Maurice Byrd, LMFT, Director of Training and Business Operations

On August 31, 2022, National Overdose Awareness Day, San Francisco will see the preventable overdose deaths of 2 of our residents. The City’s response: arrest everyone in sight that is involved with drugs in the Tenderloin. Never mind that the arrest of street level, low-level drug dealers and users has been a failed tactic for years and has not had any measurable impact on drug use. Never mind that instead our jails and prisons are overcrowded and those arrested are released within days. Or that these arrests bring chaos to communities as well as the drug supply and result in additional overdose deaths. And it certainly doesn’t matter that these practices disproportionately target Black and Brown people and poor people (despite the known fact that white people and people of means use drugs at the same rates). To be as fair as one possibly can be, this racist and failed policy does not lay in the hands of any individual; it is the outcome of systems that have existed in this country for hundreds of years. Racist systems that span the spectrum from outright hatred to more covert, institutional tactics.

The new District Attorney of San Francisco is promoting and installing the very systems and interventions that are the most extreme, dangerous, and negligent in what now feels a renewed War on Drugs in San Francisco. Let’s be very clear, this is not a personal attack on her or the fact that she is also a BIPOC person. This is not an attempt to question her fidelity, love, or membership in the BIPOC community, period. The author of this piece is a Black man that was born and raised in San Francisco. This is instead a call for all who have grown up, live, work and are deeply invested in the people of San Francisco, including our new District Attorney, to join together in the refusal for our City to recycle the same failed tactics from the drug war. We cannot sit by and watch as we continue to lose 2 San Franciscans daily to preventable drug overdose. Because we are arresting people instead of helping.  

Since the dawn of time humans have tried to alter their perception. Or increase pleasure or decrease pain. Raise your hand if you use drugs. Let me ask again: do you use coffee or any form of caffeine? Caffeine is the most widely available, used, and abused drug in the world. We talk about drugs as though they are either good or bad. All drugs have inherent benefits and harms.

We know that about 90% of people that run into problems with drugs have had trauma in their background. Kaiser conducted a big research study with a large population called ACEs or Adverse Childhood Experiences conducted between 1995-1997. They asked 10 questions about abuse and neglect that people experienced during childhood. People who answered “yes” to 6 or more of these experiences were more likely to develop problematic relationships with drugs. Additionally, those who said “yes” to 6 or more of these questions were 250% more likely to smoke, 500% more likely to develop a problematic relationship with alcohol, and 4600% more likely to be a person to use drugs intravenously.

The mechanics that influence drug use are complicated; it’s not about morals. We all are drug users; remember caffeine and I will include Tylenol and vaccines. The phenomenon of drug use depends on your biology, your psychology, and your sociology. We call it Biopsychosocial.

When we look at it this way, we understand that biology plays a significant role in your relationship with drug use. Some science stops there and refers to drug use as a disease, but drug use is not a disease. You cannot stop having diabetes one day, but you can stop using drugs suddenly. It is a mistake to think about drug use as only a biological phenomenon. 

There are biological things to consider. Yes, your grandmothers’ and grandfathers’ genes have passed on to you. So maybe you have more enzymes to process alcohol versus another person whose ancestors did not pass on those genes for those same enzymes. So your body may process and absorb more of less quickly than others. But the story doesn’t end there; there are psychological and sociological factors that contribute to drug use as well.

We all have psychological states of minds and needs. When we are upset, we look for comfort in things that calm us. When we wake up sluggish, some of us drink coffee. When we have feelings of depression, we may be prescribed and take medicines. Our psychological health is highly dependent on reaching what is seen as or considered “normal” in our culture. And remember the role that trauma plays in drug use.

Not only do our early childhood and other life experiences play a role in our relationships with drugs, but so does our social location, or our "sociology." We have an example to learn from. In Hawaii the main drug is meth. It’s not because Hawaiian people love meth; it’s because other drugs like cocaine and heroin are hard to get on the islands. And you can make meth with things on those islands. So sociological or environmental factors play a big part in drug use.

Drug use is not a disease. It is a biopsychosocial phenomenon.

In the 1980’s, when crack use became a national problem, it was seen as a Black and Brown people problem. The United States took a policy position that drug use was a moral issue and those who used drugs should be locked in jails and prisons for their failed morals. Now that the opioid epidemic is affecting middle class white people and their children it is referred to as a disease, not a moral problem, so treatment is preferred over jail or prison.

Let’s be clear: the drug war does far more harm than drug use. The U.S. spends less than a quarter of the amount of money on the drug war then we do on drug use. Which means we put more money in law enforcement and policing people then we do on things like treatment or prevention. The War on Drugs is a War on People; you can’t have a war with an inanimate object. Furthermore, it is a war on certain people. Black, Brown, and poor people are far more effected by the drug war. These communities have been hit the hardest with death, poverty, loss of family, loss of community, and the punishment of prison. There are more Black, Brown, and poor people in prisons and jails than white people. Why is that? The simple answer is that the drug war is racist. Period, full stop. 

White folx use, and are involved with, drugs at the same rate as Black and Brown folx yet the latter are punished and imprisoned at much higher rates. To be as fair as one possibly could be it does not lay on any individual, it is the outcome of systems that have existed in this country for hundreds of years. Systems that span the spectrum from outright hatred to more covert, institutional and systemic tactics of racism.

We can draw a straight-line connecting chattel slavery to Jim Crow laws to the drug war because they all were designed for, or had/have the effect of, the U.S. benefiting from free labor from mostly Black, Brown, and poor people. I suspect that most people that promote and offer safe refuge to the drug war are not consciously doing this in an effort to further promote racism or classism. Nonetheless, it has the same effect. So, let’s acknowledge this together and offer a notice that you are now aware, and we are all aware. 

The new District Attorney of San Francisco is recycling the institutionally, and at times covertly, racist tactics used by the United States in the War on Drugs. Here is the old game plan: arrest everyone in sight that is involved with drugs. The arrest of street level, low level drug dealers and users has been going on for years and it has not had any measurably significant impact on the drug use, some may argue that it has only made it worse. It has grown the prison population to the point that imprisoning people has become a business that people profit from.

When the strategy is to arrest low-level drug dealers, who are often drug users, the drug market constantly shifts, changes, and becomes unpredictable. This introduces chaos into the drug market and increases the potential for more people to overdose as quality of product is hard to determine. Additionally, if someone is arrested who has been using opiates, then is released (usually within 24-48 hours in our current system), they are released in physical withdrawal. Almost always they seek to get well quickly and may use more than intended. This causes unintentional (and preventable!) deaths.   

The U.S. government has been extremely negligent and is directly responsible for every overdose that happens in the United States. The government has refused to decriminalize or regulate a product that millions of people use and thousands of people die from. So, in effect, they have left the regulation of these drugs to the low-level drug dealers. And the new San Francisco District Attorney wants to specifically target the very people that offer some level of quality control and regulation to the drugs that many people use, specifically fentanyl. I think the priorities of San Franciscans are more closely aligned with many of the core ideas of harm reduction than those of the drug war and the District Attorney: protect human life, defend human rights and always practice safety first. 

By Callie Olpin, ASW, Community Based Therapist

It is hard to describe to an outsider what it is like to work at the Tenderloin Center. Each day I walk into work I am immediately greeted by the warm smiles of fellow staff and guests. There is a community here which offers safety, relaxation and non-judgement. For many of the guests it is a place of refuge from the streets. The radical hospitality provided by staff allows rapport and trust building to a population that is normally ostracized. I have been working here as a harm reduction therapist providing psychotherapy services, managing crisis situations, and establishing relationships with guests.

The premise of the Tenderloin Center is simple; a place where anyone can come and get their basic needs met. Onsite there are three meals served per day, water, warm coffee, showers, bathrooms, mobile charging stations, and laundry. Guests can use the inside living room area where they can sit and relax, watch tv and utilize the internet. There is an area outside with seating and a privacy area where guests have access to a full range of harm reduction supplies and services. EMTs are onsite for any medical emergency and overdose prevention is a main goal of the center.  

There is a plethora of non-profit organizations here that work together for guests to access resources. Code Tenderloin, Urban Alchemy, SFHOT Team, RAMS, Episcopal Community Services, Health Navigation Services, Re-Entry Services, Street Medicine, Miracle Messages and Healthright 360 are only a few mentions of the organizations onsite. Guests here have assistance when applying for housing, medi-cal, employment, food stamps, mental health, and substance abuse treatment. They can reconnect with family members and be tested for STIs and HIV. As a therapist it is incredible to be able to meet with a guest and immediately walk them over to another staff member to access a resource. This low-barrier approach to resources is remarkable. 

The Tenderloin Center was created by Mayor Breed’s SF Tenderloin Emergency Initiative to help combat the substance abuse and houseless crisis. It was hastily conceived in January 2022 which has resulted in an environment that feels often chaotic and unplanned; not to mention that only 5 out of the 7 floors are utilized, and many of those just partially. It was announced two months ago that the center will close in December of this year. There is a new high-rise apartment building that has just been built across the street and many of the residents in San Francisco oppose the center. 



As a clinician working here, I find the closure to be inhumane. I question where many of these guests will go and their continuity of care. The staff here has formed meaningful relationships with guests who have aided them in receiving resources. The closure of the Tenderloin Center is reflective of the prejudice towards the population that come here and our society’s ingrained view that abstinence is the only solution. I can say that it amazes me that a center like this is considered radical, that to be nice and show compassion to others is controversial in some way. As Mahatma Ghandi spoke, “The true measure of any society can be found in how it treats its most vulnerable members.”

We are still feeling the wonderful vibes from Patt & Jeannie’s celebration! 

Thank all of you who attended and helped make the day so special. We thank each of you for your support of HRTC as we work to further Patt & Jeannie’s legacy.

HRTC is looking for passionate, community-minded individuals to serve on our Board of Directors. Interested? 

Please contact Sam Dennison, Board Chair or Maurice Byrd for more information.