Mayor, supervisors outline expanded overdose-response plan and methamphetamine task force

San Francisco leaders described a multi-pronged effort on Sept. 10 to reduce opioid and methamphetamine overdoses and expand services for people with co-occurring mental illness and substance use disorder.

Mayor London Breed told the Board of Supervisors the city has identified about 4,000 people who are homeless and suffering from both mental illness and substance use disorder and promised a multi-year initiative to "enhance individual care coordination, streamline housing and healthcare for the most vulnerable, and expand hours at the city's behavioral health access center." "These 3 elements of the initiative are just the beginning," Breed said.

The mayor and Department of Public Health officials described immediate steps already under way. Dr. Grant Colfax, director of the San Francisco Department of Public Health, said the local overdose death rate has risen in recent years and highlighted training and treatment efforts: "Our outreach workers, our shelter staff, our [Health] officers are all trained in harm reduction, including Narcan administration," and the city has expanded its street medicine capacity, providing buprenorphine on outreach and adding staff.

City officials said they have invested additional funding in street medicine. "We've invested an additional $6,000,000 and have grown our street medicine team to 10 additional people," Colfax said in the discussion. The administration also emphasized a renewed focus on methamphetamine use: Breed and Supervisor Rafael Mandelman announced a methamphetamine task force launched earlier in the year that will publish recommendations "next month" on harm reduction strategies, treatment options and policies to reduce methamphetamine-related harms.

Safe injection sites remained a focal point. Breed said the city still faces federal obstacles to opening supervised consumption sites but reaffirmed her support for them as part of a broader strategy to reduce overdose deaths. She also said criminal enforcement aimed at higher-level dealers is part of the response and cited a joint effort between the San Francisco Police Department and the U.S. Attorney's Office targeting higher‑level drug dealers.

Supervisor Matt Haney, who led the mayoral question period on this topic, urged more drop-in and detox centers as well as immediate treatment options after nonfatal overdoses. Breed said city staff and service providers are discussing expansion of locations and services where people who want help can go to access treatment and housing supports, and she acknowledged that housing remains the biggest barrier to sustained recovery.

While officials described a mix of harm-reduction, treatment and enforcement actions, they did not present a single consolidated ordinance or vote during the mayoral policy time. Instead, the session recorded commitments to publish the methamphetamine task force report, continue to expand street medicine and to pursue additional recommendations in the coming months.