Board adopts ‘Recovery First’ ordinance on first reading, says substance-use policy should prioritize long-term remission

The Board of Supervisors on May 6 passed on first reading an ordinance to amend the administrative code to establish long-term remission of substance use disorders as the primary goal of the city's substance use disorder treatment policy.

Introduced by Supervisor Matt Dorsey, the measure frames a citywide policy objective that aligns with positions offered by the San Francisco Marin Medical Society and other treatment advocates. Dorsey said the ordinance—despite its “brevity” in plain text—was the product of extensive engagement with medical professionals and community groups and was intended to make the city’s treatment goal consistent with clinicians’ guidance. He said it was important to “align our civic aspiration with what any of us would wish for a loved one struggling with drug addiction, a self directed and healthy life free from illicit drug use.”

Supervisor Fielder, among others, said the debate had been important and promised an upcoming hearing on a “four pillars” approach (prevention, treatment, harm reduction and enforcement). Supervisor Chan praised a broader approach to treatment, and Supervisor Fielder underscored that overdose prevention and harm reduction remain central even as the ordinance emphasizes remission as a stated primary goal.

The clerk recorded 11 ayes and no noes; the ordinance passed on first reading and will return for the second reading and final adoption under the board’s procedures.

Ending: Supporters said they expect further committee hearings and program-level work on the four-pillars framework and that the ordinance is intended to guide policy choices and program design. The board’s action does not by itself create new funding; it sets a municipal policy goal to guide city departments and service providers.