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In the heart of San Francisco, in a neighborhood called The Tenderloin, an open-air drug market is thriving.
A block away, in City Hall, the mayor is demanding action.
But she and her city are up against a seemingly unstoppable force: fentanyl.
Today, On Point: How did San Francisco fall to the opioid epidemic? And what can it do to recover?
Randy Shaw, director of the Tenderloin Housing Clinic, a non-profit supportive housing provider. (@beyondchron)
Leighton Woodhouse, Bay Area freelance journalist who has reported extensively on the drug trade in the Tenderloin. (@lwoodhouse)
Sam Quinones, journalist. Author of Dreamland and The Least of Us. (@samquinones7)
On the rise of drug use in the Tenderloin
Leighton Woodhouse: "COVID-19 and the emptying of the streets downtown, which created this sort of vacuum that was filled by the open-air drug market, which already existed in the Tenderloin, but then spilled out into ... other neighboring districts. So that's one big reason. The other big reason is fentanyl. Fentanyl has been on the East Coast for quite a few years, but it's relatively new to the West Coast, and now it's cut into everything.
"So if you buy cocaine, if you buy heroin, if you buy methamphetamines on the street, the chances are it's cut with fentanyl, which is a very deadly drug and highly, highly, highly addictive. And so fentanyl, it's killing more people and it's addicting people like crazy. And not just cocaine and methamphetamines and things like that. There's children, teenagers who buy Xanax on Snapchat.
"And what they get is something that's either cut with fentanyl or sometimes is pure fentanyl. And they end up getting hooked. And some of those people, kids, end up in the Tenderloin. So this plague of this new, highly potent, highly toxic opioid is another part of the reason."
If you were to walk outside right now, a couple of blocks around the neighborhood, what would you see?
Randy Shaw: "Mayor Breed got more publicity for the Tenderloin than ever. And every national and even international media covered her Tenderloin emergency order from last December. And when you hear the words that you just ran, your listeners should know that it was not followed by any increased police activity. No more police were given to the Tenderloin after that emergency order than before.
"No actual actions were taken to respond to the mayor's emergency order, even though they were promised. So, it became almost a cruel joke on the Tenderloin that they were promised that all these things were going to change. If you walk out now, most of the Tenderloin is fine.
"The problem is you have some blocks that are so out of control, dominated by open air drug markets, that people see those blocks and they are fearful for the neighborhood. And people who live in the neighborhood can't walk through the neighborhood without hitting some of those blocks. The real question is how does a progressive city like San Francisco install a drug containment zone in the last remaining multiracial, low-income community in the city?"
On the drug containment zone
Randy Shaw: "If we look in practical terms, almost a year, about a few weeks before the mayor gave the emergency order, there was a high-profile viral video of thefts coming from the Louis Vuitton store, wealthy bags from Union Square. The mayor dispatched 80 police officers to Union Square, very upscale shopping district a few blocks from the Tenderloin. And they stayed there for a month. And if you go to Union Square now, you'll still see police officers and police cars everywhere to protect the property at Union Square.
"We never got a similar response ever to the drug operations in the Tenderloin. So at some point, and I think we've reached that point, you have to conclude that this is what the city wants it to be. The mayor continually makes statements about how upset she is, but she's the mayor and hasn't allocated the resources to solve the problem."
So, you say she's not doing enough to allocate resources or even to encourage law enforcement to change how they're operating in the Tenderloin.
Randy Shaw: "Exactly. If you talk to the police chief, he'll agree with everything. Yes, it's terrible what's going on. It's awful. But why don't you solve it then? And if it happened in a more affluent neighborhood, we all know drug dealers would not be allowed to stay there for a day. So it isn't that San Francisco's incapable.
"At some point you have to decide. They've just decided to allow these drug activities in a low-income neighborhood, where people don't have the political donations and the power. And this way they can identify it as, Well, we're containing it in the Tenderloin so we don't have it in more affluent neighborhoods."
Tell me a little bit more about why you think the mayor ... in your words, is allowing this to happen. Is it just simply because of the low income?
Randy Shaw: "The point in my book on the Tenderloin, I talk about the history and the Tenderloin was a very prosperous neighborhood for a long time until really the 1960s. And it started a 40-year decline. It started reviving under Mayor Lee in 2011. And had there not been COVID, none of this would have happened. But I think what's historically, there's always been people who felt like, well, let it happen in the Tenderloin so it doesn't happen in ... the other upscale neighborhoods.
"And I think that, you know, we have district elections, so most of the supervisors don't represent the Tenderloin. So politically, it's easier for them to not have to deal with it and just feel like it's someone else's problem. And then we have this whole crazy view that says that if you arrest drug dealers, you're criminalizing poverty.
"But the people who are impacted by drug dealers are all poor. The Tenderloin is all low income. We have no single-family homes. It's the low-income areas, permanently affordable housing in most of the neighborhood. So there's no risk of gentrification. So it's really a hypocritical policy choice by a city that prides itself of being progressive."
I'm looking at the overdose death rates for the city of San Francisco in 2021. 625 people died from drug overdoses. It was more than 700 in 2020. The city itself acknowledges that overdose death rate overdose rates are still 40% above pre-pandemic levels. Is that what you're talking about?
Randy Shaw: "COVID closed down businesses, when it first started in March of 2020. And so it created empty spaces for drug dealers to proliferate. There were not this level of drug dealers prior to COVID, because businesses were thriving, and the city was operating and people were there. But once the city kind of emptied out after March 2020, when spots are empty, it invites opportunities for illegal activities.
"And it's not just the Tenderloin, it's nearby areas which are also taken over. And the city funds harm reduction programs that give out needles and encourage drug use. They've spent $30 million on a linkage center where the people can go to shoot up drugs and the drug dealers stand outside and sell them the drugs and they go in and shoot up in the city property. So there's been a lot written about and talked about the nonsensical approach to safety in San Francisco. And it's all true."
What do you think the neighborhood needs right now to really get a handle on the situation?
Randy Shaw: "Last week, the mayor announced an $8.5 million investment in community ambassadors, unarmed ambassadors in various part, but they don't deal with open drug markets. She could have taken that same 8.5 million and either have off duty police officers or armed security guards on the handful of blocks in the Tenderloin where the dealers are operating and could have cleared that out.
"So when you see money being spent for things that don't close open drug markets, it's hard to understand how the mayor's words are matched with actions, because they have not been."
What needs to happen right now in San Francisco?
Leighton Woodhouse: "The first thing that needs to happen is, as we've remarked, you know, arresting the drug dealers, in my opinion. But there are, of course, many, many other that need to take place. Some of them already are being implemented in San Francisco. There's much more treatment available than there used to be. I think the wrong mix of treatments, for example, you know, the harm reduction is sort of the prevailing philosophy in San Francisco. And harm reduction is basically premised on the idea that you need to keep people alive in order for them to be able to be steered to recovery. Obviously, nobody can recover if they're dead.
"And so this is the philosophy around things like needle exchange, safe consumption sites passing out naloxone, which is an anti-opioid remedy and things like that. But in San Francisco, people aren't pushed towards recovery. They're given the implements and the oversight to stay alive, but then they're just left where they are. I think there needs to be ... much more aggressive towards opening beds in recovery centers where people can detox and rehabilitate with medically assisted treatment.
"They can go on Suboxone, they can go on methadone and things like that. But unfortunately, there's no medication for meth. But where they can be treated and brought to point of functionality and ultimately sobriety. And that is not at all being pushed in San Francisco, it's very much about just handing out needles, handing out foils, handing naloxone. And that's it. That's kind of where it ends in terms of treatment in San Francisco."
This program aired on November 2, 2022.