It's a new day in San Francisco, according to Mayor Daniel Lurie, who recently touted the accomplishment from his first 100 days in office. Among them, was the new mayor’s abstinence-only agenda for substance-abuse treatment. This was a policy shift, not an accomplishment, but that nuance sometimes gets amidst the celebration of performative toughness.

Recently, Mayor Lurie rolled back harm-reduction policies. Included in that mandate was the order that city-funded nonprofits can no longer distribute smoking supplies unless recipients agree to treatment. That decision, medical experts say, will inevitably cause many fentanyl users to switch from smoking the drug to injecting it, resulting in the transmission of infectious diseases, overdoses and death. 

Last week, an extension of the mayor’s plan, an ordinance authored by District 6 Supervisor Matt Dorsey, came before the Public Safety & Neighborhood Services Committee of the San Francisco Board of Supervisors. The legislation which prioritized abstinence over that of harm-reduction  was greeted with harsh criticism from a lineup of medical experts and advocates. Harm reduction is the use of various public health interventions, including safe-injection sites, to preserve the lives of people with substance-use disorder.

Dr. Daniel Tsai, Lurie’s appointee to the Department of Public Health, has yet to issue a compelling response, one that substantiates the claim that forced drug treatment leads to better outcomes. 

How did scientific expertise become irrelevant and how did right-wing tropes about “common sense” triumph over data and research? Through propaganda spread by an interconnected web of conservative groups masquerading as legitimate research organizations. Abstinence-only drug policies were among the policy prescriptions pushed by Astroturf groups like GrowSF, Neighbors for a Better San Francisco, and TogetherSF in last year’s city elections.

These groups include the Manhattan Institute, a so-called think tank started by former Central Intelligence Agency director William Casey and funded by the right-wing Koch brothers; Prager University, an unaccredited educational institution offering classes on climate denialism and other “anti-woke” subjects; and Michael Shellenberger, a conservative political provocateur and author of San Fransicko: Why Progressives Ruin Cities. This shlockybook is poorly written and is essentially a tantrum calling for the criminalization of homelessness and drug use. In a review, The New York Times wrote that San Fransicko ignores “facts, best practices and complicated and heterodox approaches in favor of dogma.”

An early battleground in the fight against harm-reduction was the Tenderloin's Linkage Center. Groups like Mothers Against Drug Addiction and Death began protesting the center’s safe consumption program, characterizing it as "drug dealing" and "enabling," Overdose deaths are on the rise after the center was closed in December 2022, leaving the 400 people who visited the site each day for shelter, food and substance-abuse treatment without those vital services.

What was missing in the articles covering those protests was the connection to Shellenberger. Mothers Against Drug Addiction and Death founder Jacqui Berlinn was formerly director of Shellenberger’s Environmental Progress, a non-profit that contends global warming is “not the end of the world,” and advocates for the use of genetically modified organisms, industrial agriculture, fracking and nuclear power as weapons to combat environmental harm.

Berlinn and Shellenberger frequently host rallies, calling for the state to impose mandatory treatment as an alternative to jail for people arrested for drug use.

Another persistent voice in the anti-harm reduction camp is Shellenberger’s associate, Tom Wolf. Like Berlinn, who is the mother of a son with substance-use disorder, Wolf employs his personal story, that of being arrested for holding and using drugs in the Tenderloin (until arrest set him on the path to recovery) to argue for failed right-wing policies against drug use.

Wolf has become a leading figure in the “abstinence-only” community, branded as “recovery first.” He serves as chief executive of Shellenberger’s Pacific Alliance for Prevention and Recovery giving him a vehicle to promote his so-called “recovery first” policies. He also serves on the leadership council and as West Coast Initiative director at the Foundation for Drug Policy Solutions Inc. founded by two Shellenberger allies.

Wolf is also connected to the Manhattan Institute. He recently wrote on the "disaster" of harm reduction in its City Journal magazine. The interconnections between these right-wing groups extend further: In 2021, Shellenberger and Manhattan Institute Senior Fellow Chris Rufo worked on "conceptualizing the fight against woke ideology." In other words, Schellenberger, the PIed Piper of fighting harm reduction, is little more than a clownish right-wing propagandist.

Erica Sandberg, another City Journal contributor, wrote "Harm Production in San Francisco." Sandberg and Wolf, among others, make ample use of social media to amplify their conservative message, one based on “common sense” rather than accepted science. Sandberg takes advantage of multiple media platforms including her local television program to push an anti-harm reduction and pro-criminalization agenda.

Wolf, a recovery policy advisor to District 6’s Dorsey, is among those who informed the supervisor’s misguided ordinance. Before it could reach the full board, Dorsey’s measure was amended. “Abstinence-first” was replaced with “long-term remission,” a concession to fierce lobbying from medical experts and advocates. The full board will hear the measure in the coming months.

“Just say ‘no,’ ” was the glib slogan attached to the Reagan Era’s War on Drugs, which became an astonishing trillion-dollar failure. The medical community has learned a lot since then. San Francisco must approach the devastating fentanyl crisis by embracing science — not a right-wing agenda cloaked in emotional pleas, no matter how compelling they may be. Lives depend upon it.