by Randy Shaw on May 11, 2026 (BeyondChron.org)
A Tale of Two San Francisco’s
Sidewalk drug users do more than hurt San Francisco’s image—they also undermine the city’s remaining low-income and working-class neighborhoods. Communities our elected officials continually vow to protect.
Harm reduction policies targeted to street addicts force low-income and working people to navigate drug-filled sidewalks. Harm reduction leaves children afraid to walk to their homes, small businesses losing customers, and seniors trapped in their homes out of fear of what they will confront outside.
No supervisor or mayor publicly claims that San Francisco should prioritize sidewalk drug users over working people. But that is what’s happening. That’s what the city allowing nonprofits to distribute pipes and foil to facilitate sidewalk drug use is all about.
San Francisco’s extreme drug crisis began with COVID. But its continued for over six years! And despite the mayor’s declaration of a fentanyl emergency, the reconstitution of street outreach teams, increased police recruitment, and similar measures, there is no clear end in sight.
San Francisco’s open air drug activities are unique to major North American or European cities.
Why?
Undermining SF’s Working-Class Neighborhoods
There are now two San Francisco’s. The affluent villages outside the central city have few if any sidewalk drug users. They are thriving. When they have a crime problem—such as the wave of car break ins that occurred under Mayor Breed—scarce police resources are quickly dispatched to abate the crisis.
The difference in the city’s approach to car break ins and open air drug activities is illuminating. It reflects a contrasting view of “success” between affluent and working-class neighborhoods.
When the city sought to end car break ins, success was measured by fewer break ins. It was not measured by the number of arrests. The city knew people wanted results, not arrest numbers.
But for tackling the sidewalk drug crisis we only hear about rising arrests. Not whether there has been any actual reduction in sidewalk drug users.
The city does not count sidewalk drug users. It counts encampments, which likely explains why tent numbers have been sharply reduced. But the city’s actual progress in reducing sidewalk drug use is not tabulated.
Imagine if City Hall had to provide a monthly report on the number of drug users on sidewalks. I bet that, as with tents, overall numbers would sharply decline.
Drug arrests are not even included in city crime statistics. This allows city officials to hail crime reductions when drug activities still dominate many sidewalks..
Harm Reduction Funds Popular Nonprofits
Glide, the SF AIDS Foundation, and the Gubbio Project all get money to hand out drug materials to street addicts. These are very popular nonprofits. Every San Francisco mayor in memory has served food at Glide. The Lurie Administration has expanded the group’s city funding to include community ambassadors. This despite Glide’s longtime failure to stop open air drug activities on and next to its 300 block of Ellis headquarters.
The Harm Reduction industry, via HealthRIGHT 360, got San Francisco to spend $22 million on a Linkage Center that wreaked havoc in the Tenderloin, Mid-Market, SOMA and the Civic Center. The negative community impacts of this destructive project are still being felt.
Uncounted Tenant Displacement
Since the late 1970’s San Francisco has seen the steady displacement of the non-rich. This outflow of longtime residents has been slowed by a powerful tenants’ movement that has enacted the strongest anti-displacement protections of any major city. This has kept low-income and working class rent-controlled tenants and those subsidized by nonprofits in place.
But the number of tenants who are forced to leave their affordable homes due to surrounding drug activities is not measured. And for many Tenderloin tenants, the drug activities have left them desperate to move.
I describe in my book about the Tenderloin how nonprofit housing helped the neighborhood avoid gentrification. But keeping the Tenderloin affordable was never supposed to come at the expense of living in a neighborhood lacking the high quality of life of more affluent communities.
Making San Francisco neighborhoods affordable but unlivable means San Francisco is not a city for All. It is a wonderful city for those who can afford to live outside the impact of harm reduction policies. It’s a tough place to live for those who cannot.
Many reporters, professors, doctors, and politicians are razor focused on how harm reduction impacts the addict. Far too few balance this against the overwhelmingly negative community impacts. I would encourage the media when interviewing harm reduction advocates to challenge them about how this policy impacts surrounding communities.
I know Mayor Lurie is deeply unhappy with the survival of the open-air drug activity that he campaigned against. But as much as the mayor uses social media to send a message that sidewalk drug use won’t be tolerated, the city’s support for handing out pipes and foil to street addicts says otherwise.
If the city wants to stop young addicts from coming here to use drugs, it must end support for drug handouts.
Randy Shaw
Randy Shaw is the Editor of Beyond Chron and the Director of San Francisco’s Tenderloin Housing Clinic, which publishes Beyond Chron. Shaw’s new book is the revised and updated, The Tenderloin: Sex, Crime and Resistance in the Heart of San Francisco. His prior books include Generation Priced Out: Who Gets to Live in the New Urban America. The Activist’s Handbook: Winning Social Change in the 21st Century, and Beyond the Fields: Cesar Chavez, the UFW and the Struggle for Justice in the 21st Century.
