The fact that San Francisco, CA, has a drug abuse problem is no surprise – nor is it news, for that matter. But one new strategy to clean up the city certainly is. The number of deaths related to overdoses climbs each year, leading officials to hunt for new methods to get people off drugs. The most recent measure being considered is to pay as much as $400 per month to some welfare recipients who test clean.
San Francisco Wants to Pay People to Stay Sober
In 2020, a record 726 people died from overdoses, according to the city’s Department of Public Health. That number dropped to 647 in 2022, but last year, there were 806 overdose deaths. San Francisco Mayor London Breed’s sister was a victim, and the mayor has been a strong supporter of the newest measure, “Cash Not Drugs,” introduced on Monday, July 29.
Proposed by Supervisor Matt Dorsey, the pilot program is designed to reward good behavior. Dorsey, who is several years sober after nearly 25 years of addiction, said: “This is more carrot than stick. It’s a pretty promising approach.”
“Cash Not Drugs” is meant to enhance Proposition F, which will begin in January. The proposition was passed in March and “requires that people with a substance use disorder who want to access county-funded cash assistance participate in some form of treatment,” according to the San Francisco Human Services Agency’s website.
“The underlining principle of ‘Cash Not Drugs’ is a simple one,” Dorsey explained. “A humane and effective approach to San Francisco’s drug crisis should also include rewarding good behavior and not just punishing bad behavior.”
“I want to make it just as easy to get treatment as it is to go out there and buy dope,” Mayor Breed said at a press conference. She added, “Getting people clean and sober. Getting them on the right path so they can take care of themselves and be supported and lifted up … That’s what this is about. We are finally listening to the recovery community.”
San Francisco’s welfare program, the County Adult Assistance Program (CAAP), has more than 5,000 recipients. Single adults without children currently receive $712 per month, but if their drug tests come back negative each week, then they can get an extra $400 for a total of $1,112 a month. However, if they test positive and refuse to seek treatment, then under Proposition F, the city can withhold their cash aid.
The incentive payout amount is not set in stone, Dorsey told The San Francisco Standard. He suggests weekly increases for those who have successive negative test results. Currently, the pilot is plotted for three years, though the financial impact is not yet known. He said if every person in the program succeeded, which is not likely, then it would cost about $27 million.
“I would rather get this right and scale up,” Dorsey said, adding that San Francisco is having a rough budgetary season. “But let’s get it right first.”
Keith Humphreys, a Stanford professor who worked on drug policy for Barack Obama’s administration, told The Standard that contingency management, offering rewards for good behavior, can make an impact. “It has been done all over the country,” he wrote in a text to the outlet. “There are over 150 clinical trials supported by the National Institute of Health that have shown positive effects.”
However, the “Cash Not Drugs” legislation still needs the Board of Supervisors to endorse it. Whether it will be an effective method to combat drug abuse in the Golden Gate City is anybody's guess. Opponents worry that drug users will find ways to get around the weekly tests. Critics argue the money spent is too much and could be used to fight other issues, such as homelessness. Of course, it's a lot of money to dish out, and the idea might seem ludicrous to some people. But one thing's for sure: The current methods to mitigate the nation's drug crisis are not working.
