Kenneth Winlund holds a box of Narcan from the Post Overdose Engagement on Willow Street in San Francisco in 2023. “The hamster wheel of narcan and safe supplies isn’t working,” one city official says.

As Mayor Daniel Lurie’s administration calls for ending the distribution of fentanyl smoking supplies on city sidewalks, some are asking if harm reduction strategies should continue to play a part in San Francisco’s response to drug addiction.  

They definitely should, as long as some critical realities are borne in mind.

First, harm reduction is a total population health strategy, meaning it is supposed to ensure that everyone’s well-being counts. Because drug addiction is a deeply stigmatized condition, in many places I visit, I have to remind people that “everyone” includes people who use drugs and that their lives and health have value.

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But in San Francisco, I often have to remind harm reduction advocates that people who don’t use drugs matter, too. 

Imagine a person who begins sitting in front of a coffee shop every day using fentanyl and meth and yelling at passersby. Customers begin avoiding the cafe, depriving them of potentially restorative moments of human connection in their stressful days. Meanwhile, the cafe owner’s mental health deteriorates as she loses the income needed to employ her staff and has to lay them off, worsening their lives. Parents walking their kids to school have to cross the street through traffic to avoid the person using drugs and calm the........

© San Francisco Chronicle