San Francisco Tackles Public Drug Use

New mayor and city leaders take a tougher stance on addiction, balancing compassion and accountability

Apr. 6, 2026 at 10:08am by Ben Kaplan

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After years of a lax approach to public drug use that led to a surge in overdoses and open-air drug markets, San Francisco is now taking a new direction under a new mayor and city government. They are implementing a 'compassionate accountability' model that aims to get addicts into treatment, even if that requires more coercion than the city's previous policies allowed.

Why it matters

San Francisco's struggle with public drug use and homelessness has become a high-profile example of the challenges facing progressive cities across the country. The new approach seeks to balance personal freedom with public order and safety, finding a middle ground between the failed 'war on drugs' and an overly permissive harm reduction model.

The details

The city is deploying 'community ambassadors' to engage with drug users on the streets and persuade them to seek treatment. They are also opening a 'RESET' center where police can hold public drug users until they sober up and connect them with services. Additionally, the city is funding hundreds of new treatment beds and pushing the state government for more tools to compel users into recovery programs.

  • In 2023, San Francisco saw a record high of over 800 overdose deaths.
  • In 2024, voters elected a new mayor, Daniel Lurie, and a more centrist city government.
  • This spring, the city is launching its 'RESET' center pilot program in the SoMa neighborhood.

The players

Daniel Lurie

The new mayor of San Francisco, elected in 2024 on a platform of addressing the city's public drug use and homelessness crisis.

Jessica DiDia

A San Francisco resident struggling with addiction who exemplifies the challenges the city faces in getting people into treatment.

Kunal Modi

The chief of health and human services for San Francisco, overseeing the city's new approach to public drug use.

Paul Miyamoto

The sheriff of San Francisco, whose department is involved in the new 'RESET' center program.

Gavin Newsom

The governor of California, whose policies have sometimes hindered San Francisco's efforts to address public drug use.

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What they’re saying

“We lost our way as a city. When you swing so far that there are no consequences, that you're allowing this many people to use and to die on your streets, something has gone wrong.”

— Daniel Lurie, Mayor of San Francisco

“I think as much about how we help someone struggling on our streets as I think about the harm that's inflicted on children who see public drug use over and over and over again when they walk to school. We have to care about their public health, too.”

— Kunal Modi, Chief of Health and Human Services, San Francisco

“We don't want to criminalize someone in the throes of addiction. We want to get them help.”

— Paul Miyamoto, Sheriff, San Francisco

What’s next

The judge in the case will decide on Tuesday whether or not to allow Walker Reed Quinn out on bail.

The takeaway

San Francisco's new approach to public drug use, balancing compassion and accountability, could serve as a model for other progressive cities struggling with similar challenges. However, the city still faces significant hurdles from state-level policies that limit its ability to compel treatment and enforce public order.