Chris Roberts

California Gov. Gavin Newsom, declaring himself &#8220;<a href="https://www.sfchronicle.com/sf/bayarea/heatherknight/article/Gavin-Newsom-Care-Court-mental-health-16973070.php">disgusted</a>&#8221; with the state of San Francisco’s streets, last week jumped into a fraught debate over how to combat the drug addiction crisis with a new program that would allow judges to sentence those with substance abuse and mental health issues to treatment.&nbsp;&nbsp;

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<p>California Gov. Gavin Newsom, declaring himself "<a href="https://www.sfchronicle.com/sf/bayarea/heatherknight/article/Gavin-Newsom-Care-Court-mental-health-16973070.php">disgusted</a>" with the state of San Francisco’s streets, last week jumped into a fraught debate over how to combat the drug addiction crisis with a new program that would allow judges to sentence those with substance abuse and mental health issues to treatment.&nbsp;&nbsp;</p>

<p>California Gov. Gavin Newsom, declaring himself &#8220;<a href="https://www.sfchronicle.com/sf/bayarea/heatherknight/article/Gavin-Newsom-Care-Court-mental-health-16973070.php">disgusted</a>&#8221; with the state of San Francisco’s streets, last week jumped into a fraught debate over how to combat the drug addiction crisis with a new program that would allow judges to sentence those with substance abuse and mental health issues to treatment.&nbsp;&nbsp;</p>

Newsom’s <a href="https://sfstandard.com/public-health-safety/homelessness/explainer-gov-newsoms-controversial-plan-to-compel-people-into-drug-mental-health-treatment/">CARE Court program</a>, which he plugged once again in his <a href="https://www.youtube.com/watch?v=GDKPJHkK520">State of the State Address</a> Tuesday night and still requires approval by the legislature, is the latest push from politicians intent on helping those deemed unable or unwilling to help themselves. It comes a little over two months after current Mayor London Breed garnered national attention by <a href="https://sfstandard.com/public-health/breed-declares-state-of-emergency-in-the-tenderloin/">declaring a state of emergency in the city’s Tenderloin</a> district and vowing to end the city’s de-facto tolerance of public drug sales and consumption—or, as she put it, <a href="https://sfstandard.com/city-hall/mayor-announces-crackdown-on-tenderloin-crime-in-fiery-press-conference/">“all the bullshit that has destroyed our city.”</a>

<p>Newsom’s <a href="https://sfstandard.com/public-health-safety/homelessness/explainer-gov-newsoms-controversial-plan-to-compel-people-into-drug-mental-health-treatment/">CARE Court program</a>, which he plugged once again in his <a href="https://www.youtube.com/watch?v=GDKPJHkK520">State of the State Address</a> Tuesday night and still requires approval by the legislature, is the latest push from politicians intent on helping those deemed unable or unwilling to help themselves. It comes a little over two months after current Mayor London Breed garnered national attention by <a href="https://sfstandard.com/public-health/breed-declares-state-of-emergency-in-the-tenderloin/">declaring a state of emergency in the city’s Tenderloin</a> district and vowing to end the city’s de-facto tolerance of public drug sales and consumption—or, as she put it, <a href="https://sfstandard.com/city-hall/mayor-announces-crackdown-on-tenderloin-crime-in-fiery-press-conference/">“all the bullshit that has destroyed our city.”</a></p>

Breed’s suggestion that extra police officers would <a href="https://missionlocal.org/2022/01/mayor-breeds-prior-tenderloin-police-blitzes-promised-lots-delivered-little/">be deployed to the Tenderloin</a> to arrest more drug dealers in the area—already the city’s epicenter for drug arrests—struck a nerve. So did her declaration that anyone caught using drugs out in the open would be presented with two options: get help or go to jail.&nbsp;

<p>Breed’s suggestion that extra police officers would <a href="https://missionlocal.org/2022/01/mayor-breeds-prior-tenderloin-police-blitzes-promised-lots-delivered-little/">be deployed to the Tenderloin</a> to arrest more drug dealers in the area—already the city’s epicenter for drug arrests—struck a nerve. So did her declaration that anyone caught using drugs out in the open would be presented with two options: get help or go to jail.&nbsp;</p>

“We are not giving people the choice anymore,” she said. “We are not going to walk by and let someone use in broad daylight.”

<p>“We are not giving people the choice anymore,” she said. “We are not going to walk by and let someone use in broad daylight.”</p>

A man wearing multiple hospital wristbands, including a yellow “Fall Risk” bracelet, sleeps on the ground in the Tenderloin on March 5, 2022. | Dan Fenstermacher


<figure class="wp-block-image size-large"><img src="https://content.sfstandard.com/wp-content/uploads/2022/03/TenderloinCompelledTreatment_DanFenstermacher_SFS-22-2500x1667.jpg" alt="" class="wp-image-41483"/><figcaption><em>A man wearing multiple hospital wristbands, including a yellow “Fall Risk” bracelet, sleeps on the ground in the Tenderloin on March 5, 2022. | Dan Fenstermacher</em></figcaption></figure>


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<figure class="wp-block-image size-large"><img src="https://content.sfstandard.com/wp-content/uploads/2022/03/TenderloinCompelledTreatment_DanFenstermacher_SFS-22-2500x1667.jpg" alt="" class="wp-image-41483"/><figcaption><em>A man wearing multiple hospital wristbands, including a yellow “Fall Risk” bracelet, sleeps on the ground in the Tenderloin on March 5, 2022. | Dan Fenstermacher</em></figcaption></figure>

Breed’s speech was interpreted as an endorsement of what centrist Democrats, moderate Republicans and desperate family members of people with intractable substance-abuse problems across the country are demanding—a legally binding means of forcing people to address their addiction problems.

<p>Breed’s speech was interpreted as an endorsement of what centrist Democrats, moderate Republicans and desperate family members of people with intractable substance-abuse problems across the country are demanding—a legally binding means of forcing people to address their addiction problems.</p>

Embraced by President Joe Biden during the 2020 election cycle, “mandatory treatment” is framed as a kinder and gentler alternative to imprisonment and a responsible way to address the ugly status quo in neighborhoods like the Tenderloin or Skid Row in Los Angeles. Many drug addiction specialists disagree, pointing to research that concludes forced treatment doesn’t work, and even going so far as to call it incarceration in disguise.

<p>Embraced by President Joe Biden during the 2020 election cycle, “mandatory treatment” is framed as a kinder and gentler alternative to imprisonment and a responsible way to address the ugly status quo in neighborhoods like the Tenderloin or Skid Row in Los Angeles. Many drug addiction specialists disagree, pointing to research that concludes forced treatment doesn’t work, and even going so far as to call it incarceration in disguise.</p>

In San Francisco, efforts to force people into rehab are further complicated by logistical issues—it’s not clear whether there are enough treatment beds, even for those who <em>want</em> them—as well as medical questions. While some treatment programs offer patients drugs like methadone or Suboxone to help manage withdrawal symptoms, others expect people to go cold turkey.

<p>In San Francisco, efforts to force people into rehab are further complicated by logistical issues—it’s not clear whether there are enough treatment beds, even for those who <em>want</em> them—as well as medical questions. While some treatment programs offer patients drugs like methadone or Suboxone to help manage withdrawal symptoms, others expect people to go cold turkey.</p>

Add it all up, and a policy conundrum emerges: Mandatory treatment is an increasingly popular talking point and a seemingly common-sense approach to the twin crises of opioid overdoses and <a href="https://www.sfexaminer.com/findings/meth-san-franciscos-drug-crisis-within-a-drug-crisis/">ballooning stimulant abuse</a>. Yet many experts in the field reject the approach, and it is far from clear if and how it might ultimately make a difference, either for individual drug users or for conditions on the city’s streets.

<p>Add it all up, and a policy conundrum emerges: Mandatory treatment is an increasingly popular talking point and a seemingly common-sense approach to the twin crises of opioid overdoses and <a href="https://www.sfexaminer.com/findings/meth-san-franciscos-drug-crisis-within-a-drug-crisis/">ballooning stimulant abuse</a>. Yet many experts in the field reject the approach, and it is far from clear if and how it might ultimately make a difference, either for individual drug users or for conditions on the city’s streets.</p>


<h4 class="wp-block-heading" id="h-tough-love"><strong>Tough Love</strong></h4>


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<h4 id="h-tough-love"><strong>Tough Love</strong></h4>

Currently, in the United States, substance use disorder is grounds for involuntary commitment in more than 30 states. Allowing a nonviolent offender to choose treatment over jail is already a key component of diversion programs in San Francisco.<br>Proponents say mandatory treatment would help make San Francisco a place where it’s easy to get well, instead of merely get high. When juxtaposed against the city’s grim death toll from drug overdoses—1,350 people dead over the past two years, almost double the deaths attributed to Covid, <a href="https://sf.gov/news/sf-drug-overdoses-decline-first-time-three-years-city-overdose-prevention-efforts-intensify">according to the San Francisco Department of Public Health</a>—using the police and the courts to herd recalcitrant drug users into treatment looks to many like the humane choice.

<p>Currently, in the United States, substance use disorder is grounds for involuntary commitment in more than 30 states. Allowing a nonviolent offender to choose treatment over jail is already a key component of diversion programs in San Francisco.<br>Proponents say mandatory treatment would help make San Francisco a place where it’s easy to get well, instead of merely get high. When juxtaposed against the city’s grim death toll from drug overdoses—1,350 people dead over the past two years, almost double the deaths attributed to Covid, <a href="https://sf.gov/news/sf-drug-overdoses-decline-first-time-three-years-city-overdose-prevention-efforts-intensify">according to the San Francisco Department of Public Health</a>—using the police and the courts to herd recalcitrant drug users into treatment looks to many like the humane choice.</p>

Officer O’Brien speaks through a glass window with a woman reporting a sexual assault on March 5, 2022 at the Tenderloin Police Station. The alleged attack occurred in the Tenderloin in the previous week. | Dan Fenstermacher


<figure class="wp-block-image size-large"><img src="https://content.sfstandard.com/wp-content/uploads/2022/03/TenderloinCompelledTreatment_DanFenstermacher_SFS-2-2500x1667.jpg" alt="" class="wp-image-41480"/><figcaption><em>Officer O’Brien speaks through a glass window with a woman reporting an alleged sexual assault on March 5, 2022 at the Tenderloin Police Station. | Dan Fenstermacher</em></figcaption></figure>


Mandatory treatment is having a moment locally, in part due to some very vocal advocates. Chief among them is Michael Shellenberger, the Berkeley-based author of the <a href="https://sfstandard.com/perspectives/dueling-perspectives-sanfransicko/">anti-progressive polemic<em> San Fransicko</em></a>, who argues that hands-off “harm reduction” programs—which emphasizes keeping users healthy through efforts such as needle exchanges and <a href="https://sfstandard.com/public-health/safe-consumption-controversy/">supervised consumption sites</a>, rather than threatening them with punishment—is what created the Tenderloin’s sidewalk morality play. Mandatory treatment is a key mechanism for ending the mayhem, he argues.<br>And San Francisco isn’t the only place where the idea is gaining ground. <a href="https://vancouversun.com/news/daphne-bramham-compulsory-addiction-treatment-high-on-canadians-priority-list">Recent polling reveals</a> compulsory treatment is extremely popular in Canada, even as the country has embraced a full range of harm reduction programs that in some cities extends even to guaranteeing <a href="https://time.com/6108812/drug-deaths-safe-supply-opioids/">a clean supply of heroin and other drugs</a>.

<p>Mandatory treatment is having a moment locally, in part due to some very vocal advocates. Chief among them is Michael Shellenberger, the Berkeley-based author of the <a href="https://sfstandard.com/perspectives/dueling-perspectives-sanfransicko/">anti-progressive polemic<em> San Fransicko</em></a>, who argues that hands-off “harm reduction” programs—which emphasizes keeping users healthy through efforts such as needle exchanges and <a href="https://sfstandard.com/public-health/safe-consumption-controversy/">supervised consumption sites</a>, rather than threatening them with punishment—is what created the Tenderloin’s sidewalk morality play. Mandatory treatment is a key mechanism for ending the mayhem, he argues.<br>And San Francisco isn’t the only place where the idea is gaining ground. <a href="https://vancouversun.com/news/daphne-bramham-compulsory-addiction-treatment-high-on-canadians-priority-list">Recent polling reveals</a> compulsory treatment is extremely popular in Canada, even as the country has embraced a full range of harm reduction programs that in some cities extends even to guaranteeing <a href="https://time.com/6108812/drug-deaths-safe-supply-opioids/">a clean supply of heroin and other drugs</a>.</p>

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<blockquote class="twitter-tweet" data-width="500" data-dnt="true"><p lang="en" dir="ltr">If we truly care about the lives being lost on the streets we need to persuade our fellow citizens not just that the lives of addicts and the untreated mentally ill matter, but also that many of them can only be saved by police officers arresting them.<br><br>/END</p>&mdash; Michael Shellenberger (@shellenberger) <a href="https://twitter.com/shellenberger/status/1495796480019693569?ref_src=twsrc%5Etfw">February 21, 2022</a></blockquote><script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>

Powerful anecdotes help make the case for forced treatment. Tom Wolf, a recovering opioid addict who spent time homeless in the Tenderloin, <a href="https://sfstandard.com/public-health-safety/recovering-heroin-addict-san-francisco-failing-drug-users/">credits the police officer</a> who arrested him in 2018—triggering a journey from county jail, where he was forced to stay clean, to rehab and onto sobriety, where he is today—with saving his life.&nbsp;

<p>Powerful anecdotes help make the case for forced treatment. Tom Wolf, a recovering opioid addict who spent time homeless in the Tenderloin, <a href="https://sfstandard.com/public-health-safety/recovering-heroin-addict-san-francisco-failing-drug-users/">credits the police officer</a> who arrested him in 2018—triggering a journey from county jail, where he was forced to stay clean, to rehab and onto sobriety, where he is today—with saving his life.&nbsp;</p>

Wolf’s experience has turned him into a minor local celebrity. He is frequently quoted in the media, and he appears as a main character in <em>San Fransicko</em>. Wolf is also featured in a new documentary alongside celebrity doctor <a href="https://www.dailynews.com/2021/04/18/dr-drew-pinskys-nomination-to-la-countys-homeless-commission-sparks-pushback/">Drew “Dr. Drew” Pinsky</a>, a mandatory-treatment advocate who was briefly floated as a candidate for Los Angeles County’s homeless commission.

<p>Wolf’s experience has turned him into a minor local celebrity. He is frequently quoted in the media, and he appears as a main character in <em>San Fransicko</em>. Wolf is also featured in a new documentary alongside celebrity doctor <a href="https://www.dailynews.com/2021/04/18/dr-drew-pinskys-nomination-to-la-countys-homeless-commission-sparks-pushback/">Drew “Dr. Drew” Pinsky</a>, a mandatory-treatment advocate who was briefly floated as a candidate for Los Angeles County’s homeless commission.</p>

Wolf himself is presented as a folksy data point supporting involuntary treatment—even though he admits that voluntary treatment is preferable.

<p>Wolf himself is presented as a folksy data point supporting involuntary treatment—even though he admits that voluntary treatment is preferable.</p>

“I can line up at least 10 people right now that got clean in handcuffs. But voluntary treatment is always better,” he said in an interview with The Standard.

<p>“I can line up at least 10 people right now that got clean in handcuffs. But voluntary treatment is always better,” he said in an interview with The Standard.</p>

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Wolf went into involuntary treatment via a city drug court. Of the 90 people who started his abstinence-based Salvation Army rehab program, 22 completed it, he said, although one of the 22 recently relapsed and is currently in treatment at Walden House.&nbsp;

<p>Wolf went into involuntary treatment via a city drug court. Of the 90 people who started his abstinence-based Salvation Army rehab program, 22 completed it, he said, although one of the 22 recently relapsed and is currently in treatment at Walden House.&nbsp;</p>

Then again, he continued, “Here I am, four years later, clean and sober. How’s that for evidence, buddy?”

<p>Then again, he continued, “Here I am, four years later, clean and sober. How’s that for evidence, buddy?”</p>

Addiction medicine specialists generally agree that entering treatment voluntarily is far more likely to succeed than any form of coercion, but some support for “tough love” approaches can also be found in academic circles. Keith Humphreys, a professor of psychiatry and behavioral sciences at Stanford University who studies addiction and has helped lay the intellectual foundation for drug-policy reforms including marijuana legalization, is among those who say it can work.

<p>Addiction medicine specialists generally agree that entering treatment voluntarily is far more likely to succeed than any form of coercion, but some support for “tough love” approaches can also be found in academic circles. Keith Humphreys, a professor of psychiatry and behavioral sciences at Stanford University who studies addiction and has helped lay the intellectual foundation for drug-policy reforms including marijuana legalization, is among those who say it can work.</p>

He points to a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3578041/">2015 article in the Journal of Substance Abuse Treatment</a> which found that among 160 people enrolled in treatment between 2007 and 2010, “those who were mandated” were more likely to finish their programs.

<p>He points to a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3578041/">2015 article in the Journal of Substance Abuse Treatment</a> which found that among 160 people enrolled in treatment between 2007 and 2010, “those who were mandated” were more likely to finish their programs.</p>

“People are surprised by this only if they assume the typical person in addiction treatment came in with no pressure on them whatsoever, but that is rare,” he said in an email. “Usually the boss, the spouse, the kids leaned on them to go, or the grim reaper did when their doctor said, ‘I’ve looked at your liver tests, and if you keep this up, you won’t last another year.’”

<p>“People are surprised by this only if they assume the typical person in addiction treatment came in with no pressure on them whatsoever, but that is rare,” he said in an email. “Usually the boss, the spouse, the kids leaned on them to go, or the grim reaper did when their doctor said, ‘I’ve looked at your liver tests, and if you keep this up, you won’t last another year.’”</p>

“A court-mandate is formalized pressure,” he added. “But most people are under pressure of some form.”

<p>“A court-mandate is formalized pressure,” he added. “But most people are under pressure of some form.”</p>

<strong>Politics &amp; Practicality</strong>


<h4 class="wp-block-heading"><strong>Politics &amp; Practicality</strong></h4>


<h4><strong>Politics &amp; Practicality</strong></h4>

Statistically speaking, most efforts at treatment for substance-abuse fail. Half of people who enter treatment <a href="https://pubmed.ncbi.nlm.nih.gov/23995204/">don’t last a month</a> before they’re out of rehab and off the wagon. Some are kicked out for breaking curfew or relapsing. Others are simply disinterested in whatever was on offer.<br><br>Some programs are “abstinence-based,” meaning a client fails and is kicked out if they relapse at any time during their stay, be it three weeks or ninety days.<br>Other programs offer what drug researchers call “evidence-based” treatment—that is, approaches current medical science says are most likely to work. For opioid users, evidence-based treatment would offer them opioid agonists like Suboxone, <a href="https://www.health.harvard.edu/blog/5-myths-about-using-suboxone-to-treat-opiate-addiction-2018032014496">a drug</a> that combines a long-release opioid, buprenorphine, with the overdose-reversing drug naloxone, better known by its brand name, Narcan.

<p>Statistically speaking, most efforts at treatment for substance-abuse fail. Half of people who enter treatment <a href="https://pubmed.ncbi.nlm.nih.gov/23995204/">don’t last a month</a> before they’re out of rehab and off the wagon. Some are kicked out for breaking curfew or relapsing. Others are simply disinterested in whatever was on offer.<br><br>Some programs are “abstinence-based,” meaning a client fails and is kicked out if they relapse at any time during their stay, be it three weeks or ninety days.<br>Other programs offer what drug researchers call “evidence-based” treatment—that is, approaches current medical science says are most likely to work. For opioid users, evidence-based treatment would offer them opioid agonists like Suboxone, <a href="https://www.health.harvard.edu/blog/5-myths-about-using-suboxone-to-treat-opiate-addiction-2018032014496">a drug</a> that combines a long-release opioid, buprenorphine, with the overdose-reversing drug naloxone, better known by its brand name, Narcan.</p>

An individual takes shelter under a bed sheet across the street from the Tenderloin Police Station on Eddy Street on March 5, 2022. | Dan Fenstermacher


<figure class="wp-block-image size-full"><img src="https://content.sfstandard.com/wp-content/uploads/2022/03/TenderloinCompelledTreatment_DanFenstermacher_SFS-40-e1646802096668.jpg" alt="" class="wp-image-41493"/><figcaption><em>An individual takes shelter under a bed sheet across the street from the Tenderloin Police Station on Eddy Street on March 5, 2022. | Dan Fenstermacher</em></figcaption></figure>


For methamphetamine users, evidence-based treatment is in shorter supply, as there is no Suboxone equivalent for those dependent on speed. However, “<a href="https://www.npr.org/sections/health-shots/2021/09/30/1040412804/to-combat-meth-california-will-try-a-bold-treatment-pay-drug-users-to-stop-using">contingency management</a>,” recently legalized in California, in which meth users are literally paid to stay clean, has shown some promise.

<p>For methamphetamine users, evidence-based treatment is in shorter supply, as there is no Suboxone equivalent for those dependent on speed. However, “<a href="https://www.npr.org/sections/health-shots/2021/09/30/1040412804/to-combat-meth-california-will-try-a-bold-treatment-pay-drug-users-to-stop-using">contingency management</a>,” recently legalized in California, in which meth users are literally paid to stay clean, has shown some promise.</p>

In the U.S., most treatment options are not evidence-based. Research <a href="https://jamanetwork.com/journals/jama/fullarticle/2769709">recently published</a> in the Journal of the American Medical Association <a href="https://www.health.harvard.edu/blog/5-myths-about-using-suboxone-to-treat-opiate-addiction-2018032014496">found</a> only 29% of programs surveyed nationally offered long-term opiate-agonist therapy, with many more either not offering or “actively discourag[ing]” the treatment. Non-medical treatment is also the “most common detox pathway,” in San Francisco, according to the city’s Department of Public Health, though the agency declined to provide any figures.

<p>In the U.S., most treatment options are not evidence-based. Research <a href="https://jamanetwork.com/journals/jama/fullarticle/2769709">recently published</a> in the Journal of the American Medical Association <a href="https://www.health.harvard.edu/blog/5-myths-about-using-suboxone-to-treat-opiate-addiction-2018032014496">found</a> only 29% of programs surveyed nationally offered long-term opiate-agonist therapy, with many more either not offering or “actively discourag[ing]” the treatment. Non-medical treatment is also the “most common detox pathway,” in San Francisco, according to the city’s Department of Public Health, though the agency declined to provide any figures.</p>

Critics of mandatory treatment say the lack of evidence-based programs is yet another reason to avoid the practice.

<p>Critics of mandatory treatment say the lack of evidence-based programs is yet another reason to avoid the practice.</p>

“The literature does not support mandatory treatment on any level to help the public health situation,” said <a href="https://fcm.ucsf.edu/people/daniel-ciccarone-md-mph">Daniel Ciccarone</a>, a physician and professor of family community medicine at the University of California San Francisco, who studies drug addiction.&nbsp;

<p>“The literature does not support mandatory treatment on any level to help the public health situation,” said <a href="https://fcm.ucsf.edu/people/daniel-ciccarone-md-mph">Daniel Ciccarone</a>, a physician and professor of family community medicine at the University of California San Francisco, who studies drug addiction.&nbsp;</p>

Ciccarone doubts Newsom’s CARE program will work—even if it survives legal challenges and is accepted by the courts. “I think it is backwards and likely to fail,” said Ciccarone. “The solution to homelessness is housing; make it ‘supportive housing’ and couple it with substance treatment, case management and mental health services; anything short of that will be a revolving door.”

<p>Ciccarone doubts Newsom’s CARE program will work—even if it survives legal challenges and is accepted by the courts. “I think it is backwards and likely to fail,” said Ciccarone. “The solution to homelessness is housing; make it ‘supportive housing’ and couple it with substance treatment, case management and mental health services; anything short of that will be a revolving door.”</p>


<div class="wp-block-image cc_daniel_ciccarone"><figure class="alignright size-full is-resized"><img src="https://content.sfstandard.com/wp-content/uploads/2022/03/UCSF_20170927_Daniel-Ciccarone_057-2.jpg" alt="" class="wp-image-41503" width="356" height="376"/><figcaption><em>Photo courtesy of Daniel Ciccarone</em></figcaption></figure></div>


A 2015 meta-analysis of nine studies examining involuntary treatment around the world found that “evidence does not, on the whole, suggest improved outcomes related to compulsory treatment approaches, with some studies suggesting potential harms.” While the issue is under-studied in the United States, research from<a href="https://www.bmj.com/content/353/bmj.i2943.long"> Russia and </a><a href="https://pubmed.ncbi.nlm.nih.gov/31099592/">Mexico </a>published over the last decade agrees compulsory treatment is ineffective in solving drug addiction—and amounts to imprisonment in disguise.&nbsp;

<p>A 2015 meta-analysis of nine studies examining involuntary treatment around the world found that “evidence does not, on the whole, suggest improved outcomes related to compulsory treatment approaches, with some studies suggesting potential harms.” While the issue is under-studied in the United States, research from<a href="https://www.bmj.com/content/353/bmj.i2943.long"> Russia and </a><a href="https://pubmed.ncbi.nlm.nih.gov/31099592/">Mexico </a>published over the last decade agrees compulsory treatment is ineffective in solving drug addiction—and amounts to imprisonment in disguise.&nbsp;</p>

“Global evidence indicates that mandated treatment of drug dependence conflicts with drug users’ human rights and is not effective in treating addiction,” Karsten Lunze, a professor at the Boston University School of Medicine <a href="https://www.sciencedaily.com/releases/2016/06/160621115655.htm">found</a>.

<p>“Global evidence indicates that mandated treatment of drug dependence conflicts with drug users’ human rights and is not effective in treating addiction,” Karsten Lunze, a professor at the Boston University School of Medicine <a href="https://www.sciencedaily.com/releases/2016/06/160621115655.htm">found</a>.</p>

Given the doubts over the efficacy of involuntary treatment, why is it so alluring for some advocates?

<p>Given the doubts over the efficacy of involuntary treatment, why is it so alluring for some advocates?</p>

“On an individual level, you can always find someone who says they benefited from being shown ‘hard love,’ or ‘tough love,’ whether it was their family or a police officer or a court,” said Ciccarone. “It may actually work—politically,” he added. “From a public health point of view, will it reduce overdoses? Probably not.”

<p>“On an individual level, you can always find someone who says they benefited from being shown ‘hard love,’ or ‘tough love,’ whether it was their family or a police officer or a court,” said Ciccarone. “It may actually work—politically,” he added. “From a public health point of view, will it reduce overdoses? Probably not.”</p>

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<h4 class="wp-block-heading"><strong>No Moves Yet</strong></h4>


<p>Several months into Breed's Tenderloin emergency declaration, neither forced treatment nor the city's safe injection site have materialized.</p>

<p>Several months into Breed&#8217;s Tenderloin emergency declaration, neither forced treatment nor the city&#8217;s safe injection site have materialized.</p>

<p>Asked directly via email if Breed supports involuntary commitment for people with drug addiction—or if the police would begin funneling drug users into rehab, or when—Jeff Cretan, the mayor’s chief spokesperson, did not respond.&nbsp;</p>

<p>In an earlier email, Cretan pointed out that Breed has since 2019 supported a proposal from state Sen. Scott Wiener, a former city supervisor, to expand the state’s involuntary commitment laws to include “those who are truly suffering and unable to care for themselves,” including someone with a dual diagnosis of mental health and substance abuse issues.</p>


<figure class="wp-block-image size-full"><img src="https://content.sfstandard.com/wp-content/uploads/2022/03/HousingHereSay-45.jpg" alt="" class="wp-image-41500"/><figcaption><em>Speaker of the House Nancy Pelosi, State Sen. Scott Wiener and Mayor London Breed tour a new housing complex in San Francisco’s Sunnydale neighborhood on Oct. 14, 2021. | Camille Cohen</em></figcaption></figure>


<p>“The mayor has also said repeatedly that as we make more investments in housing, shelter and treatment, we need people to take those options when they are made available, and not be allowed to stay on the street,” Cretan added.</p>

<p>Spokespeople for District Attorney Chesa Boudin refused to discuss whether the city’s top prosecutor supports mandatory treatment, though Boudin did appear at a December press conference held by HealthRight360, one of the city’s leading treatment providers, in which involuntary treatment was cast as a regressive return to a punishment-first drug war paradigm.&nbsp;</p>

<p>Leo Beletsky, a professor of law and health sciences at Northeastern University who has extensively studied mandatory rehab, said the idea was ultimately something of a fig leaf—though maybe one that satisfies the current political zeitgeist.&nbsp;</p>

<p>Said Beletsky: “It’s much easier to say, ‘OK, well, we’re not going to incarcerate people, we’re just going to incarcerate them and call it treatment.’”</p>

core/column

<div class="wp-block-column" style="flex-basis:45%"><div style="height:18px" aria-hidden="true" class="wp-block-spacer"></div><h4><strong>No Moves Yet</strong></h4><p>Several months into Breed&#8217;s Tenderloin emergency declaration, neither forced treatment nor the city&#8217;s safe injection site have materialized.</p><p>Asked directly via email if Breed supports involuntary commitment for people with drug addiction—or if the police would begin funneling drug users into rehab, or when—Jeff Cretan, the mayor’s chief spokesperson, did not respond.&nbsp;</p><p>In an earlier email, Cretan pointed out that Breed has since 2019 supported a proposal from state Sen. Scott Wiener, a former city supervisor, to expand the state’s involuntary commitment laws to include “those who are truly suffering and unable to care for themselves,” including someone with a dual diagnosis of mental health and substance abuse issues.</p><figure class="wp-block-image size-full"><img src="https://content.sfstandard.com/wp-content/uploads/2022/03/HousingHereSay-45.jpg" alt="" class="wp-image-41500"/><figcaption><em>Speaker of the House Nancy Pelosi, State Sen. Scott Wiener and Mayor London Breed tour a new housing complex in San Francisco’s Sunnydale neighborhood on Oct. 14, 2021. | Camille Cohen</em></figcaption></figure><p>“The mayor has also said repeatedly that as we make more investments in housing, shelter and treatment, we need people to take those options when they are made available, and not be allowed to stay on the street,” Cretan added.</p><p>Spokespeople for District Attorney Chesa Boudin refused to discuss whether the city’s top prosecutor supports mandatory treatment, though Boudin did appear at a December press conference held by HealthRight360, one of the city’s leading treatment providers, in which involuntary treatment was cast as a regressive return to a punishment-first drug war paradigm.&nbsp;</p><p>Leo Beletsky, a professor of law and health sciences at Northeastern University who has extensively studied mandatory rehab, said the idea was ultimately something of a fig leaf—though maybe one that satisfies the current political zeitgeist.&nbsp;</p><p>Said Beletsky: “It’s much easier to say, ‘OK, well, we’re not going to incarcerate people, we’re just going to incarcerate them and call it treatment.’”</p></div>


<h4 class="wp-block-heading" id="h-insufficient-capacity-for-care"><strong>Insufficient Capacity </strong><br><strong>for Care</strong></h4>


<h4 id="h-insufficient-capacity-for-care"><strong>Insufficient Capacity </strong><br><strong>for Care</strong></h4>

<p>Advocates say what would work best in San Francisco, beyond solving underlying social problems like the housing crisis, is expanding the city’s treatment capacity and making sure that the programs adhere to best practices.</p>

<p>Data on the availability of treatment beds in San Francisco is sketchy, as are exact figures for how many programs are on offer in the city, but the available numbers are not encouraging. According to a recent statement provided by the DPH, the city has 2,200 “spaces” in its “residential care and treatment offerings,” with “over 400 spaces being added.”</p>

<p>However, according to a recent publicly available snapshot on <a href="https://findtreatment-sf.org/" target="_blank" rel="noreferrer noopener">findtreatment-sf.org</a>, the city advertised a capacity of 500 substance-use disorder treatment beds in three categories and had only a few dozen available. Of the 58 “detox now” beds, 48 offered medical detox. “There remains reduced capacity at some sites due to Covid and the required safety precautions,” DPH spokesperson Zoe Harris wrote in an email.</p>

<p>These figures only include treatment beds contracted by DPH and not beds offered by nonprofit service providers who might contract with the courts.</p>

<p>A <a href="https://sf.curbed.com/2018/5/9/17336090/san-francisco-needles-syringes-exchange-numbers-sf" target="_blank" rel="noreferrer noopener">2016 DPH estimate</a> put the number of intravenous drug users in San Francisco at roughly 22,000. That figure has been repeated as gospel ever since. The number of hard drug users who may snort or smoke their stuff is surely higher, especially considering that fentanyl and its analogs—often smoked rather than injected—didn’t really take off in the Tenderloin until around 2018, and drug experts like Daniel Ciccarone of UCSF identify stimulants as the current overdose crisis’ "fourth wave."nonprofit service providers who might contract with the courts.</p>

<p>A <a href="https://sf.curbed.com/2018/5/9/17336090/san-francisco-needles-syringes-exchange-numbers-sf" target="_blank" rel="noreferrer noopener">2016 DPH estimate</a> put the number of intravenous drug users in San Francisco at roughly 22,000. That figure has been repeated as gospel ever since. The number of hard drug users who may snort or smoke their stuff is surely higher, especially considering that fentanyl and its analogs—often smoked rather than injected—didn’t really take off in the Tenderloin until around 2018, and drug experts like Daniel Ciccarone of UCSF identify stimulants as the current overdose crisis’ &#8220;fourth wave.&#8221;nonprofit service providers who might contract with the courts.</p>

<p>Critics also question the city’s commitment to “social” or “non-medical” treatment programs–the most common approach, according to DPH–which don’t offer those struggling with an opioid addiction the option of an agonist like Suboxone.</p>

<p>Whatever the specifics of the treatment, unless the city built a new dedicated treatment facility or converted the San Bruno jail to a drug-rehab center—<a href="https://www.theatlantic.com/politics/archive/2019/11/going-jail-substance-abuse-treatment/602206/" target="_blank" rel="noreferrer noopener">a proposition some experts think is smart policy</a>—committing even a fraction of local addicts to treatment is not currently something the city can physically do.</p>

<div class="wp-block-column cc_insufficient_col" style="flex-basis:44%"><div style="height:14px" aria-hidden="true" class="wp-block-spacer"></div><h4 id="h-insufficient-capacity-for-care"><strong>Insufficient Capacity </strong><br><strong>for Care</strong></h4><p>Advocates say what would work best in San Francisco, beyond solving underlying social problems like the housing crisis, is expanding the city’s treatment capacity and making sure that the programs adhere to best practices.</p><p>Data on the availability of treatment beds in San Francisco is sketchy, as are exact figures for how many programs are on offer in the city, but the available numbers are not encouraging. According to a recent statement provided by the DPH, the city has 2,200 “spaces” in its “residential care and treatment offerings,” with “over 400 spaces being added.”</p><p>However, according to a recent publicly available snapshot on <a href="https://findtreatment-sf.org/" target="_blank" rel="noreferrer noopener">findtreatment-sf.org</a>, the city advertised a capacity of 500 substance-use disorder treatment beds in three categories and had only a few dozen available. Of the 58 “detox now” beds, 48 offered medical detox. “There remains reduced capacity at some sites due to Covid and the required safety precautions,” DPH spokesperson Zoe Harris wrote in an email.</p><p>These figures only include treatment beds contracted by DPH and not beds offered by nonprofit service providers who might contract with the courts.</p><p>A <a href="https://sf.curbed.com/2018/5/9/17336090/san-francisco-needles-syringes-exchange-numbers-sf" target="_blank" rel="noreferrer noopener">2016 DPH estimate</a> put the number of intravenous drug users in San Francisco at roughly 22,000. That figure has been repeated as gospel ever since. The number of hard drug users who may snort or smoke their stuff is surely higher, especially considering that fentanyl and its analogs—often smoked rather than injected—didn’t really take off in the Tenderloin until around 2018, and drug experts like Daniel Ciccarone of UCSF identify stimulants as the current overdose crisis’ &#8220;fourth wave.&#8221;nonprofit service providers who might contract with the courts.</p><p>Critics also question the city’s commitment to “social” or “non-medical” treatment programs–the most common approach, according to DPH–which don’t offer those struggling with an opioid addiction the option of an agonist like Suboxone.</p><p>Whatever the specifics of the treatment, unless the city built a new dedicated treatment facility or converted the San Bruno jail to a drug-rehab center—<a href="https://www.theatlantic.com/politics/archive/2019/11/going-jail-substance-abuse-treatment/602206/" target="_blank" rel="noreferrer noopener">a proposition some experts think is smart policy</a>—committing even a fraction of local addicts to treatment is not currently something the city can physically do.</p></div>

core/columns

<div class="wp-block-columns"><div class="wp-block-column" style="flex-basis:45%"><div style="height:18px" aria-hidden="true" class="wp-block-spacer"></div><h4><strong>No Moves Yet</strong></h4><p>Several months into Breed&#8217;s Tenderloin emergency declaration, neither forced treatment nor the city&#8217;s safe injection site have materialized.</p><p>Asked directly via email if Breed supports involuntary commitment for people with drug addiction—or if the police would begin funneling drug users into rehab, or when—Jeff Cretan, the mayor’s chief spokesperson, did not respond.&nbsp;</p><p>In an earlier email, Cretan pointed out that Breed has since 2019 supported a proposal from state Sen. Scott Wiener, a former city supervisor, to expand the state’s involuntary commitment laws to include “those who are truly suffering and unable to care for themselves,” including someone with a dual diagnosis of mental health and substance abuse issues.</p><figure class="wp-block-image size-full"><img src="https://content.sfstandard.com/wp-content/uploads/2022/03/HousingHereSay-45.jpg" alt="" class="wp-image-41500"/><figcaption><em>Speaker of the House Nancy Pelosi, State Sen. Scott Wiener and Mayor London Breed tour a new housing complex in San Francisco’s Sunnydale neighborhood on Oct. 14, 2021. | Camille Cohen</em></figcaption></figure><p>“The mayor has also said repeatedly that as we make more investments in housing, shelter and treatment, we need people to take those options when they are made available, and not be allowed to stay on the street,” Cretan added.</p><p>Spokespeople for District Attorney Chesa Boudin refused to discuss whether the city’s top prosecutor supports mandatory treatment, though Boudin did appear at a December press conference held by HealthRight360, one of the city’s leading treatment providers, in which involuntary treatment was cast as a regressive return to a punishment-first drug war paradigm.&nbsp;</p><p>Leo Beletsky, a professor of law and health sciences at Northeastern University who has extensively studied mandatory rehab, said the idea was ultimately something of a fig leaf—though maybe one that satisfies the current political zeitgeist.&nbsp;</p><p>Said Beletsky: “It’s much easier to say, ‘OK, well, we’re not going to incarcerate people, we’re just going to incarcerate them and call it treatment.’”</p></div><div class="wp-block-column cc_insufficient_col" style="flex-basis:44%"><div style="height:14px" aria-hidden="true" class="wp-block-spacer"></div><h4 id="h-insufficient-capacity-for-care"><strong>Insufficient Capacity </strong><br><strong>for Care</strong></h4><p>Advocates say what would work best in San Francisco, beyond solving underlying social problems like the housing crisis, is expanding the city’s treatment capacity and making sure that the programs adhere to best practices.</p><p>Data on the availability of treatment beds in San Francisco is sketchy, as are exact figures for how many programs are on offer in the city, but the available numbers are not encouraging. According to a recent statement provided by the DPH, the city has 2,200 “spaces” in its “residential care and treatment offerings,” with “over 400 spaces being added.”</p><p>However, according to a recent publicly available snapshot on <a href="https://findtreatment-sf.org/" target="_blank" rel="noreferrer noopener">findtreatment-sf.org</a>, the city advertised a capacity of 500 substance-use disorder treatment beds in three categories and had only a few dozen available. Of the 58 “detox now” beds, 48 offered medical detox. “There remains reduced capacity at some sites due to Covid and the required safety precautions,” DPH spokesperson Zoe Harris wrote in an email.</p><p>These figures only include treatment beds contracted by DPH and not beds offered by nonprofit service providers who might contract with the courts.</p><p>A <a href="https://sf.curbed.com/2018/5/9/17336090/san-francisco-needles-syringes-exchange-numbers-sf" target="_blank" rel="noreferrer noopener">2016 DPH estimate</a> put the number of intravenous drug users in San Francisco at roughly 22,000. That figure has been repeated as gospel ever since. The number of hard drug users who may snort or smoke their stuff is surely higher, especially considering that fentanyl and its analogs—often smoked rather than injected—didn’t really take off in the Tenderloin until around 2018, and drug experts like Daniel Ciccarone of UCSF identify stimulants as the current overdose crisis’ &#8220;fourth wave.&#8221;nonprofit service providers who might contract with the courts.</p><p>Critics also question the city’s commitment to “social” or “non-medical” treatment programs–the most common approach, according to DPH–which don’t offer those struggling with an opioid addiction the option of an agonist like Suboxone.</p><p>Whatever the specifics of the treatment, unless the city built a new dedicated treatment facility or converted the San Bruno jail to a drug-rehab center—<a href="https://www.theatlantic.com/politics/archive/2019/11/going-jail-substance-abuse-treatment/602206/" target="_blank" rel="noreferrer noopener">a proposition some experts think is smart policy</a>—committing even a fraction of local addicts to treatment is not currently something the city can physically do.</p></div></div>

The politics of addiction: Newsom sees forced treatment as a solution, but doctors have their doubts

Annie Gaus

Bilal Mahmood, an entrepreneur, scientist and former policy analyst, is not a conventional candidate for state assembly: he’s spent much of his career in the technology sector, working in product development and analytics roles at startups. More recently, he created a fund that studies and donates money to social causes in the Bay Area, such as combating anti-Asian violence and income support for restaurant workers. He also served a stint as a national policy advisor for the U.S. Department of Commerce under President Obama, but has never held political office.&nbsp;

<p>Bilal Mahmood, an entrepreneur, scientist and former policy analyst, is not a conventional candidate for state assembly: he’s spent much of his career in the technology sector, working in product development and analytics roles at startups. More recently, he created a fund that studies and donates money to social causes in the Bay Area, such as combating anti-Asian violence and income support for restaurant workers. He also served a stint as a national policy advisor for the U.S. Department of Commerce under President Obama, but has never held political office.&nbsp;</p>

Mahmood has earned the endorsements of the South West Asian North African (SWANA) SF Democratic Club, the moderate-leaning political action group Grow SF, as well as parent activists Meredith Willa-Dodson, Matt Brezina and Robin Pham, prosecutor Nancy Tung, and others.&nbsp;

<p>Mahmood has earned the endorsements of the South West Asian North African (SWANA) SF Democratic Club, the moderate-leaning political action group Grow SF, as well as parent activists Meredith Willa-Dodson, Matt Brezina and Robin Pham, prosecutor Nancy Tung, and others.&nbsp;</p>

Asked about his lack of political experience compared to competitors, Mahmood argued that career politicians in San Francisco haven’t shown results and that it is time for a new approach. He linked the city’s issues—from a floundering school district to housing and transit—to politicians using local offices as a stepping stone for higher positions rather than long-term problem solving.&nbsp;

<p>Asked about his lack of political experience compared to competitors, Mahmood argued that career politicians in San Francisco haven’t shown results and that it is time for a new approach. He linked the city’s issues—from a floundering school district to housing and transit—to politicians using local offices as a stepping stone for higher positions rather than long-term problem solving.&nbsp;</p>

“Over the last five to 10 years, inequality is up. The number of people who are unhoused is up. The number of people with opioid overdoses is up. The housing prices have gone up,” Mahmood said. “So if that&#8217;s what political leadership gets us today, then I think something is fundamentally off.”

<p>“Over the last five to 10 years, inequality is up. The number of people who are unhoused is up. The number of people with opioid overdoses is up. The housing prices have gone up,” Mahmood said. “So if that's what political leadership gets us today, then I think something is fundamentally off.”</p>

<p>“Over the last five to 10 years, inequality is up. The number of people who are unhoused is up. The number of people with opioid overdoses is up. The housing prices have gone up,” Mahmood said. “So if that&#8217;s what political leadership gets us today, then I think something is fundamentally off.”</p>

Mahmood points to his experience as a son of Pakistani immigrants as inspiration for his political aspirations. Like many other immigrant families, his parents raised children in a small, multigenerational apartment in the Bay Area and worked to achieve the American Dream. The region’s high costs and difficult conditions for working families have threatened that pathway to the middle class, he said.&nbsp;

<p>Mahmood points to his experience as a son of Pakistani immigrants as inspiration for his political aspirations. Like many other immigrant families, his parents raised children in a small, multigenerational apartment in the Bay Area and worked to achieve the American Dream. The region’s high costs and difficult conditions for working families have threatened that pathway to the middle class, he said.&nbsp;</p>


<h2 class="wp-block-heading" id="housing">Housing</h2>


<figure class="wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio"><div class="wp-block-embed__wrapper">
https://youtu.be/aUT5_OZtwuM
</div></figure>

On housing, Mahmood said he supports the state taking a heavier hand in local housing development goals and ensuring that city governments don’t improperly block projects in the name of lengthy environmental reviews. Crediting former Assemblyman David Chiu’s and State Senator Scott Wiener’s work on housing legislation, he praised streamlining efforts such as SB-35 and suggested setting time targets as a way to eliminate undue delays.

<p>On housing, Mahmood said he supports the state taking a heavier hand in local housing development goals and ensuring that city governments don’t improperly block projects in the name of lengthy environmental reviews. Crediting former Assemblyman David Chiu’s and State Senator Scott Wiener’s work on housing legislation, he praised streamlining efforts such as SB-35 and suggested setting time targets as a way to eliminate undue delays.</p>

“If we set median targets and time to build, it&#8217;ll put pressure on counties and municipalities to reform,” he said. “The state can&#8217;t go and eliminate every permit in every county&#8230;but it can set top-down, outcomes-level legislation, that then gives local control on how to decide how [cities] should best implement towards those targets.”

<p>“If we set median targets and time to build, it'll put pressure on counties and municipalities to reform,” he said. “The state can't go and eliminate every permit in every county...but it can set top-down, outcomes-level legislation, that then gives local control on how to decide how [cities] should best implement towards those targets.”</p>

<p>“If we set median targets and time to build, it&#8217;ll put pressure on counties and municipalities to reform,” he said. “The state can&#8217;t go and eliminate every permit in every county&#8230;but it can set top-down, outcomes-level legislation, that then gives local control on how to decide how [cities] should best implement towards those targets.”</p>


<h2 class="wp-block-heading" id="education">Education</h2>


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https://youtu.be/kHcDQx5MPQc
</div></figure>

Mahmood supports the recall of three members of the San Francisco school board, citing a need for greater accountability and better administrative oversight of the district, which is facing a $125 million budget shortfall and waning enrollment. He pushed back on what he views as “lowering the standards” in the district, citing a de-emphasis on accelerated math and a lottery system that presents unpredictability for local families.&nbsp;

<p>Mahmood supports the recall of three members of the San Francisco school board, citing a need for greater accountability and better administrative oversight of the district, which is facing a $125 million budget shortfall and waning enrollment. He pushed back on what he views as “lowering the standards” in the district, citing a de-emphasis on accelerated math and a lottery system that presents unpredictability for local families.&nbsp;</p>

A resident of District 6, Mahmood pointed to a lack of positive outcomes in the Tenderloin and surrounding areas, which have seen a spike in overdose deaths, small business closures, and violence linked to the drug trade. He supports interventions such as safe injection sites, as well as stricter charges for fentanyl dealers and increased funding for enforcement of international trafficking rings.&nbsp;

<p>A resident of District 6, Mahmood pointed to a lack of positive outcomes in the Tenderloin and surrounding areas, which have seen a spike in overdose deaths, small business closures, and violence linked to the drug trade. He supports interventions such as safe injection sites, as well as stricter charges for fentanyl dealers and increased funding for enforcement of international trafficking rings.&nbsp;</p>

On homelessness, Mahmood expressed support for Built for Zero, a program in more than 80 cities and counties that seeks to end homelessness through a combination of gathering data and matching individuals with housing solutions.

<p>On homelessness, Mahmood expressed support for Built for Zero, a program in more than 80 cities and counties that seeks to end homelessness through a combination of gathering data and matching individuals with housing solutions.</p>


<h2 class="wp-block-heading" id="economy">Economy</h2>


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https://youtu.be/ww5sVLlj5LU
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On the economy, Mahmood said he supports a guaranteed income program for Californians. He proposed expanding the California Earned Income Tax Credit ceiling to $75,000, which would ensure $500 per month for eligible families, to be funded through some combination of carbon and wealth taxes.

<p>On the economy, Mahmood said he supports a guaranteed income program for Californians. He proposed expanding the California Earned Income Tax Credit ceiling to $75,000, which would ensure $500 per month for eligible families, to be funded through some combination of carbon and wealth taxes.</p>

Read more about Mahmood’s <a href="https://www.bilalforassembly.com/">campaign here</a>.&nbsp;

<p>Read more about Mahmood’s <a href="https://www.bilalforassembly.com/">campaign here</a>.&nbsp;</p>

Bilal Mahmood, entrepreneur and scientist, on why he’s running

Sam Mondros

Emily Shugerman

The art collectors of San Francisco are exhausted.&nbsp;

<p>The art collectors of San Francisco are exhausted.&nbsp;</p>

For the past week, they schlepped in their finery to soirees across the city as part of San Francisco Art Week, rushing to accept Partiful invites and sometimes waiting days to find out exact party locations. Caviar was eaten by the tray. THC gummies were consumed in demure 2 mg doses. And millions of dollars were spent on artworks.

<p>For the past week, they schlepped in their finery to soirees across the city as part of San Francisco Art Week, rushing to accept Partiful invites and sometimes waiting days to find out exact party locations. Caviar was eaten by the tray. THC gummies were consumed in demure 2 mg doses. And millions of dollars were spent on artworks.</p>

One of the hardest-to-score invitations was for Thursday’s top-secret party hosted by interior designer <strong>Nicole Hollis</strong>, who told invitees only that the event would be somewhere in San Francisco. When the address arrived in attendees&#8217; in-boxes hours before the event, it led to the English Tudor estate of private equity billionaire <strong>Scott Crabill</strong>, whose house boasts art by the likes of Richard Serra, Ruth Asawa, Andy Warhol, and Keith Haring.&nbsp;

<p>One of the hardest-to-score invitations was for Thursday’s top-secret party hosted by interior designer <strong>Nicole Hollis</strong>, who told invitees only that the event would be somewhere in San Francisco. When the address arrived in attendees' in-boxes hours before the event, it led to the English Tudor estate of private equity billionaire <strong>Scott Crabill</strong>, whose house boasts art by the likes of Richard Serra, Ruth Asawa, Andy Warhol, and Keith Haring.&nbsp;</p>

<p>One of the hardest-to-score invitations was for Thursday’s top-secret party hosted by interior designer <strong>Nicole Hollis</strong>, who told invitees only that the event would be somewhere in San Francisco. When the address arrived in attendees&#8217; in-boxes hours before the event, it led to the English Tudor estate of private equity billionaire <strong>Scott Crabill</strong>, whose house boasts art by the likes of Richard Serra, Ruth Asawa, Andy Warhol, and Keith Haring.&nbsp;</p>

“If this is a private collection,” remarked interior designer <strong>Tina Lai</strong>, “it’s a private museum.”

<p>“If this is a private collection,” remarked interior designer <strong>Tina Lai</strong>, “it’s a private museum.”</p>

It was at parties like this that the real action of San Francisco Art Week, which launched two years ago on the coattails of the FOG Fair, took place. And this year, the parties were more numerous than ever. “It was impossible to do everything,” said <strong>Ethan Beard</strong>, chair of the Institute of Contemporary Art San Francisco.

<p>It was at parties like this that the real action of San Francisco Art Week, which launched two years ago on the coattails of the FOG Fair, took place. And this year, the parties were more numerous than ever. “It was impossible to do everything,” said <strong>Ethan Beard</strong>, chair of the Institute of Contemporary Art San Francisco.</p>

Host Sonya You, second from right, mingles with guests at the Fog Gala after party at Gallery 419 January 22, 2025. San Francisco Standard attends Art World's post-gala after hour party during FOG Art and Design Week.


<figure class="wp-block-image alignwide size-large"><img src="https://content.sfstandard.com/wp-content/uploads/2025/01/8251978043_fogartweekparties_0796.jpg?w=2500" alt="A group of people stand close together at a lively gathering, engaged in animated conversation, with some holding drinks and smiling brightly at each other." class="wp-image-359546"/><figcaption class="wp-element-caption">Host Sonya Yu, second from right, mingles with guests at the FOG Gala after-party at Four One Nine.</figcaption></figure>


Hundreds of people attend an SF Art Week party and exhibition hosted by Ken Fulk and the St. Joseph’s Art Society in San Francisco’s SoMa neighborhood on Thursday, January 23, 2025. The San Francisco Standard dispatches from lavish parties during the city’s FOG Art and Design Week.


<figure class="wp-block-image alignwide size-large"><img src="https://content.sfstandard.com/wp-content/uploads/2025/01/8251978043_fogartweekparties-me-15.jpg?w=1668" alt="A vibrant party in a grand hall features a domed ceiling, colorful lights, and people mingling and dancing. A DJ is set up on a stage surrounded by ornate arches." class="wp-image-359551"/><figcaption class="wp-element-caption">Hundreds attend an SF Art Week party and exhibition at St. Joseph’s Art Society.</figcaption></figure>



<h2 class="wp-block-heading" id="h-the-belles-of-the-balls">The belles of the balls</h2>


ICA SF kicked off the week with a free event on Saturday that got so many RSVPs the organizers sent out a text blast hours beforehand asking people to cancel if they were no longer coming. More than 1,600 showed up. Despite the enthusiasm, some art cognoscenti turned up their noses at the crowd. “They weren’t really there for the art,” sniffed one FOG Gala attendee. Implied but not said: They were there for the open bar.&nbsp;&nbsp;

<p>ICA SF kicked off the week with a free event on Saturday that got so many RSVPs the organizers sent out a text blast hours beforehand asking people to cancel if they were no longer coming. More than 1,600 showed up. Despite the enthusiasm, some art cognoscenti turned up their noses at the crowd. “They weren’t really there for the art,” sniffed one FOG Gala attendee. Implied but not said: They were there for the open bar.&nbsp;&nbsp;</p>

One big name who did make it out: <strong>Mayor Daniel Lurie</strong>, who stopped by just four days into the job. “The days of outsiders defining San Francisco are over,” Lurie said in a speech barely audible over the din. “We, the artists, the innovators, get to decide how we define ourselves.”

<p>One big name who did make it out: <strong>Mayor Daniel Lurie</strong>, who stopped by just four days into the job. “The days of outsiders defining San Francisco are over,” Lurie said in a speech barely audible over the din. “We, the artists, the innovators, get to decide how we define ourselves.”</p>

As the night wound down, a group of VIPs — including ICA director <strong>Ali Gass</strong> and Christie’s executive <strong>Sarah Wendell Sherrill</strong> and her husband, District 2 Supervisor <strong>Stephen Sherrill</strong> — peeled back an “access restricted” sign over the fourth-floor elevator button and headed up to the top of the atrium, where they found a small group of venture capitalists and art patrons kicking a bottle of Casa Dragones añejo between them.

<p>As the night wound down, a group of VIPs — including ICA director <strong>Ali Gass</strong> and Christie’s executive <strong>Sarah Wendell Sherrill</strong> and her husband, District 2 Supervisor <strong>Stephen Sherrill</strong> — peeled back an “access restricted” sign over the fourth-floor elevator button and headed up to the top of the atrium, where they found a small group of venture capitalists and art patrons kicking a bottle of Casa Dragones añejo between them.</p>


<h2 class="wp-block-heading" id="h-let-the-good-times-roll">Let the good times roll</h2>


On Tuesday at Mission Bowling Club, <strong>Jeffrey Fraenkel</strong> of Fraenkel Gallery, a 46-year San Francisco institution, was hosting what he called his annual “leveling party” that “mixes the high and low” — though the crowd seemed decidedly high-level: Among the bowlers were revered event producer <strong>Stanlee Gatti</strong>, philanthropist and art collector <strong>Susan Swig</strong>, and art dealer <strong>Sabrina Buell</strong>.&nbsp;

<p>On Tuesday at Mission Bowling Club, <strong>Jeffrey Fraenkel</strong> of Fraenkel Gallery, a 46-year San Francisco institution, was hosting what he called his annual “leveling party” that “mixes the high and low” — though the crowd seemed decidedly high-level: Among the bowlers were revered event producer <strong>Stanlee Gatti</strong>, philanthropist and art collector <strong>Susan Swig</strong>, and art dealer <strong>Sabrina Buell</strong>.&nbsp;</p>

Oh, and <strong>John Waters</strong>, whose appearance thrilled even the city’s jaded socialites. The filmmaker stayed until 9:30 before disappearing in an UberX. “He should have taken a Waymo,” huffed one observer.

<p>Oh, and <strong>John Waters</strong>, whose appearance thrilled even the city’s jaded socialites. The filmmaker stayed until 9:30 before disappearing in an UberX. “He should have taken a Waymo,” huffed one observer.</p>

No one bowled particularly well — The Standard did not see a score over 130 — though artists <strong>Carrie Mae Weems</strong> and <strong>Richard Misrach</strong> got points for enthusiasm.&nbsp;

<p>No one bowled particularly well — The Standard did not see a score over 130 — though artists <strong>Carrie Mae Weems</strong> and <strong>Richard Misrach</strong> got points for enthusiasm.&nbsp;</p>

Richard Misrach attends Fraenkel Gallery's annual pre-FOG Bowling Party co-hosted by Lisson Gallery on January 21st 2025 at Mission Bowling Club in San Francisco, CA


<figure class="wp-block-image alignwide size-large"><img src="https://content.sfstandard.com/wp-content/uploads/2025/01/1082-prefog-2501212.jpg?w=2136" alt="A person with gray hair is excitedly holding a blue bowling ball on a wooden lane, with colorful bowling balls in a rack beside them." class="wp-image-359763"/><figcaption class="wp-element-caption">Photographer and Fraenkel Gallery artist Richard Misrach is an enthusiastic bowler.</figcaption></figure>



<h2 class="wp-block-heading" id="h-a-rich-tradition">A rich tradition</h2>


All of this was just a warm-up for the week’s crown jewel on Wednesday: the FOG Gala that officially opens the fair. Artists, collectors, and industry professionals gathered inside Fort Mason Center for first dibs on works from 59 galleries — and to see and be seen among carts of caviar, seas of sushi, and mountains of martinis.&nbsp;

<p>All of this was just a warm-up for the week’s crown jewel on Wednesday: the FOG Gala that officially opens the fair. Artists, collectors, and industry professionals gathered inside Fort Mason Center for first dibs on works from 59 galleries — and to see and be seen among carts of caviar, seas of sushi, and mountains of martinis.&nbsp;</p>

The former Army post was covered in red and purple jewel-tone drapes and outfitted with an upstairs lounge, where attendees sipped cocktails under lamps covered in what looked like dried moss. One area the design team couldn’t quite transform: the bathrooms, which remained dingy and drafty, though they performed better than in year&#8217;s past. (Two years ago, a plumbing leak brought flowing sewage into the booth of Oakland’s Part 2 Gallery, forcing the booth to shut down for two hours.)

<p>The former Army post was covered in red and purple jewel-tone drapes and outfitted with an upstairs lounge, where attendees sipped cocktails under lamps covered in what looked like dried moss. One area the design team couldn’t quite transform: the bathrooms, which remained dingy and drafty, though they performed better than in year's past. (Two years ago, a plumbing leak brought flowing sewage into the booth of Oakland’s Part 2 Gallery, forcing the booth to shut down for two hours.)</p>

<p>The former Army post was covered in red and purple jewel-tone drapes and outfitted with an upstairs lounge, where attendees sipped cocktails under lamps covered in what looked like dried moss. One area the design team couldn’t quite transform: the bathrooms, which remained dingy and drafty, though they performed better than in year&#8217;s past. (Two years ago, a plumbing leak brought flowing sewage into the booth of Oakland’s Part 2 Gallery, forcing the booth to shut down for two hours.)</p>

The caviar cart at SFMOMA's FOG Fair 2025 on January 22, 2025 at Fort Mason Piers 2 and 3 (Festival Pavilion and Gateway Pavilion) in San Francisco.


<figure class="wp-block-image alignwide size-large"><img src="https://content.sfstandard.com/wp-content/uploads/2025/01/9438-fogfair-2501221.jpg?w=2500" alt="Two women in white uniforms stand behind a caviar cart with ice, lemons, parsley, and crackers. In the background is an art gallery setting." class="wp-image-359528"/><figcaption class="wp-element-caption">Waiters dish up caviar at the FOG Gala.</figcaption></figure>


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