Crisis isn’t accidental — leaders need to act now

San Francisco suffered a record 806 “accidental” drug overdose deaths in 2023. But the misery we see on San Francisco’s streets is anything but happenstance. It’s a policy choice.

San Francisco has had a comprehensive overdose prevention plan since 2022. Part of that plan is opening overdose prevention sites, which were thrown into legal limbo after Gov. Newsom vetoed a 2022 bill that would have given the city authorization to run such facilities.

Yet providing treatment on demand for substance abuse — an essential component of our plan — is fully within our power to achieve. We have not. Instead, evidence-based policy pursuits have become mired in debates over crime and punishment.

The editorial board has highlighted the efficacy of Portugal’s approach to problematic drug use, decriminalizing possession with a focus on treatment.

But it’s also worth mentioning Europe’s most deadly region for drug overdoses: Scotland.

After a record 1,339 overdose deaths in 2020, Scotland moved away from a focus on punitive measures for drug use and began pivoting toward Portugal’s approach. Overdose prevention centers opened in the deadliest cities. Conservatives pushed for a universal right to treatment.

Overdose deaths plummeted by 22% in 2022.

Of course, the scourge of fentanyl has largely yet to land on European shores. Its arrival has the potential to collapse systems of care. But fentanyl’s presence in San Francisco is even more reason to stop arguing and get on the same page. The only inevitable consequence of continued squabbling is more death.