S.F. recovery first drug plan sees key word change after criticism from advocates

The San Francisco Board of Supervisors advanced a revised "recovery first" ordinance, shifting its focus from an "abstinence-first" model to "long-term remission" after advocacy criticism. The change was prompted by harm-reduction supporters, including the San Francisco Marin Medical Society, which argued for a more inclusive definition of recovery. Dorsey noted that many residents are frustrated with harm reduction strategies, emphasizing the need for a balanced approach. The ordinance aims to guide city contractors and future legislation, though it currently lacks enforceable measures. Notably, overdose deaths in San Francisco have surged again, following a decline, with 65 fatalities reported in March 2025.

Advocates warn that recent policy shifts could exacerbate the crisis, particularly among fentanyl users. Dorsey, a recovering addict, supports diverse recovery pathways, reflecting a growing consensus among medical professionals for both harm reduction and abstinence strategies. Public commentary during the Thursday hearing included voices from individuals with personal recovery experiences, underscoring the ordinance's local significance.