San Francisco to Require Drug-Free Living at New Permanent Supportive Housing
New permanent supportive housing in San Francisco must prohibit on-site drug use in order to receive full city funding, after a controversial vote this week at the Board of Supervisors.
The board voted 7-4 to approve the ordinance, authored by Supervisor Matt Dorsey, that enables evictions on the basis of drug use in city-funded housing projects. The plan has drawn criticism from public health and homelessness advocates who say it could send more drug users to the street if they relapse, a common experience for people recovering from substance-use disorder.
But proponents say it will create environments where more people in recovery can succeed.
“This responds to real needs of [permanent supportive housing] residents themselves, people who may or may not be in recovery, but who simply want to live in a drug-free residential community,” Dorsey, who identifies as a former drug addict himself, said at Tuesday’s Board of Supervisors meeting.
San Francisco has around 9,600 site-based permanent supportive housing units, most of which follow the state’s Housing First approach, which attempts to keep people housed regardless of drug use.
The city’s new policy applies specifically to new city-funded permanent supportive housing projects and not those that are fully state-funded.
If someone living in a drug-free building were to get caught using drugs, Dorsey said eviction would be uncommon. But those who do violate the policy could be evicted or relocated to a new building or homeless shelter.
“We should expect evictions under this ordinance to be exceedingly rare,” he said. “The self-selection of residents who voluntarily opt into drug-free residential communities largely solves in advance for scenarios that involve persistent drug relapses or habitual returns to use.”
Supporters of the plan said it builds on the work the city is doing to prop up more sober-living options, such as Hope House and James Baldwin Place.
But opposing members on the Board of Supervisors raised concerns about unintended outcomes from the policy change. Supervisor Jackie Fielder put forward an amendment that would have removed shelters from the list of places someone relapsing could be relocated.
“Shelter is not housing. Shelter is a rough place for someone struggling with substance-use disorder to be. A person is not considered housed when they’re in shelter, they’re still considered homeless,” Fielder said on Tuesday. “People should be offered the option for treatment and if they participate in treatment, be able to return to their unit.”
The amendment failed to pass, despite research showing that relapse is a common part of the recovery journey for many people who have struggled with substance use.
“We don’t want somebody who doesn’t have the linear progression of being sober and falls off the wagon a couple of times to have to go back to square one and have to start in the coordinated entry system at shelter,” said Supervisor Myrna Melgar, who supported Fielder’s amendment.
The version of the ordinance passed this week comes after years of advocacy at the state level to allow for more state-funded drug-free housing, along with months of discussions about the local proposal with neighbors, local leaders and medical professionals, including some who previously opposed Dorsey’s measure for putting additional risk on vulnerable residents.
“An individual with a substance-use disorder evicted from housing because of relapses should be moved to a setting with more intensive services,” a May 4 letter from members of the San Francisco-Marin Medical Society said. “The ordinance as currently written does not contain minimum guardrails that, at the very least, would ensure that the evicted individual is not relegated to an undetermined setting with less support and possibly homelessness.”
The policy does not prohibit alcohol or marijuana or medication-assisted recovery treatment like methadone or buprenorphine, which assist in opioid-use disorder.
Other homelessness advocates said the plan creates new barriers to building housing that is affordable to extremely low-income residents, at a time when rents in the city are skyrocketing, evictions are increasing and the city is on the hook to build thousands of affordable housing units to meet state requirements.
“This unnecessarily creates obstacles for backfilling Trump HUD cuts, and for projects in the pipeline,” Jennifer Friedenbach, executive director for the Coalition on Homelessness, said in a letter to the Board of Supervisors. “We can and should do sober housing, have done sober housing and simply need to recognize that by doing so we don’t want to drive up evictions.”
San Francisco has seen a downward trend in overdose deaths this year, according to new data from the Department of Public Health. From January to June 2026, there were a total of 262 overdose deaths, around 27% fewer compared to the same time period last year.
“This downward trend is encouraging, but the number of people that continue to die of overdose is still unacceptable,” Deputy Director of Public Health Naveena Baba said during a press conference on Wednesday. “It is not enough to prevent deaths. We want people to flourish.”
Health officials attributed the changes in overdose deaths to a number of interventions in the city, including ramping up access to medication-assisted treatment. The city’s trajectory also mirrors nationwide trends of a decreasing rate of overdose deaths, Baba said.
The new policy also comes as Mayor Daniel Lurie has initiated various changes to the city’s drug response, including a shift away from harm reduction practices that aim to reduce health and social risks involved with drug use.
Under his administration, the city has stopped handing out safe smoking supplies and people seeking access to other harm reduction services now must participate in counseling.
Now that the ordinance has passed, Dorsey said city leaders can still work together to finalize details around implementation.
“We should be sensitive to not being overly prescriptive in how we legislate to avoid setting our departments up for failure,” Dorsey said. “I am confident that the specifics on housing offers, evictions and broader program components can be addressed in the rulemaking process.”