Mayor-Elect Daniel Lurie won’t have the ability to enact the “fentanyl state of emergency” he many times promised at the marketing campaign path; an emergency declaration will require the overdose disaster to be new and sudden. It’s neither. That’s what Mayor London Breed’s place of work discovered in 2021, when it inquired about mentioning a fentanyl state of emergency and was once rebuffed by way of the town lawyer’s place of work. As an alternative, the mayor declared a extra circumscribed “Tenderloin” state of emergency. Regardless, fentanyl stays an issue: 380 other folks in San Francisco have died between January and October of this yr, even though per 30 days overdose deaths are trending down. Dependancy mavens inform Venture Native {that a} mayor needn’t claim a state of emergency to deal with that. 
Daniel Lurie walks via Chinatown, adopted by way of a crowd straight away after his acceptance speech. Photograph on Nov. 8, 2024 by way of Abigail Van Neely. Lurie “doesn’t have to awaken new powers,” stated Dr. Keith Humpreys, a professor on the Stanford Faculty of Medication who makes a speciality of habit. “Simply workout management and articulate what the imaginative and prescient is.” There is not any query amongst mavens that fentanyl has transform an extraordinary killer. About 80 % of the 813 overdose deaths recorded in San Francisco between January of 2023 and January of 2024 concerned fentanyl.
There’s, on the other hand, no unanimous imaginative and prescient of how you can mitigate fentanyl’s devastating results. Public fitness mavens and advocates are ceaselessly divided between “injury discount” methods that search to regard customers with out requiring abstinence, and public-safety-first approaches with extra visual policing and obligatory remedy to quell the open-air drug use and working. The half-dozen mavens Venture Native spoke to all stated San Francisco wishes a pace-setter who can bridge this ideological divide. An “pointless duel between the 2 approaches” has emerged, stated Jonathan Caulkins, a drug-policy researcher at Carnegie Mellon College.“If the mayor is daring, and the mayor in point of fact desires to guide — be in rate,” added Dr. Daniel Ciccarone, an habit skilled on the College of California, San Francisco. “Carry factions in combination.”
Newly elected mayor Daniel Lurie addresses a crowd in Chinatown as he broadcasts plans for a “fentanyl state of emergency.” Photograph on Nov. 8, 2024 by way of Abigail Van Neely.Streets owned by way of citizens, ‘no longer the drug scene’Humphreys, the Stanford researcher, stated {that a} extra visual police presence would no longer remove drug use. However it will, he stated, lend a hand ensure that San Francisco’s streets are “owned by way of citizens and no longer the drug scene,” a justified concern of many town dwellers. Humprehys says the town’s technique must prioritize long-term restoration reasonably than transient injury discount. Nonetheless, he additionally famous that the divide between public fitness and public security “can not exist.” Legislation enforcement and public fitness execs want to cooperate, Humprehys stated: After a police drug bust, there must be a methadone van on web page. A a hit mayor, he endured, would appoint individuals who conform to paintings in combination and contract a middle to oversee them. Dr. David Smith, an habit drugs specialist who opened the Haight Ashbury Loose Medical institution in 1967, stated he and different physicians suggested Lurie earlier than the election on insurance policies that will lend a hand take away sellers and addicts from the streets. “San Francisco has virtually transform too liberal,” Smith stated. Whilst he doesn’t wish to see a “rebirth of the battle on medication,” Smith believes that obligatory remedy and conservatorship is had to cut back the drug provide and insist.Lurie’s “willingness to hear mavens” inspired Smith. He stays positive, he stated, that Lurie’s announcement will a minimum of advised a extra pressing debate about new, cutting edge remedies. 
A person receives a Covid vaccine in addition to a recent spherical of bandages. Nurses stated he had edema from long-term drug use, and his pant legs had been chafing, inflicting the injuries to bleed. He may just most effective stroll with excessive problem. Photograph by way of Griffin Jones on July 8, 2023.Cooperation speaks louder than wordsDr. William Andereck, a health care provider and clinical ethics skilled at California Pacific Scientific Middle, stated mentioning a state of emergency by way of press unencumber, in particular one that will no longer include any added powers, won’t repair the town’s fentanyl downside. “I feel it’s good to name within the Nationwide Guard and the Air Power and no longer get issues performed,” Andereck stated. The mayor’s rhetoric can get other folks involved, however “it’s no longer definitely worth the political capital to check out to position it into legislation.” “A public-health method is the one solution to deal with addicts, as a result of they be afflicted by a illness,” Andereck endured. The “criminalization of customers has no longer labored.” Nonetheless, he stated, there additionally must be force to take part in rehabilitation methods and a greater conservatorship procedure. Andereck additionally famous the harm-reduction as opposed to rehabilitation debate. Given restricted sources, he stated, the other camps’ want “to offer protection to their respective silos” is comprehensible. On the other hand, he cautioned, execs “can’t be so boastful” when “each have a task.” The will for cooperation, Andereck added, extends past execs. The general public sector, he stated, must paintings with the non-public sector to protected grants and reinforce companies suffering from drug use. Officers, he stated, must paintings with contributors of the general public bored with seeing an open-air drug marketplace. 
Daniel Lurie walks via Chinatown adopted by way of a crowd straight away after his acceptance speech. Photograph on Nov. 8, 2024 by way of Abigail Van Neely. In the long run, Ciccarone, the UCSF researcher, hopes to peer Lurie enact insurance policies that convey in combination other approaches. He’s a proponent of the “4 Pillars Technique” proposed in a document launched by way of Manager Dean Preston — who simply misplaced his bid for reelection — final week. The method, which effectively lowered overdose deaths in Zurich, Switzerland, goals to unite prevention, injury discount, remedy, and legislation enforcement drug insurance policies. As an example, police can be prompt to take an “competitive method” to informing customers that they are going to be arrested. On the identical time, they’d remind customers of the provision of safe-consumption websites the place they wouldn’t be topic to arrest. Ciccarone helps injury discount. That stated, he doesn’t simply wish to see the long run mayor institute a “namby-pamby leftist answer.” He described his concept of a excellent chief: “In the event that they’re sensible — and the fellow seems lovely rattling sensible — they take a hard-nosed have a look at a solvable downside and so they do the fitting factor.”
