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These San Franciscans Say Recovery From Drug Addiction Is Possible

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A person sits on a bench outdoors and looks at the camera.
Jean, 60, sits outside of the Opiate Treatment Outpatient Program (OTOP) at Zuckerberg San Francisco General Hospital in San Francisco on Aug. 29, 2023. (Beth LaBerge/KQED)

In the first half of 2023, 473 people — at least — died from accidental drug overdose in San Francisco, according to the medical examiner’s office.

The majority (80%) of those deaths involved fentanyl, an opioid 50 times stronger than heroin. This year, the overdose rate is currently on pace to be the highest for overdose deaths in the city’s history, exceeding the record set in 2020 when 725 people died due to drug overdose.

The overdose epidemic in San Francisco has continued to escalate despite attempts from city leaders to expand access to treatment and tap the National Guard to throttle drug supply trafficking.

The situation is bleak, but it’s not without hope. Recovery is possible.

What follows is the story of three San Francisco residents, who share their journey through recovery and life beyond drug addiction.

KQED is publishing these stories on Aug. 31, International Overdose Awareness Day, and the week the Biden administration has designated to “honor and remember those who have lost their lives to the drug overdose epidemic.”

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Jean

San Francisco has long been a city where people come to reinvent themselves. Sometimes, it just takes a little while.

Take Jean, now 60, a mother and longtime San Francisco resident.

Jean, who is not using her last name to protect her privacy, grew up in Berkeley and faced numerous traumatizing experiences, including abuse at a young age. She started consuming drugs at just 9 years old to cope with feelings and cover up shame. Over the years, Jean developed addictions to cocaine, alcohol and heroin.

“I basically did a lot of things in order to support a heroin habit and a cocaine habit and alcohol. And it just got progressively worse,” Jean told KQED of her experience with addiction.

When she was diagnosed with cancer later on in her life, she thought she might not make it.

But Jean defied the odds she gave herself and beat cancer. Armed with a new perspective, she decided it was time to fight her addiction, too.

She started by going to Zuckerberg San Francisco General Hospital and asking for help. There, she got connected to an outpatient treatment program.

“I sought help because I knew that I couldn’t get out of my drug addiction by myself,” she said. “I got help and throughout that process. I learned about addiction. I learned that it’s a disease, it’s something that you can work through and that doesn’t have to take all your life away. It can be a new beginning, and the energy you put into that, you’re going to get back.”

Through her treatment, Jean was connected to substance-use counselors like Louie Ramos and had access to medications that helped ease cravings and withdrawal. She also participated in a detox program at HealthRight360, a nonprofit that provides mental health therapy and substance-use treatment for extremely low-income residents in San Francisco and other parts of California.

Today, Jean is living a life she once couldn’t imagine: sober and living on her own in an apartment near the Giants’ baseball stadium. She’s established a new community of friends who support her changes and understand the challenges she faces.

She wants other people in similar positions to know they can do the same.

Two people walk down a hallway beneath a banner that reads "Welcome to OTOP."
Jean, 60, walks with counselor Louie Ramos, UCSF/OTOP clinical supervisor, through the Opiate Treatment Outpatient Program (OTOP) at Zuckerberg San Francisco General Hospital in San Francisco on Aug. 29, 2023. (Beth LaBerge/KQED)

“There is a way out. There is freedom from addiction. It’s possible to come out from under fentanyl. You really just have to keep putting your best foot forward,” Jean said.

While Jean walked into San Francisco General on her own, San Francisco has a handful of teams that respond to overdoses and drug-related medical problems on the street. They include the Street Overdose Response Team, Post Overdose Engagement Team, and the Bridge and Engagement Services Team Neighborhoods program, which aims to identify individuals who may be in crisis and connect them to long-term behavioral health services.

Getting connected to methadone, a medication that can help relieve addiction cravings and withdrawal symptoms, was a crucial stepping stone in recovering from addiction, Jean said.

San Francisco has been simultaneously working to expand ways people can get connected to methadone and other medication-assisted treatments for drug addiction, through mobile clinics, longer open hours at brick-and-mortar clinics in the city and even delivery services in supportive housing buildings.

“I’ve been doing this job for many years, and I just want people to know that recovery is very possible. Treatment is accessible,” said Ramos, who is a clinical site supervisor for one of San Francisco General’s mobile methadone clinics in the Bayview. “A lot of people are reluctant to seek services, and you don’t want to force or impose. It takes a while to build trust and not everybody is able to do everything at once. You have to walk with them continuously, through the ups and downs, [and] let them know they are not being judged.”

It wasn’t a linear path to where she is today. At several points since deciding she wanted to quit using, Jean relapsed. One time, it happened after someone she knew sexually assaulted her.

“I went towards street drugs to ease my pain instead of reaching out to the recovery community, so it led me down a path that took a long time to come out of,” Jean said, after an appointment with her counselor on a recent Wednesday afternoon. “But I did.”

Juliana and Michael

Juliana, 29, and her partner Michael, 31, fell in love dancing at raves and music festivals in their early 20s. Michael worked up the courage to talk to her at a show in Las Vegas, and the two kept in touch at various music events. The two made their relationship official after attending the Coachella Valley Music and Arts Festival in Indio, California.

“She was super beautiful, and I just knew that she was really cool. She liked the same things as me,” Michael said. “After Coachella, I was like, I got to make her my girlfriend.”

The duo had fun getting lost in the music together. But drugs were common in the festival scene, and Michael already struggled with an addiction to smoking oxycontin when they met.

Juliana eventually consumed harder drugs with Michael, including heroin and fentanyl, and the two spent several years drifting between family members’ houses in San José and Santa Rosa, and many nights in and out of jail for drug use and shoplifting. They talked about getting help and quitting drugs, but it still felt too far off, and too expensive, so they delayed.

“The three things we always made sure we had were a car, a hotel and drugs, always,” Juliana said.

During the pandemic, they stayed in hotels in San Francisco. But their lives suddenly changed one day in 2021.

Juliana felt an extremely sharp pain in her abdomen and checked into the hospital. There, she discovered that she not only was pregnant, but was in labor and about to give birth.

“She wasn’t active in my stomach, and I didn’t have morning sickness. I didn’t really have the regular pregnancy signs,” said Juliana, referring to her baby girl.

Michael was equally shocked.

Two adults and one infant sit on the floor and play together with blocks.
Juliana and Michael play blocks with their daughter Paloma at their home in San Francisco on Aug. 29, 2023. (Beth LaBerge/KQED)

“If we had known that we were having a baby, I would have been too scared to be a father. I wasn’t ready. But it just happened all of the sudden. They let me in and said, congratulations, you have a daughter. I felt a connection immediately, her smile, I was like, ‘Oh my God, I have a daughter.’”

Child protective services and Family Treatment Court quickly approached them, helping create a plan for how they would re-establish their lives together and welcome home their baby.

Juliana and Michael entered treatment and joined groups to help them in their recovery. That included living at Hamilton Families, a transitional housing program where they stayed while starting their recovery journey.

Meanwhile, Juliana worked with Team Lily, a group at San Francisco General Hospital that supports pregnant people and new parents who are experiencing homelessness, substance-use disorders, incarceration and other challenges.

Just like Jean, Michael and Juliana relapsed during their effort to stay sober. They separated for a short period of time during their treatment programs and used again after reuniting.

“It was a problem of not being able to set boundaries with each other,” Juliana said.

Michael agrees.

“We basically had to learn how to be a couple again, without the drugs, because that was part of our relationship for so long,” he said. “We had to relearn how to be a normal couple, and not only that, but parents.”

A framed photo of a group of people in an official looking setting.
A photo sits on a shelf from a graduation ceremony for the San Francisco Family Treatment Court at the home of Juliana and Michael in San Francisco on Aug. 29, 2023. (Beth LaBerge/KQED)

With help from their case manager, the two were able to get back on track and hold on to the progress they made, including their housing and future as a family together.

Juliana added that the city’s prenatal program for those experiencing homelessness “connected us with a bunch of things that helped us get back on our feet, like health insurance, and just showed us a lot of options that were available to us that we didn’t know about.”

Methadone has been a big part of their recovery. Each month, Juliana will visit an outpatient treatment program to refill her prescription of opioid addiction medication and take a drug test before meeting with a counselor.

“Some people look at methadone in a bad light. But honestly, it’s the only thing that helps me stop smoking. My life is so much better and I’m happy and able to have a family and be a father. All this just wouldn’t be possible without it,” Michael said.

Today, the couple is raising their baby, Paloma, in a bright apartment in the Richmond District, while continuing to meet with recovery groups and other programs that have supported their journey.

Michael is leading a group for fathers within the prenatal program that helped his family. He’s also taking a course on mental health and substance abuse to further his training in counseling facilitation. Juliana has plans to someday return to hairstyling and has maintained a cosmetology license.

It’s not always an easy journey, but it’s given the two more faith in what they can overcome.

“If you can find an addiction together,” Michael said, “you can find recovery together.”

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