SAN FRANCISCO (KRON) — San Francisco is poised to begin requiring mandatory drug testing and treatment programs for some residents who receive cash assistance from the county.

Mayor London Breed, supervisors, and the San Francisco Human Services Agency announced the newly proposed legislation on Tuesday. The legislation would require “individuals with substance use disorder who want to access county-funded cash assistance to be enrolled in treatment and services,” the mayor’s office wrote.

San Franciscans who apply for, or receive, benefits from the County Adult Assistance Programs (CAAP) would have to undergo screening and participate in a substance abuse treatment program when the screening reveals that they may be addicted to drugs.

“In recent years, San Francisco has earned a reputation as a destination for people who use the most toxic drugs to come, and eventually die,” Supervisor Raphael Mandelman said.

Before the new rules go into effect, the legislation must be approved by the Board of Supervisors through a majority vote.

“In our pursuit to address the opioid crisis, let our message be clear: the city isn’t going to give you money to buy drugs. If you are ready for help, we are ready to help you,” Supervisor Catherine Stefani said.

In recent months, San Francisco Police Department officers arrested hundreds of drug users for consuming illegal narcotics in public. Nearly all of those arrested, however, declined voluntary substance use treatment services.

Far too many people are refusing help and later dying from overdoses, the mayor said.

Breed said, “We fund a wide range of services. Local government lack tools to compel people into treatment. This initiative aims to create more accountability and help get people to accept the treatment and services they need. It should not be more convenient to get access to drugs than it is to get access to treatment.”

Mayor Breed
San Francisco Mayor London Breed (AP Photo /Eric Risberg /File)

Under the new proposal, as a condition of eligibility to receive CAAP, people with suspected
substance use disorder would be required to participate in substance abuse screenings or treatment programs funded by SFHSA. These treatment programs would include a range of interventions from residential treatment, medical detox, medically-assisted treatment, outpatient options, and abstinence- based treatment.

Anyone who refuses, or does not successfully engage in treatment, would be cut off from CAAP cash assistance.

The San Francisco Human Services Agency oversees the CAAP program. Currently, about 5,200 people are receiving cash payments between $100-$700 monthly.

Supervisor Aaron Peskin said cutting off welfare recipients is a bad idea.

Peskin wrote Tuesday, “These are serious times in San Francisco – and we need serious ideas, not politicians desperately grasping for a political lifeline. Mayor Breed does not have the ability, nor the will, to organize our many public safety resources to close down drug supermarkets and open-air fencing of stolen goods. If she can’t find the way to prevent several hundred brazen criminals from selling deadly drugs — how does she think she will find the resources to drug test thousands of welfare recipients? The answer is she can’t, and she won’t, and this would simply be silly politics if the issues we face as a city were not so serious.”

San Francisco’s previous efforts to curb the rise in overdose deaths have so far not taken hold.

The city’s fentanyl overdose epidemic deepened this summer with fatal overdoses spiking. In July, there were 74 overdose deaths. In August, 84 lives were lost to overdoses.

“It is a tragedy that is unfolding every day. We had nearly three deaths a day in August in San Francisco due to overdoses,” SF Public Health Director Grant Colfax previously told KRON4.

In 2022, the San Francisco Homeless Count and Survey found that 52 percent of people experiencing homelessness reported their drug or alcohol use as a disabling health condition. In its Accidental Drug Overdose Reports for 2020 through 2022, the Office of the Chief Medical Examiner determined that at least 25 percent of fatal drug overdose victims had no fixed address.