The City’s Strategies for Fighting the Drug Epidemic Aren’t Working—and Our Children are Paying the Price

San Franciscans have become accustomed to seeing evidence of our city’s drug epidemic on our city’s streets. But recently, the crisis spilled over into Moscone Park playground when a 10-month old boy accidentally ingested fentanyl while playing there with his nanny. The child will survive thanks to the first responders who administered Narcan within minutes of the incident. As a mother with a toddler of my own, I cannot stop thinking about how easily that could have happened to my family. We visit San Francisco’s playgrounds daily.
Children have been paying the price for our city’s ineffective drug policies for too long. They are forced to walk to school in dangerous conditions. They face threats of violence from users and dealers. Warnings about used hypodermic needles can be found in children’s areas across the city. Last year, an eleven year old girl whose family fled to San Francisco from war-torn Yemen was punched in the face on her way to school. My family also came to the Bay Area as refugees, from Sri Lanka nearly 25 years ago. I went on to have a successful career working in public policy thanks to the services I received as a child. This young woman is living in a completely different reality.

In an effort to avoid repeating the past mistakes of the War on Drugs, well-intentioned policy makers in San Francisco have taken “harm reduction” policies to the extreme. We’ve employed even more lenient needle exchange programs than the rest of the country, handing out fresh needles to users instead of requiring that they bring used ones back. We continue using this strategy regardless of the fact that The Economist reports that needle exchanges have led to a 22 percent uptick in opioid-related deaths nationally. We have not held drug dealers accountable for their actions: the district attorney’s office led by Chesa Boudin convicted just three drug dealers in 2021. The city spent $22 million to open the Tenderloin Linkage Center, which referred fewer than one percent of their visitors to recovery programs before ultimately closing. San Francisco regulates vinyl windows, plastic straws, and noodle shops more rigorously than it regulates open-air drug dealing.

Not only do harm reduction policies lead to a dystopian reality for the families and children who live in the city, they also don’t work to reduce harm for drug users. In the last three years alone, more than 1,800 people (that’s over 2 per day) have died from drug overdoses. According to our own Medical Examiner, between 2019 and 2020, 25 percent of all deaths in San Francisco were caused by a drug overdose. Overdose deaths are 14 times more common than firearms deaths, and 16 times more common than traffic deaths. Drug users outnumber high school students by nearly two to one. 

Given all of this, how could anyone be surprised that a child came into contact with drugs in a public park? San Francisco’s local politicians were quick to perform outrage when the news about the child ingesting fentanyl in the park broke. As a parent in this city, I have to say: outrage is not enough. It is abundantly clear that harm reduction strategies are not working. We need our lawmakers to propose new policies that take into account both the reality of the situation and the harm the drug crisis is causing everyone—not just drug users and dealers.
Mayor Breed and District Attorney Brooke Jenkins have pledged to take this issue seriously. Critics like Supervisor Dean Preston and Public Defender Manu Raju have accused them of waging a new War on Drugs. I understand their concern about the inequitable outcomes of the War on Drugs for Black and brown people. But the introduction of fentanyl in 2013 and the ensuing opioid crisis has changed everything. Fentanyl is “50 times stronger than heroin and 100 times stronger than morphine,” according to the Centers for Disease Control and Prevention. It is so strong that a user could drop a tiny grain of it on the ground and a child could accidentally ingest it and die. This is not a new War on Drugs. This is a battle for the future generation of San Franciscans we hope will continue to call this city home.

We must make sure we win.

Kanishka Karunaratne Cheng is the Executive Director of TogetherSF and TogetherSF Action,  sister nonprofits dedicated to educating and empowering San Franciscans to demand change from their city government.