Supervisors hear BLA and health experts on adopting Zurich-style "4 pillars" approach; departments outline coordinated street teams and treatment expansion

The Government Audit and Oversight Committee held an extended hearing May 15 on a proposed “4 pillars” framework to address public drug use and open‑air markets. The four pillars (prevention, harm reduction, treatment and enforcement) are the organizing framework the Budget and Legislative Analyst (BLA) studied in comparison with Zurich’s long-running program, and the committee heard BLA staff, addiction medicine physicians, public health leadership, emergency management and police representatives.

BLA findings and safe‑consumption modeling Fred Brusseau and Terry Feeley of the city’s Budget and Legislative Analyst office summarized a report comparing Zurich’s experience with San Francisco and presented a cost–benefit model for a supervised consumption site in San Francisco. Brusseau said Zurich adopted an integrated 4‑pillars approach beginning in the 1980s–1990s and credited cross‑agency collaboration for reducing visible open‑air drug use in public parks.

Key BLA data presented to the committee: - Zurich’s model emphasizes coordinated action among police, health and social services and includes safe consumption sites; San Francisco currently has none in operation. - The BLA’s baseline cost model for a single supervised consumption site showed estimated annual benefits of about $3.5 million versus costs of about $3.7 million; a larger facility yielded greater net benefits in the BLA scenarios (benefits ≈ $6.3 million). The report excluded the statistical “value of a life” calculation in headline figures but estimated a prevented 15–27 fatal overdoses per year attributable to a site. - The…