More people died in San Francisco last year from fentanyl overdoses than COVID-19, a fact that fueled the historic recall election of the city’s District Attorney Chesa Boudin. While he was blamed for rising crime rates in the city, what angered many voters most was the staggering number of overdoses, drug dealing, and an open-air tent city that became a marketplace for fentanyl, the powerful synthetic opioid that is driving overdose deaths across the country. Boudin’s approach was to avoid prosecuting low-level drug possession while trying to divert substance abusers to treatment, but the drug dealing inextricably led to a surge in other crimes such as theft, property break-ins, and carjackings. Just three people were convicted for possession with intent to sell in 2021—for meth, heroin, and cocaine. Boudin says his office pursued diversion programs for drug users or agreed to lesser charges in many cases, but it’s not clear how many individuals eventually entered treatment. The tent city near City Hall, which offered food, medical care, and counseling paid for by taxpayers, reflected the idea that drug users should be free to make their own medical decisions. And then fentanyl came along and changed everything. The recall comes as many cities and states are considering decriminalizing low-level drug possession, and focusing instead on engaging with users so they enter treatment. But as seen in San Francisco, this is a complex and vexing problem for those struggling with substance abuse as well as the government and communities, who must get the balance right between maintaining safe streets and putting in place systems to curb drug dealing and provide a pathway to treatment.
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Rosenthal Center for AddictIon Studies