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Committee forwards ordinance to require San Francisco pharmacies to stock buprenorphine
Summary
The Public Safety and Neighborhood Services Committee voted to forward an ordinance requiring retail pharmacies that dispense controlled substances in San Francisco to maintain an on-hand supply of buprenorphine to fill existing prescriptions plus two additional 7‑day fills; the committee will send a committee report with a positive recommendation to the full Board.
The Public Safety and Neighborhood Services Committee voted on July 9 to forward to the full Board an ordinance that would require retail pharmacies in San Francisco that dispense controlled substances to maintain a minimum supply of buprenorphine, a medication used to treat opioid use disorder.
Supporters said the measure is aimed at improving immediate access to medication as the city confronts an overdose crisis. "Buprenorphine ... reduces cravings, facilitate[s] long term recovery, and cut[s] mortality risk by as much as 50 percent," a presenter said. Department of Public Health staff described local outreach and previous city efforts — including emergency department prescribing, a BHS pharmacy at 10th and Howard, mobile-dispensing authority under state law, and a nighttime telehealth line — intended to expand treatment access.
The health-department presentation cited surveys the department said demonstrate gaps in pharmacy availability: a 2023 California study found about 47% of pharmacies in the state stocked buprenorphine, and a 2024 San Francisco call survey found roughly 44% of pharmacies reached had buprenorphine in stock the day they were called. Presenters said that prescribing alone does not guarantee patients can promptly obtain medication at a local retail pharmacy.
Under the ordinance as presented, retail pharmacies that dispense controlled substances would be required to keep enough buprenorphine on hand to fill all existing prescriptions and at least two additional prescriptions of 24 milligrams per day for seven days. The bill would permit a notice of violation and administrative penalties for noncompliance consistent with existing city law, and would include a three-day grace period when a pharmacy recently filled a prescription and is awaiting replacement stock. The presenters said the city intends to provide technical assistance to pharmacies to support compliance.
Committee members asked staff about reasons for limited prescribing and stocking. Department of Public Health staff cited stigma among health-care providers and historical federal training requirements that earlier limited prescribers; they noted those extra training requirements were eliminated in the 2023 Consolidated Appropriations Act. Public comment on the item was not offered at the hearing.
The committee unanimously forwarded the ordinance as a committee report with a positive recommendation to the full Board; the clerk noted items acted on in committee are expected to appear on the Board agenda on July 16, 2024. The full Board will consider the ordinance at a later meeting.
