures energetically at a podium, addressing an audience, with others clapping in the background.
At the “March to Prevent Fentanyl Deaths” at City Hall, Mayor London Breed offered her strongest rebuke yet of harm reduction, a strategy to combat the negative effects of drug use that critics say enables people with addiction instead of pushing them toward treatment. | Source: Estefany Gonzalez/The Standard

In perhaps her strongest rebuke yet of harm reduction, a strategy to combat drug addiction that critics say enables people to continue using, San Francisco Mayor London Breed said the policy has played a role in fueling the city's fentanyl crisis.

"Harm reduction, from my perspective, is not reducing the harm," said Breed during a rally in front of City Hall on Monday afternoon raising awareness about the city's fentanyl deaths. "It is making things worse. I will not apologize for the stances I have taken that are controversial. For the people who are selling poison on the streets of San Francisco, that's taken life."

Breed's comments on Monday are part of her increasingly zero-tolerance approach to drug use in the city during her nearly six-year tenure, a stance that comes as overdose deaths in San Francisco have exploded and led to a heated debate in recent years about what approach elected officials, social services and law enforcement should take when it comes to combating the issue.

A man smokes drugs on tinfoil using a straw.
Ken Reigenborn uses drugs in the Tenderloin District of San Francisco on July 4, 2022. | Source: Benjamin Fanjoy for The Standard

The conversation has led some to question the policy of harm reduction, which aims to lessen the negative effects of drug use through a variety of public health interventions, some of which include clean needle exchanges, overdose prevention training or safe consumption sites.

While proponents of the strategy see it as the best chance to prevent users from overdosing on drugs or spreading blood-borne illnesses, critics have argued it doesn't turn the tide on addiction or encourage sobriety.

"We are drawing a line in the sand," said Steve Adami, executive director of the Salvation Army's the Way Out program, during Monday's rally. "[And] standing up to the status quo. And challenging the city to enlarge the solutions base and start getting a grip in promoting recovery."

The change in tenor also comes as the mayor faces increasingly worrisome poll numbers from multiple moderate candidates, including Levi Strauss heir Daniel Lurie and former Supervisor Mark Farrell. Polling released by the San Francisco Chronicle on Feb. 22 shows Breed at risk of losing her reelection campaign, with voters preferring Farrell in a ranked-choice contest.

In response to the mayor's comments on Monday, harm reduction advocates said Breed was shifting her position purely for political reasons and was "ignoring best practices."

"We firmly believe harm reduction is public health and harm reduction is good for public safety," said Laura Guzman, executive director of the National Harm Reduction Coalition. "It really helps keep people safe. Mayor Breed has shifted. And has really gone back and forth. There is nothing that indicates anything else other than political motivation."

On Monday, the mayor had few words in response to the polling numbers.

"Polls are gonna be what they be," she said. "But the results will speak for themselves when I win in November.”

For her part, the mayor's posture on drug use seemed to shift with a now-famous December 2021 speech about public safety in which she called for for the city to be "less tolerant of all the bullshit."

At the time, the mayor helped usher in the opening of the now-defunct Tenderloin Center, a facility that aimed to help get addicts into treatment but garnered intense criticism after effectively becoming a safe consumption site with visible public drug use.

A person is holding a sign reading "Fentanyl? Not @ All" in a crowd.
Michael Ruiz, center, holds a sign reading, “Fentanyl? Not @ All,” at the "March to Prevent Fentanyl Deaths" at San Francisco City Hall on Monday. | Source: Estefany Gonzalez/The Standard

Last year, the mayor's position budged further during a press conference at United Nations Plaza, when she said, in response to a question about the drug crisis, that "compassion is killing people. And we have to push forth some tough love to change what’s happening on the streets of San Francisco.”

More recently, the mayor has placed on the ballot a controversial ballot measure, Prop. F, which would mandate that some suspected illicit drug users undergo screening and treatment to continue receiving welfare benefits.

Last week, a union attorney challenged the legality of the ballot measure in a letter addressed to the city. In response, the mayor on Monday said that "people's lives should not be politicized."

The pronouncements are a far cry from Breed's homelessness strategy back when she was running for mayor in 2018. In a Medium post published at the time, Breed called for safe injection sites and said she had visited such facilities abroad.

Earlier this month, Breed also came out in support of what would have been the first long-term, city-funded sober living home in Chinatown. Opposition to its location, however, has forced Breed to look elsewhere to open the facility.