Drug devilishly difficult to kick, with no replacement medication

“It’s a super frustrating place for a physician to be in.” Dr. Josh Bamberger, street addiction specialist.

As she sat on Turk Street sucking in a deep pull from her lit “bubble,” or methamphetamine pipe, Roche shook her head. “Kick meth? Are you kidding?” she said. Roche, a 20something who said she only goes by the one name in the streets where she sleeps, blames her homelessness, her nagging cough and her constant jitters on meth. But she said she feels there is nothing she can do about it.

“When it’s got you, it’s got you,” she said. “I have about 10 friends who are dead from smoking this — and not just from fentanyl being in it — and someday that will probably be me.”

Doctors feel just as confounded as Roche does about the meth epidemic, which has long been a widespread crisis in San Francisco’s homeless community, destroying countless lives. While meth has been a problem for more than two decades, city officials say they’ve seen a huge uptick in its use over the past decade, and it’s contributed to what is widely seen as a mental health crisis on the city’s streets.

Officials announced plans last week for developing a meth sobering center in an attempt to move addicts off the street. But getting users into effective treatment won’t be as easy.

The drug is probably the hardest to treat for addiction, they say, largely because there is no replacement medication, such as methadone, which helps stave off cravings for heroin.

Even crack cocaine, which also has no replacement medication, is easier to kick than meth, most experts agree.

“It’s a super frustrating place for a physician to be in,” said Dr. Josh Bamberger, a longtime street addiction specialist and assistant director of the Benioff Homeless