David Sjostedt

A man named Dre was slumped up against a car, unable to zip up his pants and hardly able to stand as he came down from the effects of fentanyl, when The Standard found him in San Francisco&#8217;s beleaguered Tenderloin neighborhood on Thursday.&nbsp;

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A man named Dre was slumped up against a car, unable to zip up his pants and hardly able to stand as he came down from the effects of fentanyl, when The Standard found him in San Francisco's beleaguered Tenderloin neighborhood on Thursday.&nbsp;

A man named Dre was slumped up against a car, unable to zip up his pants and hardly able to stand as he came down from the effects of fentanyl, when The Standard found him in San Francisco&#8217;s beleaguered Tenderloin neighborhood on Thursday.&nbsp;

In broken phrases, he explained he’d been homeless for eight years in the city and that his son, now in the 10th grade, was growing up without a father.

In broken phrases, he explained he’d been homeless for eight years in the city and that his son, now in the 10th grade, was growing up without a father.

“Time’s ticking. I got to get out of this shit,” he said.

“Time’s ticking. I got to get out of this shit,” he said.

Then, as if by fate, an apple fell from his tent neighbor’s bag of stolen goods and rolled toward him.&nbsp;

Then, as if by fate, an apple fell from his tent neighbor’s bag of stolen goods and rolled toward him.&nbsp;

“Let me get that,” he muttered, grabbing the apple.&nbsp;

“Let me get that,” he muttered, grabbing the apple.&nbsp;

Without stopping to dust the dirt off its red exterior, he took a squelching bite. Juice ran down his arm, his eyes lit up, and within minutes, the apple was gone and he was reborn.&nbsp;

Without stopping to dust the dirt off its red exterior, he took a squelching bite. Juice ran down his arm, his eyes lit up, and within minutes, the apple was gone and he was reborn.&nbsp;

Now standing upright, pants zipped, he explained why sugar is so popular on the city&#8217;s streets.

Now standing upright, pants zipped, he explained why sugar is so popular on the city's streets.

Now standing upright, pants zipped, he explained why sugar is so popular on the city&#8217;s streets.

“It fills that gap of feeling starving,” Dre said. “It puts your mind at rest.”&nbsp;

“It fills that gap of feeling starving,” Dre said. “It puts your mind at rest.”&nbsp;

Candy, chocolate and ice cream <a href="https://sfstandard.com/2024/03/01/fentanyl-candy-shoplifting/">were recently revealed as favorites</a> among people who use fentanyl and other illegal drugs in San Francisco, becoming <a href="https://sfstandard.com/2024/02/18/candy-sells-faster-fentanyl-san-francisco/">some of the most popular products</a> at the city’s illegal street markets.

Fentanyl users steal ice cream daily, store says. They even have a favorite flavor

Candy sells faster than fentanyl in San Francisco’s open-air drug markets

Candy, chocolate and ice cream <a href="https://sfstandard.com/2024/03/01/fentanyl-candy-shoplifting/">were recently revealed as favorites</a> among people who use fentanyl and other illegal drugs in San Francisco, becoming <a href="https://sfstandard.com/2024/02/18/candy-sells-faster-fentanyl-san-francisco/">some of the most popular products</a> at the city’s illegal street markets.

Easter candy and gummies are displayed on the sidewalk at a street vendor in the Tenderloin neighborhood of San Francisco on Monday, Mar. 11, 2024. Candy and sugary items are prevalent throughout stores and with street vendors in the Tenderloin where opioid use runs high.

<figure class="wp-block-image size-large"><img src="https://content.sfstandard.com/wp-content/uploads/2024/03/20240306-sugarmarketfolo-05.jpg?w=2500" alt="Assorted Easter candies, including Haribo and chocolate bunnies, displayed on the ground." class="wp-image-258123"/><figcaption class="wp-element-caption">Easter candy and gummies are displayed on the sidewalk at a street vendor in the Tenderloin neighborhood of San Francisco on Monday.</figcaption></figure>

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<figure class="wp-block-image size-large"><img src="https://content.sfstandard.com/wp-content/uploads/2024/03/20240306-sugarmarketfolo-05.jpg?w=2500" alt="Assorted Easter candies, including Haribo and chocolate bunnies, displayed on the ground." class="wp-image-258123"/><figcaption class="wp-element-caption">Easter candy and gummies are displayed on the sidewalk at a street vendor in the Tenderloin neighborhood of San Francisco on Monday.</figcaption></figure>

Fentanyl users told The Standard the sugar high helps them survive excruciating withdrawal symptoms. Some said they often go days without eating real food, instead surviving off Starbursts, Snickers and pints of ice cream.&nbsp; However, experts say such a diet is likely worsening symptoms of mental illness experienced on the city&#8217;s streets.

Fentanyl users told The Standard the sugar high helps them survive excruciating withdrawal symptoms. Some said they often go days without eating real food, instead surviving off Starbursts, Snickers and pints of ice cream.&nbsp; However, experts say such a diet is likely worsening symptoms of mental illness experienced on the city's streets.

Fentanyl users told The Standard the sugar high helps them survive excruciating withdrawal symptoms. Some said they often go days without eating real food, instead surviving off Starbursts, Snickers and pints of ice cream.&nbsp; However, experts say such a diet is likely worsening symptoms of mental illness experienced on the city&#8217;s streets.

Relying on sugar for sustenance can cause a person’s brain to move slower, fueling paranoia, according to Stanford University’s Shebani Sethi, an obesity physician and psychiatrist.

Relying on sugar for sustenance can cause a person’s brain to move slower, fueling paranoia, according to Stanford University’s Shebani Sethi, an obesity physician and psychiatrist.

Sethi said she’s witnessed schizophrenic patients see a dramatic drop in hallucinations after making changes to their diet.&nbsp;

Sethi said she’s witnessed schizophrenic patients see a dramatic drop in hallucinations after making changes to their diet.&nbsp;

“What they’re eating is, unfortunately, cheap, processed and easy to get,” Sethi said. “If we treat these metabolic issues, we have an improvement in brain health.”

“What they’re eating is, unfortunately, cheap, processed and easy to get,” Sethi said. “If we treat these metabolic issues, we have an improvement in brain health.”

‘It’s like being back in bed with some ice cream’&nbsp;

<h2 class="wp-block-heading" id="h-it-s-like-being-back-in-bed-with-some-ice-cream-nbsp">‘It’s like being back in bed with some ice cream’&nbsp;</h2>

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<h2 class="wp-block-heading" id="h-it-s-like-being-back-in-bed-with-some-ice-cream-nbsp">‘It’s like being back in bed with some ice cream’&nbsp;</h2>

But people using drugs on the city&#8217;s streets say sugar often serves as a lifeline.

But people using drugs on the city's streets say sugar often serves as a lifeline.

But people using drugs on the city&#8217;s streets say sugar often serves as a lifeline.

“Candy is essential out here,” said James Hawkins, a homeless man in the Tenderloin, who said he hadn’t eaten anything in two days besides a Smuckers Uncrustables sandwich. “It sustains people.”

“Candy is essential out here,” said James Hawkins, a homeless man in the Tenderloin, who said he hadn’t eaten anything in two days besides a Smuckers Uncrustables sandwich. “It sustains people.”

A bag of candy is much easier to carry than other foods. It’s easily stolen or bought for just a few bucks. Although ice cream is more difficult to store because it melts, some say it’s worth the risk because it’s just so delicious.

A bag of candy is much easier to carry than other foods. It’s easily stolen or bought for just a few bucks. Although ice cream is more difficult to store because it melts, some say it’s worth the risk because it’s just so delicious.

“It’s not melting faster than I can eat it,” said a 33-year-old woman who identified herself only as Brittany H.

“It’s not melting faster than I can eat it,” said a 33-year-old woman who identified herself only as Brittany H.

“We all had a home once. It’s like being back in bed with some ice cream,” she said Friday while trying to trade Starburst candy for food and other items on Willow Street.&nbsp;

“We all had a home once. It’s like being back in bed with some ice cream,” she said Friday while trying to trade Starburst candy for food and other items on Willow Street.&nbsp;

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Francesco Leri, an addiction science researcher at Canada’s University of Guelph, said his studies have found a correlation between sugar and drug addiction.

Francesco Leri, an addiction science researcher at Canada’s University of Guelph, said his studies have found a correlation between sugar and drug addiction.

Leri said lab mice with a taste for Oreos were more likely to enjoy cocaine than their counterparts that preferred rice cakes. He said this may point to some people having a greater desire for short-term highs like those afforded by candy and drugs.

Leri said lab mice with a taste for Oreos were more likely to enjoy cocaine than their counterparts that preferred rice cakes. He said this may point to some people having a greater desire for short-term highs like those afforded by candy and drugs.

“Prohibition doesn’t work. Candies will be sold anyway. This is big money,” Leri said. “Education is the best thing we can do.”&nbsp;

“Prohibition doesn’t work. Candies will be sold anyway. This is big money,” Leri said. “Education is the best thing we can do.”&nbsp;

Bags of Haribo gummies hang by the dozens amid several racks full of candy at Cadillac Market in the Tenderloin neighborhood of San Francisco on Monday, Mar. 11, 2024. Candy and sugary items are prevalent throughout stores and with street vendors in the Tenderloin where opioid use runs high.

<figure class="wp-block-image size-large"><img src="https://content.sfstandard.com/wp-content/uploads/2024/03/20240306-sugarmarketfolo-03.jpg?w=2500" alt="A display of colorful candy packages, with Haribo Goldbears at the forefront." class="wp-image-258121"/><figcaption class="wp-element-caption">Bags of Haribo gummies hang by the dozens amid several racks full of candy at Cadillac Market in the Tenderloin neighborhood.</figcaption></figure>

Leri said his own son, who is otherwise healthy and active, eats too many Oreos, causing him concern at home.

Leri said his own son, who is otherwise healthy and active, eats too many Oreos, causing him concern at home.

“This is what I do with my son,” Leri said. “I don’t tell him not to buy those Oreos. I try to explain to him what I know about these behaviors.”

“This is what I do with my son,” Leri said. “I don’t tell him not to buy those Oreos. I try to explain to him what I know about these behaviors.”

Some homeless people told The Standard they don’t eat regularly because they’re too prideful to visit a food bank or because the free food isn’t good.

Some homeless people told The Standard they don’t eat regularly because they’re too prideful to visit a food bank or because the free food isn’t good.

Others are simply ignoring their hunger pains because of their addictions or mental illnesses.

Others are simply ignoring their hunger pains because of their addictions or mental illnesses.

“Everybody has their vices, whether it’s candy, sex, drugs or whatever,” said Shauna Henry, who’s lived on and off the city’s streets since the 1980s. “Maybe we need a 12 steps for candy.”

“Everybody has their vices, whether it’s candy, sex, drugs or whatever,” said Shauna Henry, who’s lived on and off the city’s streets since the 1980s. “Maybe we need a 12 steps for candy.”

Fentanyl is their drug, sugar is their vice. Users explain their desperate need for candy

President Joe Biden and Chinese President Xi Jinping are reportedly set to agree on terms to crack down on the production and distribution of illicit fentanyl from Beijing, <a href="https://www.bloomberg.com/news/articles/2023-11-14/biden-xi-to-announce-deal-for-fentanyl-crackdown-by-china" target="_blank" rel="noreferrer noopener">according to Bloomberg</a>.

President Joe Biden and Chinese President Xi Jinping are reportedly set to agree on terms to crack down on the production and distribution of illicit fentanyl from Beijing, <a href="https://www.bloomberg.com/news/articles/2023-11-14/biden-xi-to-announce-deal-for-fentanyl-crackdown-by-china" target="_blank" rel="noreferrer noopener">according to Bloomberg</a>.

Ahead of their planned meeting on the sidelines of the Asia-Pacific Economic Cooperation summit in San Francisco this week, Xi Jinping and Biden are said to have reached a tentative agreement that would see China crackdown on the companies that make the chemicals used to manufacture the deadly opioid in exchange for the U.S. lifting restrictions on its forensic police institute, an organization the U.S. says is allegedly responsible for human rights abuses, reported Bloomberg, quoting sources close to the deal.

Ahead of their planned meeting on the sidelines of the Asia-Pacific Economic Cooperation summit in San Francisco this week, Xi Jinping and Biden are said to have reached a tentative agreement that would see China crackdown on the companies that make the chemicals used to manufacture the deadly opioid in exchange for the U.S. lifting restrictions on its forensic police institute, an organization the U.S. says is allegedly responsible for human rights abuses, reported Bloomberg, quoting sources close to the deal.

Biden and Xi Jinping will meet on Wednesday as part of the APEC gathering at San Francisco’s Moscone Center.

Biden and Xi Jinping will meet on Wednesday as part of the APEC gathering at San Francisco’s Moscone Center.

The White House announced Monday that Biden would also meet with Mexican President Andrés Manuel López Obrador later this week. The two leaders will discuss the growing migration issue at the U.S.-Mexico border and beyond.

The White House announced Monday that Biden would also meet with Mexican President Andrés Manuel López Obrador later this week. The two leaders will discuss the growing migration issue at the U.S.-Mexico border and beyond.

A San Francisco Police Department (SFPD) vehicle slowly cruises past people congregating near the intersection of Seventh and Market in downtown San Francisco on Oct. 16, 2023. The intersection is known for its open-air drug trade, where fentanyl and other narcotics are bought and sold. 

<figure class="wp-block-image size-large"><img src="https://content.sfstandard.com/wp-content/uploads/2023/10/FEATURED_SeventhMarket102623.jpg?w=2500" alt="A police car shines its lights next to a crowd of people." class="wp-image-215246"/><figcaption class="wp-element-caption">A police vehicle cruises past people congregating near an intersection known for its open-air drug trade, where fentanyl and other narcotics are bought and sold.</figcaption></figure>

Mexico and China are the primary sources of fentanyl and fentanyl-related substances trafficked directly into the U.S., according to the Drug Enforcement Administration. Nearly all the precursor chemicals that are needed to make fentanyl come from China. And the companies that make the precursors routinely use fake return addresses and mislabel the products to avoid being caught by law enforcement.

Mexico and China are the primary sources of fentanyl and fentanyl-related substances trafficked directly into the U.S., according to the Drug Enforcement Administration. Nearly all the precursor chemicals that are needed to make fentanyl come from China. And the companies that make the precursors routinely use fake return addresses and mislabel the products to avoid being caught by law enforcement.

Last week, the Biden administration imposed sanctions on 13 members of Mexico&#8217;s powerful Sinaloa cartel and four Sonora, Mexico-based firms accused of trafficking fentanyl and other drugs into the United States.

Last week, the Biden administration imposed sanctions on 13 members of Mexico's powerful Sinaloa cartel and four Sonora, Mexico-based firms accused of trafficking fentanyl and other drugs into the United States.

Last week, the Biden administration imposed sanctions on 13 members of Mexico&#8217;s powerful Sinaloa cartel and four Sonora, Mexico-based firms accused of trafficking fentanyl and other drugs into the United States.

San Francisco has witnessed a rapid rise in fentanyl abuse in recent years, losing more than 1,900 lives to the drug since January 2020. Local and state law enforcement authorities have led a crackdown on the drug since May.

San Francisco has witnessed a rapid rise in fentanyl abuse in recent years, losing more than 1,900 lives to the drug since January 2020. Local and state law enforcement authorities have led a crackdown on the drug since May.

Gov. Gavin Newsom said he also raised the issue of fentanyl distribution <a href="https://www.gov.ca.gov/2023/10/25/governor-newsom-meets-with-chinese-president-xi-jinping/" target="_blank" rel="noreferrer noopener">during his trip to China in October</a>.

Gov. Gavin Newsom said he also raised the issue of fentanyl distribution <a href="https://www.gov.ca.gov/2023/10/25/governor-newsom-meets-with-chinese-president-xi-jinping/" target="_blank" rel="noreferrer noopener">during his trip to China in October</a>.

Biden to announce China fentanyl crackdown while in San Francisco: Report

Gabe Greschler

Mayoral candidate Daniel Lurie is going on the offensive this week against incumbent London Breed, calling for a &#8220;state of emergency&#8221; to combat the city&#8217;s drug crisis and blasting his opponent as ineffective on the issue. But the mayor immediately fired back, calling Lurie&#8217;s proposals &#8220;embarrassing.&#8221;

Mayoral candidate Daniel Lurie is going on the offensive this week against incumbent London Breed, calling for a "state of emergency" to combat the city's drug crisis and blasting his opponent as ineffective on the issue. But the mayor immediately fired back, calling Lurie's proposals "embarrassing."

Mayoral candidate Daniel Lurie is going on the offensive this week against incumbent London Breed, calling for a &#8220;state of emergency&#8221; to combat the city&#8217;s drug crisis and blasting his opponent as ineffective on the issue. But the mayor immediately fired back, calling Lurie&#8217;s proposals &#8220;embarrassing.&#8221;

Lurie released details Wednesday for a so-called “fentanyl state of emergency” he promised to declare if elected mayor, a move he said could unlock more resources to fight the epidemic of deadly overdoses.

Lurie released details Wednesday for a so-called “fentanyl state of emergency” he promised to declare if elected mayor, a move he said could unlock more resources to fight the epidemic of deadly overdoses.

More than 800 people died of drug overdoses in San Francisco in 2023, though not all of those involved fentanyl.&nbsp;

More than 800 people died of drug overdoses in San Francisco in 2023, though not all of those involved fentanyl.&nbsp;

<a href="https://sfmayor.org/article/mayor-london-breed-declares-state-emergency-tenderloin" target="_blank" rel="noreferrer noopener">In previous emergency declarations</a>, the city was able to waive certain rules around contracting, zoning and planning codes, allowing for rapid construction of facilities aimed at helping drug users. In his call for an emergency declaration Wednesday, Lurie did not go into specifics on how resources would be used but referred back to the <a href="https://www.daniellurie.com/_files/ugd/9a7de0_8781e514c784433ca1aeb5b1455e0e9c.pdf?emci=285f48f3-51ec-ee11-aaf0-002248223794&amp;emdi=d60e3707-68ec-ee11-aaf0-002248223794&amp;ceid=22824365" target="_blank" rel="noreferrer noopener">drug and mental health plan</a> he&nbsp;detailed in February.

<a href="https://sfmayor.org/article/mayor-london-breed-declares-state-emergency-tenderloin" target="_blank" rel="noreferrer noopener">In previous emergency declarations</a>, the city was able to waive certain rules around contracting, zoning and planning codes, allowing for rapid construction of facilities aimed at helping drug users. In his call for an emergency declaration Wednesday, Lurie did not go into specifics on how resources would be used but referred back to the <a href="https://www.daniellurie.com/_files/ugd/9a7de0_8781e514c784433ca1aeb5b1455e0e9c.pdf?emci=285f48f3-51ec-ee11-aaf0-002248223794&amp;emdi=d60e3707-68ec-ee11-aaf0-002248223794&amp;ceid=22824365" target="_blank" rel="noreferrer noopener">drug and mental health plan</a> he&nbsp;detailed in February.

The nonprofit leader and Levi’s heir <a href="https://sfstandard.com/2021/12/17/breed-declares-state-of-emergency-in-the-tenderloin/">also lambasted Breed’s previous attempt at a state of emergency</a> focused on the Tenderloin in December 2021 during heightened criticism over the conditions of San Francisco’s streets during the pandemic.&nbsp;

Breed declares &#8216;state of emergency&#8217; in the Tenderloin to force people into treatment

The nonprofit leader and Levi’s heir <a href="https://sfstandard.com/2021/12/17/breed-declares-state-of-emergency-in-the-tenderloin/">also lambasted Breed’s previous attempt at a state of emergency</a> focused on the Tenderloin in December 2021 during heightened criticism over the conditions of San Francisco’s streets during the pandemic.&nbsp;

Daniel Lurie departs the Department of Elections after filing  paperwork officially announcing his candidacy for mayor at City Hall in San Francisco on Tuesday, Sept. 26, 2023. Lurie, is challenging Mayor London Breed for the position.

<figure class="wp-block-image size-large"><img src="https://content.sfstandard.com/wp-content/uploads/2023/09/LurieForMayor09262023__0267.jpg?w=2500" alt="A man in a suit speaking to a smiling woman in a red jacket, both indoors, with signs and a recycling symbol nearby." class="wp-image-204618"/><figcaption class="wp-element-caption">Daniel Lurie departs the city&#8217;s Department of Elections after filing paperwork officially announcing his candidacy for mayor in September.</figcaption></figure>

<figure class="wp-block-image size-large"><img src="https://content.sfstandard.com/wp-content/uploads/2023/09/LurieForMayor09262023__0267.jpg?w=2500" alt="A man in a suit speaking to a smiling woman in a red jacket, both indoors, with signs and a recycling symbol nearby." class="wp-image-204618"/><figcaption class="wp-element-caption">Daniel Lurie departs the city's Department of Elections after filing paperwork officially announcing his candidacy for mayor in September.</figcaption></figure>

<figure class="wp-block-image size-large"><img src="https://content.sfstandard.com/wp-content/uploads/2023/09/LurieForMayor09262023__0267.jpg?w=2500" alt="A man in a suit speaking to a smiling woman in a red jacket, both indoors, with signs and a recycling symbol nearby." class="wp-image-204618"/><figcaption class="wp-element-caption">Daniel Lurie departs the city&#8217;s Department of Elections after filing paperwork officially announcing his candidacy for mayor in September.</figcaption></figure>

Breed’s announcement then was aimed at cutting bureaucratic red tape and compelling drug users into treatment.&nbsp;The effort was centered around the now-defunct Tenderloin Center, <a href="https://sfstandard.com/2022/11/17/city-funded-survey-says-the-tenderloin-center-improved-the-neighborhood-others-arent-convinced/">which was supposed to be aimed at getting drug users</a> into treatment but was criticized for effectively becoming a “safe consumption site” where people used illicit substances out in the open. It was closed in December 2022.&nbsp;

City-funded survey says the Tenderloin Center improved the neighborhood. Many are unconvinced

Breed’s announcement then was aimed at cutting bureaucratic red tape and compelling drug users into treatment.&nbsp;The effort was centered around the now-defunct Tenderloin Center, <a href="https://sfstandard.com/2022/11/17/city-funded-survey-says-the-tenderloin-center-improved-the-neighborhood-others-arent-convinced/">which was supposed to be aimed at getting drug users</a> into treatment but was criticized for effectively becoming a “safe consumption site” where people used illicit substances out in the open. It was closed in December 2022.&nbsp;

On Wednesday, Lurie claimed the mayor’s efforts focused on the Tenderloin had failed and called for a plan that would be “coordinated, accountable and ensure[s] follow through.” The candidate said he would also create a position in his office to oversee the response.

On Wednesday, Lurie claimed the mayor’s efforts focused on the Tenderloin had failed and called for a plan that would be “coordinated, accountable and ensure[s] follow through.” The candidate said he would also create a position in his office to oversee the response.

But Breed’s campaign questioned the feasibility of Lurie’s proposal, arguing that the city wouldn’t have a legal leg to stand on to declare a local emergency like it did during the pandemic. The city also declared an emergency in 2022 <a href="https://sfstandard.com/2022/10/20/san-francisco-to-end-mpx-public-health-emergency-this-month/">during an outbreak of the monkeypox virus</a>.&nbsp;&nbsp;

San Francisco to end MPX public health emergency this month

But Breed’s campaign questioned the feasibility of Lurie’s proposal, arguing that the city wouldn’t have a legal leg to stand on to declare a local emergency like it did during the pandemic. The city also declared an emergency in 2022 <a href="https://sfstandard.com/2022/10/20/san-francisco-to-end-mpx-public-health-emergency-this-month/">during an outbreak of the monkeypox virus</a>.&nbsp;&nbsp;

Farrell calls for armed National Guard troops in San Francisco to fight fentanyl

2024 brings stiffer penalties for fentanyl dealers in California as overdose crisis rages

“Daniel Lurie’s embarrassing proposals continue to demonstrate his inexperience and lack of basic understanding for how government and policy work,” said Joe Arellano, Breed’s campaign spokesperson. “His solution to addressing the city’s fentanyl crisis is a flimsy local declaration that might not even be legal and [is] hiring one person.”&nbsp;

“Daniel Lurie’s embarrassing proposals continue to demonstrate his inexperience and lack of basic understanding for how government and policy work,” said Joe Arellano, Breed’s campaign spokesperson. “His solution to addressing the city’s fentanyl crisis is a flimsy local declaration that might not even be legal and [is] hiring one person.”&nbsp;

The scrum over how to respond to the fentanyl crisis comes as the mayor has become increasingly skeptical about so-called harm reduction strategies, an approach that aims to combat the negative effects of drug use through public health interventions such as distributing clean needles and overdose reversal medications.

The scrum over how to respond to the fentanyl crisis comes as the mayor has become increasingly skeptical about so-called harm reduction strategies, an approach that aims to combat the negative effects of drug use through public health interventions such as distributing clean needles and overdose reversal medications.

In late February, <a href="https://sfstandard.com/2024/02/26/mayor-takes-aim-at-harm-reduction-says-strategy-has-furthered-fentanyl-crisis/">Breed offered her harshest criticism yet of the strategy</a>, saying, “Harm reduction, from my perspective, is not reducing the harm. It is making things worse.” Advocates of harm reduction have pushed back, saying the approach is in line with public health best practices and that the mayor is using the issue for political means as concerns around homelessness, public drug use and crime continue to be central issues for voters.&nbsp;

Breed blames harm reduction strategy for surging drug overdose deaths

In late February, <a href="https://sfstandard.com/2024/02/26/mayor-takes-aim-at-harm-reduction-says-strategy-has-furthered-fentanyl-crisis/">Breed offered her harshest criticism yet of the strategy</a>, saying, “Harm reduction, from my perspective, is not reducing the harm. It is making things worse.” Advocates of harm reduction have pushed back, saying the approach is in line with public health best practices and that the mayor is using the issue for political means as concerns around homelessness, public drug use and crime continue to be central issues for voters.&nbsp;

Mayor London Breed speaks  outside of City Hall during the "March to Prevent Fentanyl Deaths" in San Francisco on Monday, Feb. 26, 2024. Hundreds of people marched to raise awareness of the dangers of fentanyl and promote resources for those experiencing addiction.

<figure class="wp-block-image size-large"><img src="https://content.sfstandard.com/wp-content/uploads/2024/02/20240227-fentanylmarch-10.jpg?w=2500" alt="A woman speaks at a podium marked &quot;CITY HALL&quot; with onlookers behind her, some wearing shirts with &quot;UNITE&quot; and &quot;SAVE&quot; visible." class="wp-image-252859"/><figcaption class="wp-element-caption">Mayor London Breed speaks outside of City Hall during the &#8220;March to Prevent Fentanyl Deaths&#8221; in San Francisco on Feb. 26.</figcaption></figure>

<figure class="wp-block-image size-large"><img src="https://content.sfstandard.com/wp-content/uploads/2024/02/20240227-fentanylmarch-10.jpg?w=2500" alt="A woman speaks at a podium marked &quot;CITY HALL&quot; with onlookers behind her, some wearing shirts with &quot;UNITE&quot; and &quot;SAVE&quot; visible." class="wp-image-252859"/><figcaption class="wp-element-caption">Mayor London Breed speaks outside of City Hall during the "March to Prevent Fentanyl Deaths" in San Francisco on Feb. 26.</figcaption></figure>

<figure class="wp-block-image size-large"><img src="https://content.sfstandard.com/wp-content/uploads/2024/02/20240227-fentanylmarch-10.jpg?w=2500" alt="A woman speaks at a podium marked &quot;CITY HALL&quot; with onlookers behind her, some wearing shirts with &quot;UNITE&quot; and &quot;SAVE&quot; visible." class="wp-image-252859"/><figcaption class="wp-element-caption">Mayor London Breed speaks outside of City Hall during the &#8220;March to Prevent Fentanyl Deaths&#8221; in San Francisco on Feb. 26.</figcaption></figure>

The March 5 election <a href="https://sfstandard.com/2024/03/05/san-francisco-election-results-prop-f-drug-welfare/">offered the latest litmus test on the shifting public opinion about drug use after voters approved Prop. F</a>. The ballot measure requires some welfare recipients suspected of using illicit substances to go through screening and treatment—or risk losing their cash subsidy.

Prop. F, requiring drug screening for welfare aid, approved by voters

The March 5 election <a href="https://sfstandard.com/2024/03/05/san-francisco-election-results-prop-f-drug-welfare/">offered the latest litmus test on the shifting public opinion about drug use after voters approved Prop. F</a>. The ballot measure requires some welfare recipients suspected of using illicit substances to go through screening and treatment—or risk losing their cash subsidy.

Gina McDonald, a member of Mothers Against Drug Addiction and Deaths, said that whoever clinches the mayor’s seat needs to ensure that the city’s vast bureaucracy is actually working together.

Gina McDonald, a member of Mothers Against Drug Addiction and Deaths, said that whoever clinches the mayor’s seat needs to ensure that the city’s vast bureaucracy is actually working together.

“It has to be an all hands on deck between law enforcement, public health and the Mayor’s Office,” McDonald said in an interview. “And I feel like they’re all not working in tandem. It feels like everyone is throwing spaghetti against the wall.”

“It has to be an all hands on deck between law enforcement, public health and the Mayor’s Office,” McDonald said in an interview. “And I feel like they’re all not working in tandem. It feels like everyone is throwing spaghetti against the wall.”

A ‘fentanyl state of emergency’? Mayoral candidates argue over plan

Fentanyl users living on the Tenderloin’s streets say they’ve had enough. Many are chronically sick. They face near-constant scrutiny from law enforcement. And now, the drugs don’t work like they used to. San Francisco’s fentanyl purity has dropped over the past few months, according to more than a dozen Tenderloin drug users and the U.S. Drug Enforcement Administration. The supply is diluted with unknown chemicals, plastics, and hygiene products, they say, <a href="https://sfstandard.com/2024/08/12/fentanyl-soap-purity/">earning the weaker drugs a new nickname: “soap”</a>.

Weak fentanyl named &#8216;soap&#8217; is flooding the market — and spurring robberies

Fentanyl users living on the Tenderloin’s streets say they’ve had enough. Many are chronically sick. They face near-constant scrutiny from law enforcement. And now, the drugs don’t work like they used to. San Francisco’s fentanyl purity has dropped over the past few months, according to more than a dozen Tenderloin drug users and the U.S. Drug Enforcement Administration. The supply is diluted with unknown chemicals, plastics, and hygiene products, they say, <a href="https://sfstandard.com/2024/08/12/fentanyl-soap-purity/">earning the weaker drugs a new nickname: “soap”</a>.

As the city <a href="https://sfstandard.com/2023/09/04/over-220-pounds-of-drugs-seized-in-3-months-in-san-franciscos-tenderloin-soma-neighborhoods/">launched a crackdown</a> on visible drug markets last year, overdose totals climbed to <a href="https://sfstandard.com/2023/12/14/san-francisco-overdose-drug-death-worst-year/">record numbers</a>. But now, rehabs are seeing&nbsp;a surge in patients, and overdose fatalities are down over the past three months — though still alarmingly high — <a href="https://www.npr.org/2024/09/18/nx-s1-5107417/overdose-fatal-fentanyl-death-opioid">in line with the national trend</a>.&nbsp;

Over 220 pounds of drugs seized in 3 months in San Francisco&#8217;s Tenderloin, SoMa neighborhoods

San Francisco suffers worst drug overdose death year on record

As the city <a href="https://sfstandard.com/2023/09/04/over-220-pounds-of-drugs-seized-in-3-months-in-san-franciscos-tenderloin-soma-neighborhoods/">launched a crackdown</a> on visible drug markets last year, overdose totals climbed to <a href="https://sfstandard.com/2023/12/14/san-francisco-overdose-drug-death-worst-year/">record numbers</a>. But now, rehabs are seeing&nbsp;a surge in patients, and overdose fatalities are down over the past three months — though still alarmingly high — <a href="https://www.npr.org/2024/09/18/nx-s1-5107417/overdose-fatal-fentanyl-death-opioid">in line with the national trend</a>.&nbsp;

There were 248 rehab admissions between April and June — the most since at least January 2021, <a href="https://app.powerbigov.us/view?r=eyJrIjoiNTlhNWQzMDItZDA2Yy00ZTkxLTk3NWUtZGNiNGNmY2Q1YzQ0IiwidCI6IjIyZDVjMmNmLWNlM2UtNDQzZC05YTdmLWRmY2MwMjMxZjczZiJ9&amp;pageName=ReportSection085cc28cbaffa9384119">data show</a>. And many street drug users say the lifestyle they once had is dead.

There were 248 rehab admissions between April and June — the most since at least January 2021, <a href="https://app.powerbigov.us/view?r=eyJrIjoiNTlhNWQzMDItZDA2Yy00ZTkxLTk3NWUtZGNiNGNmY2Q1YzQ0IiwidCI6IjIyZDVjMmNmLWNlM2UtNDQzZC05YTdmLWRmY2MwMjMxZjczZiJ9&amp;pageName=ReportSection085cc28cbaffa9384119">data show</a>. And many street drug users say the lifestyle they once had is dead.

“It’s not fun anymore,” said Carmen Sierra. “The drugs we’re doing have gone so far away from what we were originally trying to do.”&nbsp;

“It’s not fun anymore,” said Carmen Sierra. “The drugs we’re doing have gone so far away from what we were originally trying to do.”&nbsp;

Drug users say the purity of fentanyl in the city has decreased in recent months.

<figure class="wp-block-image size-large"><img src="https://content.sfstandard.com/wp-content/uploads/2024/08/dsc07171.jpg?w=2500" alt="A person's hand is holding a crumpled piece of foil and a worn blue straw, with a bottle in the background and seated legs on a concrete surface." class="wp-image-300140"/><figcaption class="wp-element-caption">Drug users say the purity of fentanyl in the city has decreased in recent months.</figcaption></figure>

Several drug users who spoke to The Standard speculated that enforcement of dealing — which has amounted to nearly 1,300 arrests and the removal of 540 pounds of drugs since May 2023 — has forced a drop in purity.

Several drug users who spoke to The Standard speculated that enforcement of dealing — which has amounted to nearly 1,300 arrests and the removal of 540 pounds of drugs since May 2023 — has forced a drop in purity.

“It tastes like Fisherman’s Wharf,” a man who gave the name Apache said of the fentanyl. “It tastes the way a wet inner tube smells.”

“It tastes like Fisherman’s Wharf,” a man who gave the name Apache said of the fentanyl. “It tastes the way a wet inner tube smells.”

DEA data show that fentanyl purity across California has dropped to 23% from 29% last year. City health and law enforcement officials have refused to speculate as to why.&nbsp;

DEA data show that fentanyl purity across California has dropped to 23% from 29% last year. City health and law enforcement officials have refused to speculate as to why.&nbsp;

The Department of Public Health has deployed street medics, expanded hours at intake centers, opened hundreds of new treatment beds and deregulated prescriptions to withdrawal medications. Gary McCoy, a spokesperson for San Francisco’s largest drug treatment nonprofit, HealthRIGHT 360, said his organization has fixed staffing issues that <a href="https://sfstandard.com/2023/09/27/half-of-san-francisco-drug-users-seeking-treatment-werent-admitted-data-shows-its-scandalous/">caused patients to be turned away</a> by raising salaries and investing in recruitment.

Half of San Francisco drug users seeking treatment weren’t admitted, data shows: ‘it’s scandalous’

The Department of Public Health has deployed street medics, expanded hours at intake centers, opened hundreds of new treatment beds and deregulated prescriptions to withdrawal medications. Gary McCoy, a spokesperson for San Francisco’s largest drug treatment nonprofit, HealthRIGHT 360, said his organization has fixed staffing issues that <a href="https://sfstandard.com/2023/09/27/half-of-san-francisco-drug-users-seeking-treatment-werent-admitted-data-shows-its-scandalous/">caused patients to be turned away</a> by raising salaries and investing in recruitment.

The city has also dramatically increased its distribution of naloxone, an overdose reversal drug, distributing more than twice the number of doses in the first half of this year than in all of 2021.

The city has also dramatically increased its distribution of naloxone, an overdose reversal drug, distributing more than twice the number of doses in the first half of this year than in all of 2021.

A total of 462 people died of overdoses in San Francisco over the first eight months of this year, roughly 20% less than at this point last year. The Department of Public Health said it has seen a 35% increase in treatment admissions, a 32% increase in methadone prescriptions, and a 46% increase in people accessing buprenorphine so far this year.

A total of 462 people died of overdoses in San Francisco over the first eight months of this year, roughly 20% less than at this point last year. The Department of Public Health said it has seen a 35% increase in treatment admissions, a 32% increase in methadone prescriptions, and a 46% increase in people accessing buprenorphine so far this year.

Weak fentanyl named ‘soap’ is flooding the market — and spurring robberies

Bodies in streets, parks, buses: The everyday horror of stumbling on an overdose victim

Daniel Ciccarone, an addiction researcher at UC San Francisco, speculated that the decrease in fentanyl purity — and the corresponding decline in overdoses — may be traced to “supply shock” caused by the Sinaloa cartel’s <a href="https://www.wsj.com/world/americas/mexican-sinaloa-cartels-message-to-members-stop-making-fentanyl-or-die-b96d3e09">apparent ban on the sale of the drug</a> last year.

Daniel Ciccarone, an addiction researcher at UC San Francisco, speculated that the decrease in fentanyl purity — and the corresponding decline in overdoses — may be traced to “supply shock” caused by the Sinaloa cartel’s <a href="https://www.wsj.com/world/americas/mexican-sinaloa-cartels-message-to-members-stop-making-fentanyl-or-die-b96d3e09">apparent ban on the sale of the drug</a> last year.

Ciccarone noted that local efforts may play a role. But because the decline in deaths happened suddenly, instead of over an extended period, he pointed to the cartel bowing out.

Ciccarone noted that local efforts may play a role. But because the decline in deaths happened suddenly, instead of over an extended period, he pointed to the cartel bowing out.

“It could be that everyone should get a slap on the back,” Ciccarone said. “But it looks a lot like a supply shock to me.”

“It could be that everyone should get a slap on the back,” Ciccarone said. “But it looks a lot like a supply shock to me.”

<h2 class="wp-block-heading" id="h-i-can-t-keep-living-like-this">‘I can’t keep living like this’</h2>

Some users say the lower fentanyl potency is responsible for a rise <a href="https://sfstandard.com/2024/08/12/fentanyl-soap-purity/">in chaos on the streets</a>. Others say it has inspired them to leave the streets behind.

Some users say the lower fentanyl potency is responsible for a rise <a href="https://sfstandard.com/2024/08/12/fentanyl-soap-purity/">in chaos on the streets</a>. Others say it has inspired them to leave the streets behind.

Michael Butler, who has been homeless in San Francisco for 10 years, said he recently applied for a methadone prescription, explaining that he no longer finds satisfaction in his drug habit.&nbsp;

Michael Butler, who has been homeless in San Francisco for 10 years, said he recently applied for a methadone prescription, explaining that he no longer finds satisfaction in his drug habit.&nbsp;

“I can’t keep living like this,” said Butler. “I want to do landscaping. I want to get a job and be an active part of society.”&nbsp;

“I can’t keep living like this,” said Butler. “I want to do landscaping. I want to get a job and be an active part of society.”&nbsp;

But some drug users told The Standard&nbsp;they worry that a strong dose of fentanyl could cause an overdose while their tolerance is low. A few warned that a potent batch hit the streets last week.

But some drug users told The Standard&nbsp;they worry that a strong dose of fentanyl could cause an overdose while their tolerance is low. A few warned that a potent batch hit the streets last week.

A man named Austin prepares a dose of fentanyl to smoke.

<figure class="wp-block-image size-large"><img src="https://content.sfstandard.com/wp-content/uploads/2024/09/dsc07296.jpg?w=808" alt="A man in a cap and denim jacket sits on a curb, looking down and holding tools. He is in an urban area with brick buildings and trees visible in the background." class="wp-image-313178"/><figcaption class="wp-element-caption">A man named Austin prepares a dose of fentanyl to smoke.</figcaption></figure>

“Who needs good fire? I got fire fentanyl,” a dealer announced Tuesday as he strolled down Ellis Street.&nbsp;

“Who needs good fire? I got fire fentanyl,” a dealer announced Tuesday as he strolled down Ellis Street.&nbsp;

A man named Austin offered the dealer a pair of Adidas sneakers for the strong stuff. Neil Leuthold, a 52-year-old who has been homeless in San Francisco for more than 30 years, offered a dab nail, used to smoke drugs.

A man named Austin offered the dealer a pair of Adidas sneakers for the strong stuff. Neil Leuthold, a 52-year-old who has been homeless in San Francisco for more than 30 years, offered a dab nail, used to smoke drugs.

Austin turned to this reporter.&nbsp;

“You got a few bucks, David?” Austin asked. “We could test the quality for you right now.”

“You got a few bucks, David?” Austin asked. “We could test the quality for you right now.”

“Gosh, I really wish I had it,” Luethold said. “I’ve had a bag of shit all day.”&nbsp;

“Gosh, I really wish I had it,” Luethold said. “I’ve had a bag of shit all day.”&nbsp;

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