Policing the Homeless and Drug Addicted: Cruel or Kind?

‘Housing first’ and ‘harm reduction’ models are more harmful than humane, say advocates for drug addiction treatment and recovery.
Policing the Homeless and Drug Addicted: Cruel or Kind?
A drug user sits in the Tenderloin District of San Francisco on May 16, 2024. John Fredricks/The Epoch Times
Brad Jones
Updated:
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SAN FRANCISCO—Tom Wolf, a recovering heroin and fentanyl addict, spent six months homeless on the streets of San Francisco’s notorious Tenderloin district in 2018.

He was arrested several times for drug possession and other offenses and eventually went to jail for three months before going to a six-month inpatient treatment program.

“Jail saved my life,” he said.

Now clean and sober, Wolf is a recovery advocate calling for major changes to policies related to drug abuse. He founded the Pacific Alliance for Prevention and Recovery, a nonprofit group based in the San Francisco Bay Area, that has joined forces with the Foundation for Drug Policy Solutions to work on developing such reform on the West Coast.

And in 2023, Wolf walked the Tenderloin district with Robert F. Kennedy Jr.—now President-elect Donald Trump’s pick for Health and Human Services secretary—to expose the extent of San Francisco’s massive homeless and drug addiction woes.

Wolf told The Epoch Times he wants to change the way society looks at the ongoing drug crisis and provide evidence-based solutions that focus on prevention, treatment, recovery, and education.

Part of that mission begins with taking “reasonable approaches” to stopping the flow of illicit drugs through more robust law enforcement, he said.

However, the decriminalization of illicit drug use and stigmatizing law enforcement efforts to arrest addicts living on the streets has reduced the power of police to hold them accountable and try to usher them into a better situation, Wolf said.

“Unfortunately, that’s a mistake,” he said. “Sometimes, as a result of those individuals’ behaviors because of those drugs, they need the accountability part, which is law enforcement.”

When he was a homeless intravenous drug addict on the street, Wolf said he never would have stopped using, even after surviving sepsis, without intervention.

“And, in my case, it was by the police,” he said.

Jail provided a controlled environment for three months where Wolf was able to get clean and sober with medication-assisted treatment involving suboxone.

“I was given an opportunity or a choice to either stay in jail or go to treatment,” he said. “I opted for treatment, and here I am now six years clean.”

Tom Wolf, a recovery advocate based in San Francisco with Robert F. Kennedy Jr. in San Francisco’s Tenderloin district in October 2023. (Courtesy of Tom Wolf)
Tom Wolf, a recovery advocate based in San Francisco with Robert F. Kennedy Jr. in San Francisco’s Tenderloin district in October 2023. Courtesy of Tom Wolf
Tom Wolf, a recovery advocate, says he wants to shift the narrative away from "harm reduction" policies to support programs that fund and promote addiction recovery as a solution in the effort to reduce drug addiction and homelessness. Wolf is seen here walking San Francisco’s Tenderloin district in October 2023. (Courtesy of Tom Wolf)
Tom Wolf, a recovery advocate, says he wants to shift the narrative away from "harm reduction" policies to support programs that fund and promote addiction recovery as a solution in the effort to reduce drug addiction and homelessness. Wolf is seen here walking San Francisco’s Tenderloin district in October 2023. Courtesy of Tom Wolf

Preliminary data from the U.S. Centers for Disease Control and Prevention (CDC) show there were an estimated 107,543 drug overdose deaths across the nation last year and 111,029 in 2022.

In California, the CDC reported 10,952 overdose deaths in 2022. California’s drug overdose death rate is at 27 deaths per 100,000 people in the population, which is lower than the U.S. average at nearly 33 deaths per 100,000.
However, according to the California Department of Public Health, the state’s opioid overdose death rate tripled from 2018 to 2021. This followed a similar trend in the rest of the nation, which saw overdose death rates triple from 2016 to 2021.
In Oregon, the first U.S. state to decriminalize drugs in 2020, the overdose death rate is just slightly lower than the national average at 31 per 100,000. However, the number of unintentional overdose deaths in Oregon related to illicitly manufactured fentanyl nearly quadrupled between 2020 and 2022.
In Washington state, where drug penalties have also been somewhat reduced, the death rate is higher than the national average, nearly 34 per 100,000. Opioid-related deaths in Washington state more than tripled from 2018 to 2023.
Canada, which has 39 supervised drug consumption sites across the nation, saw 7,525 deaths in 2022, a rate of 19.3 per 100,000. It has also seen “substantially elevated numbers of opioid-related deaths and other harms since national surveillance began in 2016,” according to the Canadian government.

‘Harm Reduction’ Model

Governments began offering intravenous drug users clean needles in exchange for dirty ones in the 1980s to reduce the spread of blood-borne infectious diseases, and as a result, today’s addicts are less likely to share syringes, Wolf said.

“It worked,” he said. “It did slow down the spread of HIV and hepatitis C.”

What is meant by the term “harm reduction” has changed over the last four decades, and programs now employ a much wider umbrella of strategies surrounding drug use, including decriminalization and legalization.

In recent years, groups like the American Civil Liberties Union (ACLU) have increasingly advocated for removing criminal penalties for offenses such as possession of drugs for personal use.

In 2014, California voters approved Proposition 47, which reduced penalties for some drug and theft crimes from felonies to misdemeanors.

A homeless person under the influence of drugs in San Francisco’s Tenderloin district on May 16, 2024. (John Fredricks/The Epoch Times)
A homeless person under the influence of drugs in San Francisco’s Tenderloin district on May 16, 2024. John Fredricks/The Epoch Times

According to a report published in September by the Public Policy Institute of California, this policy change, as well as other factors including law enforcement responses during the pandemic, caused arrests for drug and property crimes to plummet.

“[It] sent a signal that the criminal justice system should view drug and property offenses as less serious offenses,” states the report.

“Fewer drug arrests may contribute to lower incarceration, as captured by drops in jail and prison population. But fewer drug arrests also may mean fewer opportunities for individuals to receive drug use treatment—and some untreated individuals may go on to commit crime, especially property crime, to generate income for drugs.”

The institute also said it was unable to find evidence that changes in drug arrests in the wake of Prop. 47 or the pandemic led to increases in crime.

Wolf said such strategies can come with other negative side effects, such as “people on the street using, people camping out in front of supervised consumption sites ... using drugs right in front of drug dealers posted up across the street.”

On Nov. 5, more than 68 percent of California voters passed Proposition 36, known as the Homelessness, Drug Addiction, and Theft Reduction Act, which reformed Prop. 47 and strengthened penalties for repeat offenders of certain drug and theft crimes.

The new law will allow judicial discretion to charge repeat offenders with felonies carrying sentences of up to three years and prioritize mental health and drug abuse treatment by allowing more repeat offenders to choose rehabilitation programs instead of jail or prison.

Meanwhile, proponents have defended the “harm reduction” model, blaming spikes in overdose deaths on stronger, more lethal drugs on the street, and saying a safer supply of drugs is needed, Wolf said.

“Now they’re giving out foil, pipes, and straws encouraging people to smoke their drugs instead of shoot them intravenously,” he said.

The policies, particularly on the West Coast, aren’t working, he said.

“The data no longer support the harm reduction model,” he said.

Wolf said he wants to move toward policies that fund and promote recovery from addiction as the number one solution, because he said the “harm reduction” model doesn’t do anything to address the underlying trauma that leads some people to develop addiction in the first place.

Fentanyl, which is tied to about 80 percent of drug overdoses in San Francisco, has driven the number of overdose deaths to crisis levels, according to preliminary data through July from the chief medical examiner’s office. Overdose deaths involving fentanyl increased 4,600 percent in San Francisco between 2015 and 2020.

“The same harm reduction policies that were in place prior to the arrival of illicit fentanyl in the United States and Canada are still being used today for a drug that doesn’t [care] about harm reduction and cuts through all of that and just kills you anyway, because it’s 10 to 100 times stronger than heroin ever was,” Wolf said.

While San Francisco in October this year reported six months of decline in fatal overdoses, Wolf said he believes governments will have much better results by acknowledging more law enforcement is needed to get addicts off the streets and away from their addictions, instead of doubling down on the same approach.
San Francisco’s public health department has a budget of about $3.23 billion per year, according to Mayor London Breed’s two-year plan adopted in July. A portion of this funding is used to fund 575 beds for substance abuse and residential treatment and 58 detox beds.
In the 2023–24 fiscal year, the department spent about $720 million on behavioral health, with about $661 million budgeted for 2024–25 and $607 million for 2025–26 fiscal years.
A homeless person in the Tenderloin District of San Francisco on May 16, 2024. (John Fredricks/The Epoch Times)
A homeless person in the Tenderloin District of San Francisco on May 16, 2024. John Fredricks/The Epoch Times
San Francisco’s public health department treats thousands of people every year for mental health and addiction, including nearly 5,000 people with medication treatment such as buprenorphine and methadone. And in 2023, more than 135,600 doses of Naloxone—more commonly known by the brand name Narcan—were distributed.
“In 2023, more than 25,000 people received behavioral health services across the San Francisco Health Network, 15,000 of whom accessed specialty treatment and recovery services,” according to budget documents.

According to Wolf, to meet the needs of people who suffer from addiction in San Francisco, a massive amount of investment at the state level is needed to increase the number of treatment beds to the thousands.

“Instead, the state and county have dedicated almost all the funding to low-barrier housing where drugs are allowed,” he said. “It’s not really working the way that they had intended, and they’re not making the necessary investments in treatment.”

SROs and NGOs

Roxanne Hubbard, a crack addict, who lives in an aging hotel room in the Tenderloin district run by a nonprofit group, or non-government organization known as an NGO, recently told The Epoch Times that staying clean and sober is not a requirement for housing.

“Even if that was true, they don’t have community meetings. ... They don’t even try to have support groups. Nothing,” she said. “There was no rule book when I moved here. I smoked crack. I still smoke.”

Hubbard, 44, said she was emancipated from her parents who were stationed at Treasure Island, a former Navy base in the Bay Area, when she was 17, and later went to an organization called the Larkin Street Youth Center.

“I had a hard life growing up. I wasn’t getting along with my family,” she said. “I came from the street. I used to be homeless, and I used to walk around here, not wearing shoes, just being in a tent and everything.”

Hubbard pays $320 a month toward her subsidized rent in the Single Residency Occupant room, or SRO as they are more commonly known.

“I had a boyfriend. He broke up with me on the day I got my housing, which was really hard for me,” she said. “I thought my boyfriend was going to be with me, but he broke up with me, and he told me he did me a favor. Some people aren’t ready to get off the street.”

The room was small, unfurnished, poorly ventilated, and full of cockroaches, she said.

“When I first saw my room, I was shocked,” said Hubbard. “I thought I was going to be living with a white picket fence—something like that. I’d never even seen bugs when I was sleeping on the street in tents. It was outrageous. I couldn’t even believe it.”

Despite her complaints, Hubbard said she is grateful to have a private bathroom, unlike her previous SRO in another part of the Tenderloin where she shared a bathroom with other tenants, who, she said, “were not taking care of their hygiene.”

Roxanne, an SRO resident, introduces her apartment unit in the Tenderloin District of San Francisco on May 16, 2024. (John Fredricks/The Epoch Times)
Roxanne, an SRO resident, introduces her apartment unit in the Tenderloin District of San Francisco on May 16, 2024. John Fredricks/The Epoch Times

Housing First Policies

Housing First policies embrace the notion that people who are disabled as a result of either untreated mental illness or addiction should be offered immediate housing with few conditions, because only once they’re off the street in a secure environment will they be able to deal with these issues, Wolf said.

Although it “makes sense on paper,” Wolf said practical implementation of such policies is “quite different.”

“Because it’s so low barrier, they look the other way on drugs and untreated mental illness,” he said. “They just consider that to be part of your disability.”

Currently, prospective tenants must actively seek out housing programs, which most people struggling with drug addiction aren’t going to do, Wolf said.

“They have to be pushed towards accessing those services,” he said. “That’s the reality. Otherwise, people would be getting clean ... in those buildings, and they’re not.”

JJ Smith, a local activist whose brother, Rodney, died in 2022 from a fentanyl overdose while using a “harm reduction” kit in the SRO where he lived in the city’s Tenderloin District, blames decriminalization efforts for chronic homelessness and drug addiction.

“You’ve got all these organizations out there ... pushing a hard line saying that’s normal, let them do what they want to do. You’ve got the ACLU saying that people have rights to use drugs if they want to,” said Smith, who is a good Samaritan who walks the Tenderloin offering help to those who need medical attention or may want to get clean and sober.

It used to be a crime to possess drug paraphernalia, which “harm reduction” kits contain, Smith said, and now San Francisco and other cities are paying NGOs to hand out what he calls “death supplies” to addicts, and “the police can’t arrest anyone.”

In 2020, the ACLU accused the San Francisco Police Department (SFPD) of “a long-documented history of racism” and targeting racial minorities from stops, arrests, and prosecution at “wildly disproportionate” rates.

“Ultimately, the only solution to the issue in San Francisco, as in most American cities, is to shrink the size, reach, and responsibilities of the police department, and decriminalize the use and possession of drugs,” the ACLU stated.

The ACLU did not respond to a request for comment about its support of housing first and harm reduction policies, stating in an email to The Epoch Times that no spokesperson was available for comment.

People hold drugs in the Tenderloin District of San Francisco, Calif., on May 16, 2024. (John Fredricks/The Epoch Times)
People hold drugs in the Tenderloin District of San Francisco, Calif., on May 16, 2024. John Fredricks/The Epoch Times

Treatment Programs

Wolf, who found recovery at a Salvation Army program in San Francisco, said the state and county haven’t put enough money into funding such organizations with proven records.

The solution, he said, all comes down to politics and policy choices.

If anything, “harm reduction” should focus on relaxing policies that make it easier for addicts to get methadone and suboxone, because even though there are concerns about these drugs, they are far less harmful than fentanyl, he said.

“Getting suboxone isn’t like, you just wake up in the morning and the guy at the Salvation Army hands you your suboxone. You need a prescription, and you need to go to a clinic that’s outside of the building to obtain your methadone or suboxone, and then come back and you have to do that every day,” he said. “So, this is where harm reduction can be a useful tool.”

Under California law, police can’t arrest and detain people for using illicit drugs unless they’re deemed “gravely disabled” or pose an acute risk of harm to themselves or others—such as in the case of an intentional suicide or a violent psychotic episode.

Despite the high risk of overdose, an addict injecting or smoking fentanyl on the street, for example, is not deemed an acute risk. Some can be involuntarily detained under what is known as a “5150,” the section of the Welfare and Institutions Code that allows police, members of a mobile crisis team, or mental health professionals to hold an adult experiencing a mental health crisis for up to 72 hours for psychiatric evaluation.

Last year, California Gov. Gavin Newsom signed Senate Bill 43, behavioral health legislation aimed at reducing homelessness and addiction through involuntary commitment, or mandatory drug and alcohol treatment, for those unable to care for themselves. The law took effect Jan. 1, 2024, but it allows counties two years to comply, an option 56 of 58 counties have taken statewide.

SB 43 expanded the legal definition of “gravely disabled” from people who are unable to provide for their personal safety or necessary medical care as a result of chronic alcoholism to include those with severe substance use disorders, or a co-occurring mental health disorder and severe substance use disorder.

Housing and Recovery

California’s Proposition 1, which a slim majority of California voters approved in March, renames the Mental Health Services Act from 2004 to the Behavioral Health Services Act and expands its purpose to include substance use disorders, including for people without a mental illness.

Prop. 1 issues $6.38 billion in bonds to fund housing for homeless people and veterans, including up to $4.4 billion for mental health care and drug or alcohol treatment facilities.

While it “may be a game-changer,” it could take a decade or more to tell whether Prop. 1 has a major impact, Wolf said.

Wolf also called on the state to pass legislation that would change how the state funds permanent supportive housing and allow up to 10 percent of its dollars to go toward drug-free recovery housing that emphasizes abstinence from drugs and alcohol.

The proposed legislation, Assembly Bill 2893, would require the state to perform periodic monitoring of select supportive recovery residence programs. It would prohibit tenants from being evicted for relapse, and would require the state to provide tenants who are no longer interested in living in a supportive recovery residence with other housing options in other programs that operate with “harm reduction” principles, Wolf said.

AB 2893 passed the state Assembly by a 60–0 vote, but it was amended in the Senate Housing Committee and moved to the Senate Appropriation Committee where it was shelved.

“So, they killed it this year, but we can bring it back next year,” Wolf said.

San Francisco Mayor-elect Daniel Lurie speaks at a rally in San Francisco on Nov. 8, 2024. (Lear Zhou/The Epoch Times)
San Francisco Mayor-elect Daniel Lurie speaks at a rally in San Francisco on Nov. 8, 2024. Lear Zhou/The Epoch Times

‘Times Are Changing’

Erica Sandberg, an independent journalist in San Francisco, told The Epoch Times that movements to defund the police have taken “a major bite” out of the city’s police force.

“It didn’t just deplete their ranks, it defeated their ability to enforce laws,” Sandberg said. “We saw a major difference in law and order, and we saw chaos rise. It’s been pretty bad.”

Sandberg, who recently completed a training program called Community Police Academy, said the 10-week course opened her eyes to what police officers contend with on the street “and all the new regulations that have basically pinned their arms to their sides.”

“Harm reduction has moved so far past what was sensible and what almost everybody would find a rational approach,” she said. “It just opened up the door to wild, bizarre things such as giving out meth pipes and crack pipes and fentanyl foil.”

These so-called “harm reduction” kits only make it easier for addictions to continue, she said.

“There is no effort whatsoever to help somebody stop using these toxic chemicals,” she said. “There are so many people who are involved in this, and their sole job is harm reduction, which is just such an erroneous name. ... They’re not reducing harm, they’re perpetuating addiction.”

Sandberg is hopeful new San Francisco Mayor-elect Daniel Lurie will take steps to reduce homelessness and drug addiction.

“It’s really, really tough, and it’s going to take a while for that to change, but I think it’s changing in the right direction,” she said.

While some may say that’s easier said than done, Sandberg said the November election result, in which Lurie defeated incumbent Breed, sends a “powerful” message from the people that they want to “clean house.”

“It says, what we have had, we don’t want. We don’t want this anymore,” she said.

Trump’s victory also signals times are changing, especially attitudes toward sanctuary laws which prevent police from turning illegal immigrants over to Immigration Customs and Enforcement, or ICE, she said.

“We’ve got a lot of people who come to San Francisco who are here illegally selling fentanyl that results in human suffering and death, and we have a sanctuary law that says we can’t turn them over to ICE,” she said. “That has to change, and the Trump administration and what they’re going to be doing about the border crisis is going to have an impact.”