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"content": "\u003cp>\u003cb>Here are the morning’s top stories on Tuesday, November 18, 2025…\u003c/b>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Los Angeles County’s jail system is in the middle of one of its deadliest years on record. According to the L.A. County Sheriff’s Department, there have been more than three dozen in-custody deaths so far this year, and many have involved overdoses. Now, \u003c/span>\u003ca href=\"https://calmatters.org/justice/2025/11/la-jail-opioid-treatment/\">\u003cspan style=\"font-weight: 400\">new reporting from CalMatters\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> reveals that access to critical opioid addiction treatment has been quietly scaled back. \u003c/span>\u003c/li>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">The Trump administration \u003c/span>\u003ca href=\"https://apnews.com/article/federal-agents-ice-mask-lawsuit-immigration-97bd5027946c677badfc78ba2d85c71a\">\u003cspan style=\"font-weight: 400\">is suing California\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> over a new law that bars local and federal law enforcement from wearing masks while on duty. \u003c/span>\u003c/li>\n\u003cli>\u003ca href=\"https://laist.com/news/lawsuit-claims-company-behind-eaton-fire-evacuation-warnings-was-negligent\">Another lawsuit has been filed\u003c/a> against Southern California Edison by victims of the Eaton Fire. But this time, the lawsuit also includes Genasys Inc., the company hired by Los Angeles County to provide evacuation warnings.\u003c/li>\n\u003c/ul>\n\u003ch2 class=\"entry-title \">\u003ca href=\"https://calmatters.org/justice/2025/11/la-jail-opioid-treatment/\">\u003cstrong>LA Jails Scale Back Opioid Addiction Treatment As Fatal Overdoses Continue\u003c/strong>\u003c/a>\u003c/h2>\n\u003cp>Los Angeles County jails pared back access to life-saving \u003ca href=\"https://calmatters.org/explainers/california-opioid-crisis/\" target=\"_blank\" rel=\"noreferrer noopener\">opioid addiction\u003c/a> treatment this fall during one of the system’s deadliest years on record, according to records obtained by CalMatters and interviews with staff.\u003c/p>\n\u003cp>The policy change came one week after Attorney General Rob Bonta \u003ca href=\"https://calmatters.org/justice/2025/09/los-angeles-jail-lawsuit/\" target=\"_blank\" rel=\"noreferrer noopener\">filed a lawsuit against the county\u003c/a> over “inhumane” conditions across its jail system, citing a “shocking rate of deaths,” including overdoses. In interviews with CalMatters, two Correctional Health Services physicians expressed alarm over the reductions, saying that even the slightest delay in treatment is “wildly dangerous” and can lead to more fatal overdoses. “Patients are begging me for help,” said a physician who spoke with CalMatters on the condition of anonymity because of fear of professional retaliation. “I’m on edge, waiting to see if someone is going to die.”\u003c/p>\n\u003cp>The reduction in treatment also comes as the jails hold about 700 more people every day as a result of a tough-on-crime ballot measure voters approved last year. \u003ca href=\"https://calmatters.org/justice/2025/10/proposition-36-treatment-study/\" target=\"_blank\" rel=\"noreferrer noopener\">Proposition 36 increased sentences\u003c/a> for certain drug and theft crimes, leading to a surge in jail populations and straining county resources, according to a Sept. 10 Correctional Health Services memo to the Board of Supervisors.\u003c/p>\n\u003cp>Los Angeles County allocates roughly $25 million annually for the treatment program. County supervisors this year gave the program an additional $8 million from opioid lawsuit settlements. That sum ultimately did not increase funding for treatment because the county shifted an equivalent amount of money to a different need, according to a statement from the Los Angeles County Department of Health Services. “The overall (medication-assisted treatment) program funding remained the same” despite the extra money the department received, the statement reads. In a Sept. 16 memo obtained by CalMatters, Chief Medical Officer Sean Henderson said Correctional Health Services “will be taking a pause on primary care in ordering buprenorphine.” The medication reduces cravings and prevents overdoses.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The new mandate restricts how quickly and broadly Correctional Health Services physicians can prescribe the medication. Priority will be given to people when they first enter the jail system — the largest in California — which houses roughly 13,000 people across nine main facilities. Everyone else who wants medication will be placed on a waitlist. “It’s misleading because we just put people on this list and then they stay on the list,” said a physician. That means that if someone does not accept treatment upon arrival, they won’t be able to access it during the remainder of their incarceration, even if they change their mind, said both physicians who spoke with CalMatters.\u003c/p>\n\u003ch2 class=\"Page-headline\">\u003ca href=\"https://apnews.com/article/federal-agents-ice-mask-lawsuit-immigration-97bd5027946c677badfc78ba2d85c71a\">\u003cstrong>Trump Administration Sues California Over Law Banning Masked Federal Agents\u003c/strong>\u003c/a>\u003c/h2>\n\u003cp>The Trump administration filed a lawsuit Monday over California’s new laws banning federal agents from wearing masks and requiring them to have identification while conducting operations in the state.\u003c/p>\n\u003cp>The federal government has argued the laws threaten the safety of officers who are facing “unprecedented” harassment, doxing, and violence and said it will not comply with them.\u003c/p>\n\u003cp>California became the first state to ban most law enforcement officers, including federal immigration agents, from \u003cspan class=\"LinkEnhancement\">\u003ca class=\"Link AnClick-LinkEnhancement\" href=\"https://apnews.com/article/ice-masks-immigration-enforcement-policing-aacbb45b9eca804c2295f52a33a2a0fd\" data-gtm-enhancement-style=\"LinkEnhancementA\">covering their faces\u003c/a>\u003c/span> while conducting official business under a bill that was \u003cspan class=\"LinkEnhancement\">\u003ca class=\"Link AnClick-LinkEnhancement\" href=\"https://apnews.com/article/california-ice-agents-immigration-raids-masks-ban-97936f70699b75d8b483a850967c2e42\" data-gtm-enhancement-style=\"LinkEnhancementA\">signed in September\u003c/a>\u003c/span> by Gov. Gavin Newsom. The law prohibits neck gaiters, ski masks and other facial coverings for local and federal officers, including immigration enforcement agents, while they conduct official business. It makes exceptions for undercover agents, protective equipment like N95 respirators or tactical gear, and it does not apply to state police.\u003c/p>\n\u003cp>“California’s anti-law enforcement policies discriminate against the federal government and are designed to create risk for our agents. These laws cannot stand,” U.S. Attorney General Pam Bondi said in a press release.\u003c/p>\n\u003ch2 class=\"ArticlePage-headline\">\u003ca href=\"https://laist.com/news/lawsuit-claims-company-behind-eaton-fire-evacuation-warnings-was-negligent\">\u003cstrong>Lawsuit Claims Company Behind Eaton Fire Evacuation Warnings Was Negligent\u003c/strong>\u003c/a>\u003c/h2>\n\u003cp>Attorneys representing Eaton Fire survivors filed a lawsuit Monday against Southern California Edison and Genasys Inc. over the death of a woman who died in Altadena. The lawsuit accuses the utility of igniting the blaze and Genasys of failing to issue evacuation warnings in her neighborhood.\u003c/p>\n\u003cp>The family of Stacey Darden accuses Genasys, hired by L.A. County to provide evacuation warnings, of being negligent the night of the fire. Lawyers for the family said while the company provided warnings in enough time to the houses on the east of Lake Avenue, they came too late for those on the west. 18 of the 19 deaths in the fire were people who lived west of Lake Avenue in Altadena.\u003c/p>\n\u003cp>On the evening of January 7, and into the early morning hours of January 8, Darden and her sister Gerry consistently monitored the news for the evacuation zones for the Eaton Fire to confirm that Stacey and her home were safe for her to remain in.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Stacey Darden’s last cellphone activity is believed to have been around 3:30 a.m. Jan. 8. Attorneys alleged the one and only communication regarding an evacuation order she received was not until 5:43 a.m. that same day. This is the first lawsuit targeting the alerts system in Altadena.\u003c/p>\n\n",
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"excerpt": "It comes as LA County jails are in the middle of one of its deadliest years on record.",
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"title": "LA Jails Scale Back Opioid Addiction Treatment | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cb>Here are the morning’s top stories on Tuesday, November 18, 2025…\u003c/b>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Los Angeles County’s jail system is in the middle of one of its deadliest years on record. According to the L.A. County Sheriff’s Department, there have been more than three dozen in-custody deaths so far this year, and many have involved overdoses. Now, \u003c/span>\u003ca href=\"https://calmatters.org/justice/2025/11/la-jail-opioid-treatment/\">\u003cspan style=\"font-weight: 400\">new reporting from CalMatters\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> reveals that access to critical opioid addiction treatment has been quietly scaled back. \u003c/span>\u003c/li>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">The Trump administration \u003c/span>\u003ca href=\"https://apnews.com/article/federal-agents-ice-mask-lawsuit-immigration-97bd5027946c677badfc78ba2d85c71a\">\u003cspan style=\"font-weight: 400\">is suing California\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> over a new law that bars local and federal law enforcement from wearing masks while on duty. \u003c/span>\u003c/li>\n\u003cli>\u003ca href=\"https://laist.com/news/lawsuit-claims-company-behind-eaton-fire-evacuation-warnings-was-negligent\">Another lawsuit has been filed\u003c/a> against Southern California Edison by victims of the Eaton Fire. But this time, the lawsuit also includes Genasys Inc., the company hired by Los Angeles County to provide evacuation warnings.\u003c/li>\n\u003c/ul>\n\u003ch2 class=\"entry-title \">\u003ca href=\"https://calmatters.org/justice/2025/11/la-jail-opioid-treatment/\">\u003cstrong>LA Jails Scale Back Opioid Addiction Treatment As Fatal Overdoses Continue\u003c/strong>\u003c/a>\u003c/h2>\n\u003cp>Los Angeles County jails pared back access to life-saving \u003ca href=\"https://calmatters.org/explainers/california-opioid-crisis/\" target=\"_blank\" rel=\"noreferrer noopener\">opioid addiction\u003c/a> treatment this fall during one of the system’s deadliest years on record, according to records obtained by CalMatters and interviews with staff.\u003c/p>\n\u003cp>The policy change came one week after Attorney General Rob Bonta \u003ca href=\"https://calmatters.org/justice/2025/09/los-angeles-jail-lawsuit/\" target=\"_blank\" rel=\"noreferrer noopener\">filed a lawsuit against the county\u003c/a> over “inhumane” conditions across its jail system, citing a “shocking rate of deaths,” including overdoses. In interviews with CalMatters, two Correctional Health Services physicians expressed alarm over the reductions, saying that even the slightest delay in treatment is “wildly dangerous” and can lead to more fatal overdoses. “Patients are begging me for help,” said a physician who spoke with CalMatters on the condition of anonymity because of fear of professional retaliation. “I’m on edge, waiting to see if someone is going to die.”\u003c/p>\n\u003cp>The reduction in treatment also comes as the jails hold about 700 more people every day as a result of a tough-on-crime ballot measure voters approved last year. \u003ca href=\"https://calmatters.org/justice/2025/10/proposition-36-treatment-study/\" target=\"_blank\" rel=\"noreferrer noopener\">Proposition 36 increased sentences\u003c/a> for certain drug and theft crimes, leading to a surge in jail populations and straining county resources, according to a Sept. 10 Correctional Health Services memo to the Board of Supervisors.\u003c/p>\n\u003cp>Los Angeles County allocates roughly $25 million annually for the treatment program. County supervisors this year gave the program an additional $8 million from opioid lawsuit settlements. That sum ultimately did not increase funding for treatment because the county shifted an equivalent amount of money to a different need, according to a statement from the Los Angeles County Department of Health Services. “The overall (medication-assisted treatment) program funding remained the same” despite the extra money the department received, the statement reads. In a Sept. 16 memo obtained by CalMatters, Chief Medical Officer Sean Henderson said Correctional Health Services “will be taking a pause on primary care in ordering buprenorphine.” The medication reduces cravings and prevents overdoses.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The new mandate restricts how quickly and broadly Correctional Health Services physicians can prescribe the medication. Priority will be given to people when they first enter the jail system — the largest in California — which houses roughly 13,000 people across nine main facilities. Everyone else who wants medication will be placed on a waitlist. “It’s misleading because we just put people on this list and then they stay on the list,” said a physician. That means that if someone does not accept treatment upon arrival, they won’t be able to access it during the remainder of their incarceration, even if they change their mind, said both physicians who spoke with CalMatters.\u003c/p>\n\u003ch2 class=\"Page-headline\">\u003ca href=\"https://apnews.com/article/federal-agents-ice-mask-lawsuit-immigration-97bd5027946c677badfc78ba2d85c71a\">\u003cstrong>Trump Administration Sues California Over Law Banning Masked Federal Agents\u003c/strong>\u003c/a>\u003c/h2>\n\u003cp>The Trump administration filed a lawsuit Monday over California’s new laws banning federal agents from wearing masks and requiring them to have identification while conducting operations in the state.\u003c/p>\n\u003cp>The federal government has argued the laws threaten the safety of officers who are facing “unprecedented” harassment, doxing, and violence and said it will not comply with them.\u003c/p>\n\u003cp>California became the first state to ban most law enforcement officers, including federal immigration agents, from \u003cspan class=\"LinkEnhancement\">\u003ca class=\"Link AnClick-LinkEnhancement\" href=\"https://apnews.com/article/ice-masks-immigration-enforcement-policing-aacbb45b9eca804c2295f52a33a2a0fd\" data-gtm-enhancement-style=\"LinkEnhancementA\">covering their faces\u003c/a>\u003c/span> while conducting official business under a bill that was \u003cspan class=\"LinkEnhancement\">\u003ca class=\"Link AnClick-LinkEnhancement\" href=\"https://apnews.com/article/california-ice-agents-immigration-raids-masks-ban-97936f70699b75d8b483a850967c2e42\" data-gtm-enhancement-style=\"LinkEnhancementA\">signed in September\u003c/a>\u003c/span> by Gov. Gavin Newsom. The law prohibits neck gaiters, ski masks and other facial coverings for local and federal officers, including immigration enforcement agents, while they conduct official business. It makes exceptions for undercover agents, protective equipment like N95 respirators or tactical gear, and it does not apply to state police.\u003c/p>\n\u003cp>“California’s anti-law enforcement policies discriminate against the federal government and are designed to create risk for our agents. These laws cannot stand,” U.S. Attorney General Pam Bondi said in a press release.\u003c/p>\n\u003ch2 class=\"ArticlePage-headline\">\u003ca href=\"https://laist.com/news/lawsuit-claims-company-behind-eaton-fire-evacuation-warnings-was-negligent\">\u003cstrong>Lawsuit Claims Company Behind Eaton Fire Evacuation Warnings Was Negligent\u003c/strong>\u003c/a>\u003c/h2>\n\u003cp>Attorneys representing Eaton Fire survivors filed a lawsuit Monday against Southern California Edison and Genasys Inc. over the death of a woman who died in Altadena. The lawsuit accuses the utility of igniting the blaze and Genasys of failing to issue evacuation warnings in her neighborhood.\u003c/p>\n\u003cp>The family of Stacey Darden accuses Genasys, hired by L.A. County to provide evacuation warnings, of being negligent the night of the fire. Lawyers for the family said while the company provided warnings in enough time to the houses on the east of Lake Avenue, they came too late for those on the west. 18 of the 19 deaths in the fire were people who lived west of Lake Avenue in Altadena.\u003c/p>\n\u003cp>On the evening of January 7, and into the early morning hours of January 8, Darden and her sister Gerry consistently monitored the news for the evacuation zones for the Eaton Fire to confirm that Stacey and her home were safe for her to remain in.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Stacey Darden’s last cellphone activity is believed to have been around 3:30 a.m. Jan. 8. Attorneys alleged the one and only communication regarding an evacuation order she received was not until 5:43 a.m. that same day. This is the first lawsuit targeting the alerts system in Altadena.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"slug": "how-san-francisco-harm-reduction-strategies-are-changing-under-mayor-lurie",
"title": "How San Francisco's Harm Reduction Strategies Are Changing Under Mayor Lurie",
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"headTitle": "How San Francisco’s Harm Reduction Strategies Are Changing Under Mayor Lurie | KQED",
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"content": "\u003cp>Dimitri Clark is everywhere in his South of Market apartment building. Greeting residents in the lobby, checking in on floormates and keeping a door open for others to come by the tiny studio he shares with two affectionate terriers, Porcupine and Panda.\u003c/p>\n\u003cp>He’s doing it all to promote safer drug use and reduce overdoses as part of a broader public health program that the city is now expanding within permanent supportive housing buildings. But it comes as San Francisco is \u003ca href=\"https://www.kqed.org/news/12032239/overdoses-climb-lurie-orders-scaling-back-harm-reduction-programs\">scaling back other harm reduction programs\u003c/a>, and as high overdose rates in the city persist.\u003c/p>\n\u003cp>Nearly 460 people died of overdose from January to August 2025, according to the most recently available \u003ca href=\"https://www.sf.gov/data--preliminary-unintentional-drug-overdose-deaths\">public data\u003c/a>, putting the city on pace to exceed last year’s total.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“There are people who use drugs—that’s just part of human nature—and a lot of people want to isolate themselves, and that’s often when they’ll experience an overdose,” said Clark, who has been in recovery for about a year. “We talk to people about it, take the shame away.”\u003c/p>\n\u003cp>The city’s Public Health Department recently gave the peer responder program Clark is part of a boost: $600,000 over the next five years to expand its work in San Francisco.\u003c/p>\n\u003cfigure id=\"attachment_12053915\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-12053915 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00371_TV-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00371_TV-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00371_TV-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00371_TV-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Dimitri Clark, a peer responder for Delivering Innovation in Supportive Housing, hugs his dog in his room at The Margot in San Francisco on Aug. 20, 2025. \u003ccite>(Tâm Vũ/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>As a peer responder, Clark guides neighbors through safer drug use practices and ways to prevent an overdose. For a couple of hours each week, he posts up in his building lobby to talk about overdose prevention and hands out safety supplies like oxygen masks, sanitizing wipes and information on how to get help for anyone ready—or even just curious—about quitting. He also frequently gives out \u003ca href=\"https://www.kqed.org/news/11947448/there-to-save-a-life-san-francisco-bars-fight-fentanyl-overdoses-with-narcan\">drug test kits and the opioid overdose-reversal medicine naloxone\u003c/a>.\u003c/p>\n\u003cp>The program started in 2021 with five people, including Clark, at his former South of Market residence, the Minna Lee. Overdoses were soaring during the pandemic, so the building’s service provider, a nonprofit called Delivering Innovation in Supportive Housing (DISH SF), decided to train residents with experience using drugs on life-saving strategies to help their neighbors.\u003c/p>\n\u003cp>Suddenly, overdoses at the Minna Lee began dropping.[aside postID=news_12038907 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/240109-SFCeasefireVote-10-BL_qed-1020x680.jpg']“We had multiple years of zero fatal overdoses at the Minna Lee, specifically due to, I would argue, that intervention,” said Mattie Loyce, senior manager of community development at DISH SF.\u003c/p>\n\u003cp>DISH SF has been training more peer responders ever since. This spring, 25 peer responders graduated from the program that is now operating in seven permanent supportive housing buildings.\u003c/p>\n\u003cp>To help incentivize residents to join, the program offers peer responders a $600 stipend. It’s hardly enough to cover a single month’s rent, but several members said the 14-week training program provided tools to change their own relationship to substances, help others and build confidence in other areas of their lives.\u003c/p>\n\u003cp>During the three-month training program, participants take classes on everything from how to respond to an overdose to where to direct people for treatment, as well as different substances’ potencies and effects on the mind and body.\u003c/p>\n\u003cp>“I actually didn’t know before I started this program how many overdoses were happening in our buildings,” said Nicole Flores, another peer responder in the program, who said she is still navigating her own relationship with drugs. “A lot of these resources I didn’t know were available, not just harm reduction supplies, but also wound care and other programs for our community.”\u003c/p>\n\u003cfigure id=\"attachment_12057624\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12057624\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/250826_sfharmreduction00450_TV_qed.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/250826_sfharmreduction00450_TV_qed.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/250826_sfharmreduction00450_TV_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/250826_sfharmreduction00450_TV_qed-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Nicole Flores, a peer responder for Delivering Innovation in Supportive Housing, stands outside her unit at The Auburn in San Francisco on Aug. 20, 2025. \u003ccite>(Tâm Vũ/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Peer responders have crafted overdose prevention safety plans with dozens of residents already. Harm reduction, a method backed by \u003ca href=\"https://www.cdc.gov/overdose-prevention/media/pdfs/OD2A-Case-Studies-Harm-Reduction-508.pdf\">scientific research\u003c/a> to reduce overdose risk and other negative consequences of drug use, is just one element of the city’s approach. San Francisco also sends medical professionals into supportive housing buildings to \u003ca href=\"https://www.kqed.org/news/11945418/san-francisco-has-doubled-participants-of-this-opioid-treatment-heres-why\">deliver drug treatment\u003c/a> options like buprenorphine, a medication that can reduce opioid cravings and withdrawal.\u003c/p>\n\u003cp>“I would like for people to start looking at this community and seeing an asset, instead of seeing a problem, because there’s a lot of potential,” said Katie O’Bryant, manager of the peer responder program. “There’s lot of transferable skills that people learn in this lifestyle that can be replicated for all kinds of good in other instances.”\u003c/p>\n\u003cp>Mayor Daniel Lurie made reducing overdoses, and particularly the most visible street-level drug use and dealing, a central part of his campaign. As part of the mayor’s “Breaking the Cycle” initiative, the city has opened a stabilization center at \u003ca href=\"https://www.kqed.org/news/12038376/tenderloin-welcomes-mental-health-clinic-demands-broader-city-action-on-homelessness\">822 Geary\u003c/a> St., reorganized street response teams and increased policing of outdoor drug use and dealing.[aside postID=news_12034214 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250218-SFDowntown-07-BL_qed-1020x680.jpg']Last spring, Lurie \u003ca href=\"https://www.kqed.org/news/12034214/san-francisco-ends-health-programs-for-drug-users-not-active-in-treatment\">controversially ended public health programs\u003c/a> that handed out clean smoking supplies to drug users on the street, and the city now requires people to participate in counseling in order to obtain any safer drug use supplies, like clean needles, from city-funded public health providers.\u003c/p>\n\u003cp>Critics of the city’s approach to harm reduction applauded the shift, including Stanford professor Keith Humphreys, \u003ca href=\"https://www.kqed.org/forum/2010101909499/san-francisco-scales-back-harm-reduction-policy\">who told KQED\u003c/a> it previously had not done enough to connect people to treatment.\u003c/p>\n\u003cp>One group of anonymous residents is \u003ca href=\"https://storage.courtlistener.com/recap/gov.uscourts.cand.426452/gov.uscourts.cand.426452.101.0.pdf\">suing the city\u003c/a> over its harm reduction practices, saying they have led to litter and concentration of dangerous drug activity in neighborhoods like the Tenderloin.\u003c/p>\n\u003cp>Other addiction experts like Tyler TerMeer, who leads the San Francisco Aids Foundation, \u003ca href=\"https://www.kqed.org/forum/2010101909499/san-francisco-scales-back-harm-reduction-policy\">raised concern over the change\u003c/a>, however. He warned it could strip medically vulnerable people of connections to health workers and push drug users toward tainted supplies, increasing chances of disease spread, riskier use, like injection, or overdose.\u003c/p>\n\u003cp>Fatal overdoses have slightly decreased in recent months, after several months of increasing, according to \u003ca href=\"https://www.sf.gov/data--preliminary-unintentional-drug-overdose-deaths\">city data\u003c/a>. It’s good news, yet addiction treatment providers are raising concerns about other changes they’re noticing after the city cut back on outdoor harm reduction efforts.\u003c/p>\n\u003cfigure id=\"attachment_12053919\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12053919\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00459_TV-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00459_TV-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00459_TV-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00459_TV-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Opioid emergency kits containing Narcan are placed throughout The Auburn in San Francisco on Aug. 20, 2025. \u003ccite>(Tâm Vũ/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“Our clients are letting us know that when it’s harder to get smoking supplies, they feel a pressure to inject or share equipment. It’s not large numbers, but we have been hearing that,” said Anna Berg, director of the Harm Reduction Therapy Center. She said the center is also handing out far less naloxone now that they distribute at fewer street-based sites following the policy change.\u003c/p>\n\u003cp>The residential peer responder program happens mostly indoors and is one area where San Francisco is investing more in harm reduction.\u003c/p>\n\u003cp>Berg has clients in treatment who are also participants in the city’s peer responder program, who tell her it works.\u003c/p>\n\u003cp>“They really take it seriously,” Berg said. “These are the kinds of interventions that really work; you need community and to lead with care and support in as many places as possible.”\u003c/p>\n\u003cp>For Flores, who has been in and out of rehabilitation programs, \u003ca href=\"https://www.kqed.org/news/12034006/san-francisco-mans-housing-struggle-relapse-put-him-back-on-streets\">strict abstinence-based requirements made it harder\u003c/a> to work through already difficult relapse periods. Having access to housing allowed her to stabilize, something she said was positively life-changing, but it didn’t wipe away her challenges with drug use.\u003c/p>\n\u003cfigure id=\"attachment_12053920\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12053920\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00466_TV-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00466_TV-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00466_TV-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00466_TV-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">The Auburn, a housing project under Delivering Innovation in Supportive Housing, is located in SoMa in San Francisco on Aug. 20, 2025. San Francisco has scaled back harm reduction programs, but in housing units such as The Margot, the city is expanding access to harm reduction efforts. \u003ccite>(Tâm Vũ/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“Abstinence-based programs don’t make it easy for people to reach out,” during a relapse, Flores said. “And I think that this peer responder program does make it feel very safe to reach out in those circumstances, to just come hang out in the same room so that somebody’s there if they overdose.”\u003c/p>\n\u003cp>Rob Hoffman of the city’s Office of Overdose Prevention said the goal of growing the peer responder program is “to leverage the community to connect with other people and break down isolation.”\u003c/p>\n\u003cp>That’s already beginning to happen, and people like Flores and Clark are saving lives.\u003c/p>\n\u003cp>“I know of two of our clients who have successfully reversed overdoses as part of that program,” Berg said.\u003c/p>\n\u003cp>Flores met one of her floormates after stepping into the role. She’s helped treat his wounds and said she’ll sometimes go over to his room while he is using drugs to offer support if something goes awry.\u003c/p>\n\u003cfigure id=\"attachment_12053916\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12053916\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00397_TV-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00397_TV-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00397_TV-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00397_TV-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">The Minna Lee, a housing project under Delivering Innovation in Supportive Housing, is located in SoMa in San Francisco on Aug. 20, 2025. \u003ccite>(Tâm Vũ/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“He has vision problems and other health problems, and just the knowledge that I’ve gained from helping him has been helpful in other areas of my life, too,” Flores said. “It means a lot to me that people trust me enough to come in. I would consider him one of my best friends now.”\u003c/p>\n\u003cp>Clark has occasionally given out clean needles when someone needs them. But due to legal and political challenges, the peer responder program does not fund the distribution of safe-use supplies like needles and does not describe its work as drug-use supervision. Peers themselves entirely lead those efforts..\u003c/p>\n\u003cp>“This program focuses specifically on overdose prevention, and the supplies we give out are CPR masks, naloxone and linkage to care. But the safer-use supplies, that is, the direct advocacy of peers themselves,” said Loyce, with DISH SF. “We don’t give that out, but you know we also support their inclination toward whatever types of resources they want to carry for themselves.”\u003c/p>\n\u003cp>Lurie’s changes this year aren’t the first time the city has pulled back on harm reduction, an approach pioneered in San Francisco during the AIDS crisis. In 2021, the city pulled the plug on a \u003ca href=\"https://www.kqed.org/news/11915870/inside-san-franciscos-tenderloin-center-that-serves-hundreds-every-day\">safe consumption site\u003c/a> following legal concerns and complaints from neighbors and local businesses over long lines outside the facility, which was located in United Nations Plaza.\u003c/p>\n\u003cfigure id=\"attachment_12053923\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12053923\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00241_TV-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00241_TV-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00241_TV-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00241_TV-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Dimitri Clark, a peer responder for Delivering Innovation in Supportive Housing, sets up his distribution station at The Margot in San Francisco on Aug. 20, 2025. \u003ccite>(Tâm Vũ/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Thousands of people visited the site for support. More than 300 overdoses were reversed at the facility, and no one died of an overdose on site during the program’s nearly 10-month run.\u003c/p>\n\u003cp>Berg said the disparity between what peer responders are allowed to do with the program and what neighbors come to them needing reveals a gap in the continuum of care.\u003c/p>\n\u003cp>“We have safe consumption sites all over the place, they’re just not necessarily sanctioned. It is things like neighbors looking out for each other. That is not a new concept. And the reason it sticks around is that it works,” Berg said. “What would it be like to allow people to do things that work? How many people are we losing every month in San Francisco? How many of those folks, if they had somebody there, could have a different outcome?”\u003c/p>\n\u003cp>For Clark, a simple tool is being around when someone needs him.\u003c/p>\n\u003cp>“What’s so nice about this is it’s not forceful,” Clark said. “It’s the isolation, you know, and fundamentally we have to overcome that.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Dimitri Clark is everywhere in his South of Market apartment building. Greeting residents in the lobby, checking in on floormates and keeping a door open for others to come by the tiny studio he shares with two affectionate terriers, Porcupine and Panda.\u003c/p>\n\u003cp>He’s doing it all to promote safer drug use and reduce overdoses as part of a broader public health program that the city is now expanding within permanent supportive housing buildings. But it comes as San Francisco is \u003ca href=\"https://www.kqed.org/news/12032239/overdoses-climb-lurie-orders-scaling-back-harm-reduction-programs\">scaling back other harm reduction programs\u003c/a>, and as high overdose rates in the city persist.\u003c/p>\n\u003cp>Nearly 460 people died of overdose from January to August 2025, according to the most recently available \u003ca href=\"https://www.sf.gov/data--preliminary-unintentional-drug-overdose-deaths\">public data\u003c/a>, putting the city on pace to exceed last year’s total.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“There are people who use drugs—that’s just part of human nature—and a lot of people want to isolate themselves, and that’s often when they’ll experience an overdose,” said Clark, who has been in recovery for about a year. “We talk to people about it, take the shame away.”\u003c/p>\n\u003cp>The city’s Public Health Department recently gave the peer responder program Clark is part of a boost: $600,000 over the next five years to expand its work in San Francisco.\u003c/p>\n\u003cfigure id=\"attachment_12053915\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-12053915 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00371_TV-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00371_TV-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00371_TV-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00371_TV-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Dimitri Clark, a peer responder for Delivering Innovation in Supportive Housing, hugs his dog in his room at The Margot in San Francisco on Aug. 20, 2025. \u003ccite>(Tâm Vũ/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>As a peer responder, Clark guides neighbors through safer drug use practices and ways to prevent an overdose. For a couple of hours each week, he posts up in his building lobby to talk about overdose prevention and hands out safety supplies like oxygen masks, sanitizing wipes and information on how to get help for anyone ready—or even just curious—about quitting. He also frequently gives out \u003ca href=\"https://www.kqed.org/news/11947448/there-to-save-a-life-san-francisco-bars-fight-fentanyl-overdoses-with-narcan\">drug test kits and the opioid overdose-reversal medicine naloxone\u003c/a>.\u003c/p>\n\u003cp>The program started in 2021 with five people, including Clark, at his former South of Market residence, the Minna Lee. Overdoses were soaring during the pandemic, so the building’s service provider, a nonprofit called Delivering Innovation in Supportive Housing (DISH SF), decided to train residents with experience using drugs on life-saving strategies to help their neighbors.\u003c/p>\n\u003cp>Suddenly, overdoses at the Minna Lee began dropping.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“We had multiple years of zero fatal overdoses at the Minna Lee, specifically due to, I would argue, that intervention,” said Mattie Loyce, senior manager of community development at DISH SF.\u003c/p>\n\u003cp>DISH SF has been training more peer responders ever since. This spring, 25 peer responders graduated from the program that is now operating in seven permanent supportive housing buildings.\u003c/p>\n\u003cp>To help incentivize residents to join, the program offers peer responders a $600 stipend. It’s hardly enough to cover a single month’s rent, but several members said the 14-week training program provided tools to change their own relationship to substances, help others and build confidence in other areas of their lives.\u003c/p>\n\u003cp>During the three-month training program, participants take classes on everything from how to respond to an overdose to where to direct people for treatment, as well as different substances’ potencies and effects on the mind and body.\u003c/p>\n\u003cp>“I actually didn’t know before I started this program how many overdoses were happening in our buildings,” said Nicole Flores, another peer responder in the program, who said she is still navigating her own relationship with drugs. “A lot of these resources I didn’t know were available, not just harm reduction supplies, but also wound care and other programs for our community.”\u003c/p>\n\u003cfigure id=\"attachment_12057624\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12057624\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/250826_sfharmreduction00450_TV_qed.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/250826_sfharmreduction00450_TV_qed.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/250826_sfharmreduction00450_TV_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/250826_sfharmreduction00450_TV_qed-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Nicole Flores, a peer responder for Delivering Innovation in Supportive Housing, stands outside her unit at The Auburn in San Francisco on Aug. 20, 2025. \u003ccite>(Tâm Vũ/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Peer responders have crafted overdose prevention safety plans with dozens of residents already. Harm reduction, a method backed by \u003ca href=\"https://www.cdc.gov/overdose-prevention/media/pdfs/OD2A-Case-Studies-Harm-Reduction-508.pdf\">scientific research\u003c/a> to reduce overdose risk and other negative consequences of drug use, is just one element of the city’s approach. San Francisco also sends medical professionals into supportive housing buildings to \u003ca href=\"https://www.kqed.org/news/11945418/san-francisco-has-doubled-participants-of-this-opioid-treatment-heres-why\">deliver drug treatment\u003c/a> options like buprenorphine, a medication that can reduce opioid cravings and withdrawal.\u003c/p>\n\u003cp>“I would like for people to start looking at this community and seeing an asset, instead of seeing a problem, because there’s a lot of potential,” said Katie O’Bryant, manager of the peer responder program. “There’s lot of transferable skills that people learn in this lifestyle that can be replicated for all kinds of good in other instances.”\u003c/p>\n\u003cp>Mayor Daniel Lurie made reducing overdoses, and particularly the most visible street-level drug use and dealing, a central part of his campaign. As part of the mayor’s “Breaking the Cycle” initiative, the city has opened a stabilization center at \u003ca href=\"https://www.kqed.org/news/12038376/tenderloin-welcomes-mental-health-clinic-demands-broader-city-action-on-homelessness\">822 Geary\u003c/a> St., reorganized street response teams and increased policing of outdoor drug use and dealing.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Last spring, Lurie \u003ca href=\"https://www.kqed.org/news/12034214/san-francisco-ends-health-programs-for-drug-users-not-active-in-treatment\">controversially ended public health programs\u003c/a> that handed out clean smoking supplies to drug users on the street, and the city now requires people to participate in counseling in order to obtain any safer drug use supplies, like clean needles, from city-funded public health providers.\u003c/p>\n\u003cp>Critics of the city’s approach to harm reduction applauded the shift, including Stanford professor Keith Humphreys, \u003ca href=\"https://www.kqed.org/forum/2010101909499/san-francisco-scales-back-harm-reduction-policy\">who told KQED\u003c/a> it previously had not done enough to connect people to treatment.\u003c/p>\n\u003cp>One group of anonymous residents is \u003ca href=\"https://storage.courtlistener.com/recap/gov.uscourts.cand.426452/gov.uscourts.cand.426452.101.0.pdf\">suing the city\u003c/a> over its harm reduction practices, saying they have led to litter and concentration of dangerous drug activity in neighborhoods like the Tenderloin.\u003c/p>\n\u003cp>Other addiction experts like Tyler TerMeer, who leads the San Francisco Aids Foundation, \u003ca href=\"https://www.kqed.org/forum/2010101909499/san-francisco-scales-back-harm-reduction-policy\">raised concern over the change\u003c/a>, however. He warned it could strip medically vulnerable people of connections to health workers and push drug users toward tainted supplies, increasing chances of disease spread, riskier use, like injection, or overdose.\u003c/p>\n\u003cp>Fatal overdoses have slightly decreased in recent months, after several months of increasing, according to \u003ca href=\"https://www.sf.gov/data--preliminary-unintentional-drug-overdose-deaths\">city data\u003c/a>. It’s good news, yet addiction treatment providers are raising concerns about other changes they’re noticing after the city cut back on outdoor harm reduction efforts.\u003c/p>\n\u003cfigure id=\"attachment_12053919\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12053919\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00459_TV-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00459_TV-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00459_TV-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00459_TV-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Opioid emergency kits containing Narcan are placed throughout The Auburn in San Francisco on Aug. 20, 2025. \u003ccite>(Tâm Vũ/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“Our clients are letting us know that when it’s harder to get smoking supplies, they feel a pressure to inject or share equipment. It’s not large numbers, but we have been hearing that,” said Anna Berg, director of the Harm Reduction Therapy Center. She said the center is also handing out far less naloxone now that they distribute at fewer street-based sites following the policy change.\u003c/p>\n\u003cp>The residential peer responder program happens mostly indoors and is one area where San Francisco is investing more in harm reduction.\u003c/p>\n\u003cp>Berg has clients in treatment who are also participants in the city’s peer responder program, who tell her it works.\u003c/p>\n\u003cp>“They really take it seriously,” Berg said. “These are the kinds of interventions that really work; you need community and to lead with care and support in as many places as possible.”\u003c/p>\n\u003cp>For Flores, who has been in and out of rehabilitation programs, \u003ca href=\"https://www.kqed.org/news/12034006/san-francisco-mans-housing-struggle-relapse-put-him-back-on-streets\">strict abstinence-based requirements made it harder\u003c/a> to work through already difficult relapse periods. Having access to housing allowed her to stabilize, something she said was positively life-changing, but it didn’t wipe away her challenges with drug use.\u003c/p>\n\u003cfigure id=\"attachment_12053920\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12053920\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00466_TV-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00466_TV-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00466_TV-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00466_TV-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">The Auburn, a housing project under Delivering Innovation in Supportive Housing, is located in SoMa in San Francisco on Aug. 20, 2025. San Francisco has scaled back harm reduction programs, but in housing units such as The Margot, the city is expanding access to harm reduction efforts. \u003ccite>(Tâm Vũ/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“Abstinence-based programs don’t make it easy for people to reach out,” during a relapse, Flores said. “And I think that this peer responder program does make it feel very safe to reach out in those circumstances, to just come hang out in the same room so that somebody’s there if they overdose.”\u003c/p>\n\u003cp>Rob Hoffman of the city’s Office of Overdose Prevention said the goal of growing the peer responder program is “to leverage the community to connect with other people and break down isolation.”\u003c/p>\n\u003cp>That’s already beginning to happen, and people like Flores and Clark are saving lives.\u003c/p>\n\u003cp>“I know of two of our clients who have successfully reversed overdoses as part of that program,” Berg said.\u003c/p>\n\u003cp>Flores met one of her floormates after stepping into the role. She’s helped treat his wounds and said she’ll sometimes go over to his room while he is using drugs to offer support if something goes awry.\u003c/p>\n\u003cfigure id=\"attachment_12053916\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12053916\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00397_TV-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00397_TV-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00397_TV-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00397_TV-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">The Minna Lee, a housing project under Delivering Innovation in Supportive Housing, is located in SoMa in San Francisco on Aug. 20, 2025. \u003ccite>(Tâm Vũ/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“He has vision problems and other health problems, and just the knowledge that I’ve gained from helping him has been helpful in other areas of my life, too,” Flores said. “It means a lot to me that people trust me enough to come in. I would consider him one of my best friends now.”\u003c/p>\n\u003cp>Clark has occasionally given out clean needles when someone needs them. But due to legal and political challenges, the peer responder program does not fund the distribution of safe-use supplies like needles and does not describe its work as drug-use supervision. Peers themselves entirely lead those efforts..\u003c/p>\n\u003cp>“This program focuses specifically on overdose prevention, and the supplies we give out are CPR masks, naloxone and linkage to care. But the safer-use supplies, that is, the direct advocacy of peers themselves,” said Loyce, with DISH SF. “We don’t give that out, but you know we also support their inclination toward whatever types of resources they want to carry for themselves.”\u003c/p>\n\u003cp>Lurie’s changes this year aren’t the first time the city has pulled back on harm reduction, an approach pioneered in San Francisco during the AIDS crisis. In 2021, the city pulled the plug on a \u003ca href=\"https://www.kqed.org/news/11915870/inside-san-franciscos-tenderloin-center-that-serves-hundreds-every-day\">safe consumption site\u003c/a> following legal concerns and complaints from neighbors and local businesses over long lines outside the facility, which was located in United Nations Plaza.\u003c/p>\n\u003cfigure id=\"attachment_12053923\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12053923\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00241_TV-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00241_TV-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00241_TV-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/250826_SFHARMREDUCTION00241_TV-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Dimitri Clark, a peer responder for Delivering Innovation in Supportive Housing, sets up his distribution station at The Margot in San Francisco on Aug. 20, 2025. \u003ccite>(Tâm Vũ/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Thousands of people visited the site for support. More than 300 overdoses were reversed at the facility, and no one died of an overdose on site during the program’s nearly 10-month run.\u003c/p>\n\u003cp>Berg said the disparity between what peer responders are allowed to do with the program and what neighbors come to them needing reveals a gap in the continuum of care.\u003c/p>\n\u003cp>“We have safe consumption sites all over the place, they’re just not necessarily sanctioned. It is things like neighbors looking out for each other. That is not a new concept. And the reason it sticks around is that it works,” Berg said. “What would it be like to allow people to do things that work? How many people are we losing every month in San Francisco? How many of those folks, if they had somebody there, could have a different outcome?”\u003c/p>\n\u003cp>For Clark, a simple tool is being around when someone needs him.\u003c/p>\n\u003cp>“What’s so nice about this is it’s not forceful,” Clark said. “It’s the isolation, you know, and fundamentally we have to overcome that.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>As part of efforts to treat the \u003ca href=\"https://www.kqed.org/news/12033622/sf-is-moving-away-from-harm-reduction-in-its-drug-crackdown-doctors-are-concerned\">city’s drug crisis\u003c/a>, San Francisco’s Department of Public Health is expanding a program for unhoused people that combines a shelter bed with opioid addiction treatment under one roof.\u003c/p>\n\u003cp>RESTORE — which stands for Rapid Engagement Shelter and Treatment for Opioid Recovery — currently operates 35 beds at the Adante Hotel on Geary Street in Lower Nob Hill. Officials will soon double the number of beds, with the hope of operating up to 200 across the city.\u003c/p>\n\u003cp>The expansion comes as the Office of the Chief Medical Examiner released its latest \u003ca href=\"https://media.api.sf.gov/documents/2025_04_OCME_Overdose_Report.pdf\">data \u003c/a>showing 65 accidental overdose deaths in March 2025, including 52 cases involving fentanyl. Public Health Director Daniel Tsai said the goal of RESTORE is to initiate treatment as soon as someone is off the streets to better transition them to long-term care.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“I can think of very few interventions that we have from a public health standpoint where we’re getting people plugged into a bed and initiating treatment literally immediately,” Tsai said at a press conference on Wednesday. “We will do telehealth prescribing to start someone on medications for opioid use disorder that same day.”\u003c/p>\n\u003cp>Potential clients will be required to engage with a case manager daily and agree to an opioid or mental health treatment plan to secure their stay.\u003c/p>\n\u003cp>RESTORE started as a pilot program over the past 12 months and saw success rates “unlike anything we have ever seen,” Tsai added, although he did not disclose the specific numbers.\u003c/p>\n\u003cfigure id=\"attachment_12021632\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12021632\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/01/SFDepartmentPublicHealth.jpg\" alt=\"\" width=\"2000\" height=\"1500\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/01/SFDepartmentPublicHealth.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/01/SFDepartmentPublicHealth-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/01/SFDepartmentPublicHealth-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/01/SFDepartmentPublicHealth-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/01/SFDepartmentPublicHealth-1536x1152.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/01/SFDepartmentPublicHealth-1920x1440.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">The San Francisco Department of Public Health on Feb. 6, 2014. \u003ccite>(Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“When you talk to our teams on the street, they will tell you that the availability of a RESTORE bed completely changes the type of discussion they can have with a client,” Tsai said.\u003c/p>\n\u003cp>The shelter beds offered in the program are non-congregate and stays are short-term: usually between one and two weeks. These factors lower the barrier of entry for unhoused people, Tsai said. Additionally, the combination of a bed and treatment plan means that clients don’t have to coordinate the two themselves.\u003c/p>\n\u003cp>The brief stay is meant to stabilize clients and put them on the path to recovery, which varies significantly from person to person.[aside postID=news_12035625 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2024/05/023_KQED_OBICBuprenorphineClinic_03292023_qut-1020x680.jpg']Keith Humphreys, a Stanford University professor and addiction policy researcher, said even one or two weeks could provide a “time-out” that is long enough to get people back on their feet.\u003c/p>\n\u003cp>“It is a period of stability where they can stop taking any substances that they’re taking, start taking any medications they should be taking for their mental illness or for their addiction and have a sort of headspace to make good decisions about their future,” he said.\u003c/p>\n\u003cp>Tsai said the biggest problem is capacity.\u003c/p>\n\u003cp>“One of our biggest barriers is we only have 35 beds, and there are people on the street who are willing to start treatment in this sort of setting,” he said.\u003c/p>\n\u003cp>But in light of the upcoming expansion, Humphreys noted that scaling services like those offered through RESTORE can quickly run into quality issues, too.\u003c/p>\n\u003cp>He pointed to HealthRIGHT 360, the city’s largest, publicly-funded addiction treatment provider, which saw five \u003ca href=\"https://www.sfchronicle.com/sf/article/healthright-360-drug-overdoses-19897492.php\">fatal overdoses\u003c/a> in 13 months. Wesley Saver, director of policy & public affairs for HealthRIGHT 360, said in a statement that it is “encouraging” to see the Department of Public Health scale programs like RESTORE.\u003c/p>\n\u003cfigure id=\"attachment_11995962\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11995962\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/SFOverdoseDeathDecline.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/SFOverdoseDeathDecline.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/SFOverdoseDeathDecline-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/SFOverdoseDeathDecline-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/SFOverdoseDeathDecline-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/SFOverdoseDeathDecline-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/SFOverdoseDeathDecline-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">A harm reduction program representative speaks with people on a popular alleyway in the Tenderloin neighborhood to hand out Narcan, fentanyl detection packets and tinfoil to those who need them as a part of drug addiction outreach in San Francisco. \u003ccite>(Nick Otto/Washington Post via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“A lot of life, particularly street life, is lived in five-minute intervals,” Humphreys said. “Just to have the time-out to say, OK, you’re stable, you’re safe, you don’t have to survive, you’ve got food, you’ve got shelter. Let’s talk about where you want to be in a month or six months, as opposed to where you want to be in five minutes.”\u003c/p>\n\u003cp>The expansion of RESTORE follows a slight decrease in accidental overdose deaths, down from 68 overdose deaths in February, breaking a \u003ca href=\"https://www.kqed.org/news/12031847/sf-sees-decline-in-overdose-deaths-but-fentanyl-remains-a-major-threat\">trend of monthly increases since October\u003c/a>. Of the 192 total deaths from January through March of this year, the vast majority are fentanyl-related.\u003c/p>\n\u003cp>That translates to an average of at least two deaths per day, Tsai noted.\u003c/p>\n\u003cp>“Every overdose death we have here in the city and county of San Francisco is preventable, and it’s unacceptable, and it’s tragic,” Tsai said. “The current approach of what we’ve done historically here has not delivered the results that we need.”\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>As part of efforts to treat the \u003ca href=\"https://www.kqed.org/news/12033622/sf-is-moving-away-from-harm-reduction-in-its-drug-crackdown-doctors-are-concerned\">city’s drug crisis\u003c/a>, San Francisco’s Department of Public Health is expanding a program for unhoused people that combines a shelter bed with opioid addiction treatment under one roof.\u003c/p>\n\u003cp>RESTORE — which stands for Rapid Engagement Shelter and Treatment for Opioid Recovery — currently operates 35 beds at the Adante Hotel on Geary Street in Lower Nob Hill. Officials will soon double the number of beds, with the hope of operating up to 200 across the city.\u003c/p>\n\u003cp>The expansion comes as the Office of the Chief Medical Examiner released its latest \u003ca href=\"https://media.api.sf.gov/documents/2025_04_OCME_Overdose_Report.pdf\">data \u003c/a>showing 65 accidental overdose deaths in March 2025, including 52 cases involving fentanyl. Public Health Director Daniel Tsai said the goal of RESTORE is to initiate treatment as soon as someone is off the streets to better transition them to long-term care.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“I can think of very few interventions that we have from a public health standpoint where we’re getting people plugged into a bed and initiating treatment literally immediately,” Tsai said at a press conference on Wednesday. “We will do telehealth prescribing to start someone on medications for opioid use disorder that same day.”\u003c/p>\n\u003cp>Potential clients will be required to engage with a case manager daily and agree to an opioid or mental health treatment plan to secure their stay.\u003c/p>\n\u003cp>RESTORE started as a pilot program over the past 12 months and saw success rates “unlike anything we have ever seen,” Tsai added, although he did not disclose the specific numbers.\u003c/p>\n\u003cfigure id=\"attachment_12021632\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12021632\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/01/SFDepartmentPublicHealth.jpg\" alt=\"\" width=\"2000\" height=\"1500\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/01/SFDepartmentPublicHealth.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/01/SFDepartmentPublicHealth-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/01/SFDepartmentPublicHealth-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/01/SFDepartmentPublicHealth-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/01/SFDepartmentPublicHealth-1536x1152.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/01/SFDepartmentPublicHealth-1920x1440.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">The San Francisco Department of Public Health on Feb. 6, 2014. \u003ccite>(Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“When you talk to our teams on the street, they will tell you that the availability of a RESTORE bed completely changes the type of discussion they can have with a client,” Tsai said.\u003c/p>\n\u003cp>The shelter beds offered in the program are non-congregate and stays are short-term: usually between one and two weeks. These factors lower the barrier of entry for unhoused people, Tsai said. Additionally, the combination of a bed and treatment plan means that clients don’t have to coordinate the two themselves.\u003c/p>\n\u003cp>The brief stay is meant to stabilize clients and put them on the path to recovery, which varies significantly from person to person.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Keith Humphreys, a Stanford University professor and addiction policy researcher, said even one or two weeks could provide a “time-out” that is long enough to get people back on their feet.\u003c/p>\n\u003cp>“It is a period of stability where they can stop taking any substances that they’re taking, start taking any medications they should be taking for their mental illness or for their addiction and have a sort of headspace to make good decisions about their future,” he said.\u003c/p>\n\u003cp>Tsai said the biggest problem is capacity.\u003c/p>\n\u003cp>“One of our biggest barriers is we only have 35 beds, and there are people on the street who are willing to start treatment in this sort of setting,” he said.\u003c/p>\n\u003cp>But in light of the upcoming expansion, Humphreys noted that scaling services like those offered through RESTORE can quickly run into quality issues, too.\u003c/p>\n\u003cp>He pointed to HealthRIGHT 360, the city’s largest, publicly-funded addiction treatment provider, which saw five \u003ca href=\"https://www.sfchronicle.com/sf/article/healthright-360-drug-overdoses-19897492.php\">fatal overdoses\u003c/a> in 13 months. Wesley Saver, director of policy & public affairs for HealthRIGHT 360, said in a statement that it is “encouraging” to see the Department of Public Health scale programs like RESTORE.\u003c/p>\n\u003cfigure id=\"attachment_11995962\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11995962\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/SFOverdoseDeathDecline.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/SFOverdoseDeathDecline.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/SFOverdoseDeathDecline-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/SFOverdoseDeathDecline-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/SFOverdoseDeathDecline-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/SFOverdoseDeathDecline-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/SFOverdoseDeathDecline-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">A harm reduction program representative speaks with people on a popular alleyway in the Tenderloin neighborhood to hand out Narcan, fentanyl detection packets and tinfoil to those who need them as a part of drug addiction outreach in San Francisco. \u003ccite>(Nick Otto/Washington Post via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“A lot of life, particularly street life, is lived in five-minute intervals,” Humphreys said. “Just to have the time-out to say, OK, you’re stable, you’re safe, you don’t have to survive, you’ve got food, you’ve got shelter. Let’s talk about where you want to be in a month or six months, as opposed to where you want to be in five minutes.”\u003c/p>\n\u003cp>The expansion of RESTORE follows a slight decrease in accidental overdose deaths, down from 68 overdose deaths in February, breaking a \u003ca href=\"https://www.kqed.org/news/12031847/sf-sees-decline-in-overdose-deaths-but-fentanyl-remains-a-major-threat\">trend of monthly increases since October\u003c/a>. Of the 192 total deaths from January through March of this year, the vast majority are fentanyl-related.\u003c/p>\n\u003cp>That translates to an average of at least two deaths per day, Tsai noted.\u003c/p>\n\u003cp>“Every overdose death we have here in the city and county of San Francisco is preventable, and it’s unacceptable, and it’s tragic,” Tsai said. “The current approach of what we’ve done historically here has not delivered the results that we need.”\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"slug": "its-living-hell-nurses-say-a-california-addiction-recovery-program-ended-their-careers",
"title": "'It's Living Hell': Nurses Say a California Addiction Recovery Program Ended Their Careers",
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"headTitle": "‘It’s Living Hell’: Nurses Say a California Addiction Recovery Program Ended Their Careers | KQED",
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"content": "\u003cp>Bobbie Sage thought nursing would be her salvation. She was trapped in an abusive relationship with four kids and looking for a steady income. The day she graduated vocational nursing school, she took the kids and left their father.\u003c/p>\n\u003cp>Five years later, a DUI ruined her carefully crafted stability. Sage was waiting for a taxi outside a bar with another partner when he began hitting her, she said. She fled in her own car. A mistake with enduring consequences.\u003c/p>\n\u003cp>Sage was charged with a misdemeanor for driving under the influence of alcohol in 2014. She paid a fine and completed three years of criminal probation without incident, according to court documents. She thought that tumultuous period of her life was over until her state licensing board ordered her to complete an additional probation program for health professionals with substance use problems.\u003c/p>\n\u003cp>Sage couldn’t afford the drug tests at $300 a month or a fine of $3,140. She dropped out. She surrendered her vocational nursing license in 2019 and blames the program for ending her career.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Now, Sage is among dozens of health care workers who allege they’ve been mistreated under a California law governing workers with addiction and mental health problems. They say state regulations are needlessly punitive, overly bureaucratic and based on faulty addiction science. They call it a trap that prevents them from working and leaves many of them with thousands of dollars of debt.\u003c/p>\n\u003cp>“One misdemeanor is costing my entire life,” Sage said. “Punish me for something with my (nursing) license that I’ve done with my license.”\u003c/p>\n\u003cp>The 2008 law was supposed to protect patients after a series of audits and legislative hearings suggested licensing boards were doing a poor job of keeping impaired health workers off the job. It created uniform regulations for each board to follow that stipulate exactly how to deal with these workers, including extensive drug testing, travel restrictions and psychiatric evaluations meant to catch anyone who relapsed.\u003c/p>\n\u003cp>Some boards created recovery programs as an alternative to discipline. Workers could volunteer to join as a step toward their recovery or be asked to join by their licensing board as a substitute for public punishment. Others, including Sage, were ordered into a parallel probation program after an incident such as a DUI or other licensing violation.\u003c/p>\n\u003cp>Nurses say those provisions have become so burdensome and expensive that health care workers avoid the recovery program outright unless a licensing board asks them to join. As a result, the state is monitoring fewer workers than ever. Fewer than 400 people are enrolled, down from a peak of more than 900 in 2010.\u003c/p>\n\u003cp>The recovery program \u003ca href=\"https://calmatters.org/health/2024/12/medical-board-addiction-recovery/\">has never included doctors\u003c/a>, whose lobby resisted it because members believed it was too punitive, according to Gail Jara, executive director of \u003ca href=\"https://cppph.org/\">California Public Protection and Physician Health\u003c/a>, an organization dedicated to creating a new recovery program for doctors. The California Medical Board, which licenses most doctors, plans to push for an alternative program in the Legislature in the coming year.\u003c/p>\n\u003cp>“It’s living hell,” said an emergency room nurse interviewed by CalMatters who joined voluntarily. The nurse asked for confidentiality because she could lose her license for speaking out under the terms of her contract.\u003c/p>\n\u003cp>The nurse has been unable to find a job that meets the program’s strict work limitations for nearly two years despite clean tests. She has spent more than $8,000 on drug tests, according to receipts, several thousand more on medical and psychological evaluations, and more than $20,000 paying for health insurance because she lost her work insurance.\u003c/p>\n\u003cp>Dentists, physical therapists, veterinarians and other health workers whose professional licensing boards are overseen by the California Department of Consumer Affairs are subject to the state law. Nurses make up the majority of the participants, and complaints about the program have erupted at recent Board of Registered Nurses meetings.\u003c/p>\n\u003cp>Many say they’ve followed all the rules and still see no way out, even after years of demonstrated sobriety.\u003c/p>\n\u003cp>Officials at those meetings faulted minor changes they made to increase oversight, suggesting they went too far. Participants and addiction experts interviewed by CalMatters, however, say the law itself is the root of the issue.\u003c/p>\n\u003cp>“We’ve built systems that are completely onerous and agnostic of the value of a human life,” said \u003ca href=\"https://bouve.northeastern.edu/directory/amanda-choflet/\">Amanda Choflet\u003c/a>, dean of nursing at Northeastern University in Boston and an expert in nursing addiction programs. “It’s not even that the systems themselves are actively trying to keep people from being able to recover. It’s that the systems aren’t built for humans. They’re built in order to enact legislation.”\u003c/p>\n\u003cp>A group of consumer advocates that pushed for the law argues that it is doing exactly what it is meant to do — impose consequences on workers who can’t stay sober. Michele Monserratt-Ramos, a patient advocate with Consumer Watchdog, said licensing boards’ first duty is to protect the public, not shield health workers with substance use or mental health disorders.\u003c/p>\n\u003cp>Many of the requirements that nurses and other workers say are intolerable, such as work prohibitions, were designed to protect patients, said Monserratt-Ramos, whose fiancé died after an operation with a doctor who had a history of substance abuse. If health workers know addictive behaviors and other impairments will be scrutinized by their licensing boards, they’ll be less likely to do something harmful, she said.\u003c/p>\n\u003cp>“The safety net now is the consequences,” Monserratt-Ramos said.\u003c/p>\n\u003cp>The Department of Consumer Affairs did not make anyone available for an interview, stating that the regulations governing the program were written by a committee years ago and no experts were available. In a statement, the department said each health care board is independently responsible for implementing the program, and eight boards contract with an outside vendor, Maximus Inc., to do so.\u003c/p>\n\u003cp>The Board of Registered Nursing refused several times to make executive staff or board members available for an interview to address participants’ complaints. Individual board members also failed to return calls or emails from CalMatters. In a statement to CalMatters, board staff said they have already addressed such complaints and are working to address more.\u003c/p>\n\u003cp>Maximus, a publicly traded company worth $4.5 billion, did not respond to several interview requests. The vendor’s $12.4 million state contract expires at the end of December. The company did not bid for a new contract, and the Department of Consumer Affairs did not provide a reason why.\u003c/p>\n\u003cp>Sage says she worked hard to transform her life and move on from past abuse. She’s a licensed esthetician now and runs a successful studio in the Bay Area. Family and colleagues describe her as a hard worker, a natural caregiver and someone who doesn’t complain.\u003c/p>\n\u003cfigure id=\"attachment_12019194\" class=\"wp-caption aligncenter\" style=\"max-width: 1568px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12019194\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/103124-Nursing-Rehab-MO-CM-13-copy.jpg\" alt=\"\" width=\"1568\" height=\"1045\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/103124-Nursing-Rehab-MO-CM-13-copy.jpg 1568w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/103124-Nursing-Rehab-MO-CM-13-copy-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/103124-Nursing-Rehab-MO-CM-13-copy-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/103124-Nursing-Rehab-MO-CM-13-copy-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/103124-Nursing-Rehab-MO-CM-13-copy-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1568px) 100vw, 1568px\">\u003cfigcaption class=\"wp-caption-text\">Former vocational nurse Bobbie Sage reviews her case files in the lobby of her aesthetics studio in Pleasanton. Sage has kept the files after years of trying to navigate a disciplinary program for nurses with addictions that she was forced to attend. \u003ccite>(Manuel Orbegozo for CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>She admits she made a mistake but says she never had an addiction problem. CalMatters reviewed a letter Sage provided from a doctor confirming that she did not meet the criteria for alcoholism and has never been diagnosed as an alcoholic. Under state law, any medical professional with a DUI is presumed to have a \u003ca href=\"https://casetext.com/regulation/california-code-of-regulations/title-16-professional-and-vocational-regulations/division-25-board-of-vocational-nurse-and-psychiatric-technician-examiners-of-the-state-of-california/chapter-1-vocational-nurses/article-4-licenses/section-2524-disciplinary-guidelines-and-uniform-standards-regarding-substance-abusing-licensees\">substance abuse\u003c/a> problem, even if it is a one-time offense. The Department of Consumer Affairs said the Board of Vocational Nursing and Psychiatric Technicians, which oversees Sage’s license, does not offer a recovery program, only a disciplinary track.\u003c/p>\n\u003cp>“I haven’t been a perfect person in my life, but I’ve been a good person,” Sage said. “I’ve taken full responsibility, and I don’t believe we should keep punishing someone for a misdemeanor that happened 10 years ago.”\u003c/p>\n\u003ch2>Nurse demand changes at board meetings\u003c/h2>\n\u003cp>CalMatters spoke with six nurses in the recovery program, all of whom asked not to be named for fear of retaliation from their case managers and the Board of Registered Nursing, which authorizes their licenses. The nurses said while some of the policies they regarded as arbitrary have been rolled back — including a requirement to administer narcotics to patients — many of the problems are longstanding and systemic.\u003c/p>\n\u003cp>The nurses provided documents that supported their descriptions, including their contract agreements, medical records, and recordings of individual meetings with enforcement committees.\u003c/p>\n\u003cp>Common problems outlined by interviewed nurses include:\u003c/p>\n\u003cul class=\"wp-block-list\">\n\u003cli>Moving goal posts — All of the nurses interviewed by CalMatters said the requirements to complete the program kept changing, including work requirements and the need for clinical evaluations that could take months for the board to review, prolonging their time in the program. “I felt like I was going to be in this program indefinitely,” said a former acute care nurse who dropped out with what she says were five years of sobriety.\u003c/li>\n\u003c/ul>\n\u003cul class=\"wp-block-list\">\n\u003cli>Retaliation — Nurses said they felt like they were constantly in trouble and forced to stay silent for fear of losing their licenses. They were not allowed to travel to see family or attend their children’s sports games without approval from case managers. They would be held liable if no testing centers were open, even on holidays and weekends, and the inability to pay for a drug test counted as a positive result. “I felt so small. I didn’t feel supported. Every time I saw my case manager calling me, I felt like I was going to throw up,” a second nurse interviewed by CalMatters said.\u003c/li>\n\u003c/ul>\n\u003cul class=\"wp-block-list\">\n\u003cli>Forced attendance at religious recovery meetings — A third nurse who started using drugs after escaping a religious cult said her case manager made her go to a faith-based 12-step meeting despite state law prohibiting such a requirement. “I go. I sit on a church pew. I feel like I’m back in my church, and I have palpitations,” she said.\u003c/li>\n\u003c/ul>\n\u003cul class=\"wp-block-list\">\n\u003cli>Interference with personal medical decisions — A fourth nurse who was admitted to the program for alcohol and mental health struggles said she was prohibited from taking prescribed medication for attention-deficit disorder despite demonstrated sobriety and a medical evaluation showing her cognitive performance improved with medication. Another who was prescribed suboxone, a drug commonly used to treat people with opioid dependency, said she was forced to stop by program officials against the advice of her doctor.\u003c/li>\n\u003c/ul>\n\u003cul class=\"wp-block-list\">\n\u003cli>“Cookie-cutter” requirements — A sixth nurse who was addicted to opiates said it took two and a half years for a complaint about her drug use to be processed by the nursing board. In the meantime, she put herself through rehab and stayed sober. The board told her to “voluntarily” join the recovery program or be stripped of her license despite letters from her addiction specialist, the nurse said. According to documents reviewed by CalMatters, the frequency of her random drug testing and other restrictions were substantially similar to requirements imposed on nurses who were not sober at the time of joining the program.\u003c/li>\n\u003c/ul>\n\u003cp>In May, when nurses began flooding board meetings with sweeping allegations of mistreatment, Executive Director Loretta Melby said, “What you heard from Maximus today is there’s, you know, about 250 participants in that program. We don’t have 250 people in public comment.”\u003c/p>\n\u003cp>But as more nurses called in to raise issues, other board members registered concern. “It sounds like collectively, we the board made, and this program made some errors,” board member Alison Cormack said during a June meeting. In August, the nursing board voted to rescind program changes made by Melby and chief enforcement officer Shannon Johnson, including a requirement that nurses work directly with patients and administer narcotics.\u003c/p>\n\u003cp>In response to what nurses told CalMatters about ongoing problems with enforcement committees and employees of Maximus, the board’s staff sent this unsigned statement: “Board staff actively works with the vendor to address all concerns that are brought forth by participants.”\u003c/p>\n\u003cp>The statement added that “each participant is individually evaluated on a case-by-case basis” to determine the requirements of their recovery contracts, however the unsigned statement also acknowledged that previous participant contracts may not have accounted for an individual’s case history. Case managers and enforcement committee members must now examine each individual participant’s compliance with the program before making changes to their contracts, the statement said.\u003c/p>\n\u003cfigure id=\"attachment_12019196\" class=\"wp-caption aligncenter\" style=\"max-width: 1568px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12019196\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/103124-Nursing-Rehab-MO-CM-12-copy.jpg\" alt=\"\" width=\"1568\" height=\"1045\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/103124-Nursing-Rehab-MO-CM-12-copy.jpg 1568w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/103124-Nursing-Rehab-MO-CM-12-copy-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/103124-Nursing-Rehab-MO-CM-12-copy-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/103124-Nursing-Rehab-MO-CM-12-copy-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/103124-Nursing-Rehab-MO-CM-12-copy-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1568px) 100vw, 1568px\">\u003cfigcaption class=\"wp-caption-text\">Former vocational nurse Bobbie Sage reviews a requirement plan that she was forced to complete while part of a disciplinary program designed for nurses with addiction, in Pleasanton, on Oct. 31, 2024. \u003ccite>(Manuel Orbegozo for CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>During a board meeting, Maximus, the program vendor, denied that its staff forced participants to attend religiously based meetings, an objection raised by several people during public comment. In a statement to CalMatters, board staff also denied there was such a requirement.\u003c/p>\n\u003cp>However, the nursing board’s \u003ca href=\"https://www.rn.ca.gov/intervention/intreq.shtml\">own website\u003c/a> denotes “12-Step Group Attendance” as a program requirement. The 12-step structure was created by Alcoholics Anonymous, and several steps reference God. Recovery agreements provided to CalMatters by participants say they can attend groups other than Alcoholics Anonymous, but program participants say they can’t find non-religious or non-spiritual alternatives that meet the board’s requirements, which also include finding a sponsor, another Alcoholics Anonymous rule.\u003c/p>\n\u003cp>Program regulations also stipulate that positive drug tests are not dismissed even if they are the result of a valid prescription. Regulations mandate that an approved physician submit monitoring plans for participants to take prescription medication even for chronic conditions such as high blood pressure and diabetes. Some nurses said they avoid medical care outright because of the bureaucratic hoops they are required to jump through.\u003c/p>\n\u003ch2>Workers with addiction avoid program\u003c/h2>\n\u003cp>The majority of recovery program participants, 250, are nurses, Maximus Director of Clinical Services Ginny Matthews testified during a recent nursing board meeting. That means the state nursing board is monitoring less than 0.05% of its roughly 537,000 nurses. Other licensing boards are tracking far less.\u003c/p>\n\u003cp>The state does not track how many health professionals are disciplined and ordered to probation like Sage because of a drug or mental health impairment, but only 0.1% of the health care workforce is disciplined annually for any reason. Research shows between 10% to 12% of medical professionals will develop a substance use disorder during their lifetime.\u003c/p>\n\u003cp>That means the vast majority of health workers with addictions are flying under the radar, multiple addiction experts interviewed by CalMatters said.\u003c/p>\n\u003cp>“Where are all of the people who we know should be getting into these programs, and why aren’t they turning to our programs for help?” said Choflet, the Northeastern dean of nursing. “That’s the thing that should be the most concerning to these state boards.”\u003c/p>\n\u003cp>Dr. Karen Miotto, a long-time specialist in substance use disorders and treatment for physicians, said protecting patients should be everyone’s primary concern, but programs that lean heavily on punishment rather than recovery tend to discourage participation. When that happens, regulators are left in the dark.\u003c/p>\n\u003cp>“If you create it so that no one will come … then you can’t argue we’re doing the safest thing,” Miotto said.\u003c/p>\n\u003cp>In a 2018 presentation to the nursing board, Matthews of Maximus attributed the decline in participation, which began in 2010, to a drastic drop in self-referrals after the state implemented the current law designed to increase oversight of professionals struggling with addiction or mental health issues.\u003c/p>\n\u003cp>In a statement to CalMatters, Board of Registered Nursing staff said it “cannot speculate as to the reason(s) that enrollment is low,” but some nurses “may not want to participate in this specific program because it is overseen by their licensing agency, entails worksite monitoring, and there are costs associated with it.”\u003c/p>\n\u003cp>Nurses say the reason why numbers are dropping is obvious — the program is so intolerable that current participants tell their colleagues with addiction to stay invisible.\u003c/p>\n\u003cp>“We’re only the tip of the iceberg. When you become an addict, you recognize other people,” a nurse who spent three years in the program told CalMatters.\u003c/p>\n\u003ch2>What does evidence-based recovery look like?\u003c/h2>\n\u003cp>Rigorous monitoring and drug testing can be effective even if they are intrusive and inconvenient, experts on health care worker addiction told CalMatters.\u003c/p>\n\u003cp>Research shows that daily check-ins, random drug tests, attending recovery meetings, and years of monitoring all help health workers stay sober and care for patients safely. Requiring a professional to adhere to these conditions in exchange for keeping their license is known as leveraged treatment — the point being to balance recovery with public safety.[aside label=\"Related Stories\" postID=\"news_11983752,news_11987204,news_11957005\"]“Leveraged treatment, we know, is enormously successful,” Miotto said.\u003c/p>\n\u003cp>Some studies suggest more than 90% of health workers who complete recovery and monitoring programs are sober and working five years later. In comparison, about 75% of the general population will recover from addiction. Success among health workers corresponds with random drug tests and lengthier program requirements.\u003c/p>\n\u003cp>But there are limits to what is effective.\u003c/p>\n\u003cp>Participants are the most successful with daily check-ins, weekly group meetings such as those held by Alcoholics Anonymous, twice monthly drug testing and nurse support meetings, and at least three years of monitoring, according to the \u003ca href=\"https://www.ncsbn.org/public-files/OutcomesofSubstanceUseDisorderMonitoringProgramsforNursesJNR.pdf\">only study to assess nurse monitoring program characteristics\u003c/a>.\u003c/p>\n\u003cp>Requiring nurses to do more did not yield better results, according to the study, which assessed 14 state programs, not including California.\u003c/p>\n\u003cp>In comparison, California’s requirements are far more stringent.\u003c/p>\n\u003cp>\u003ca href=\"https://www.dca.ca.gov/enforcement/uniform_standards_4_2021.pdf\">State law\u003c/a> requires all health care professionals to be tested once per week the first year in the program. Minimum test requirements drop in ensuing years but still average three times per month.\u003c/p>\n\u003cp>Regulations allow an average annual maximum of two tests per week, and many nurses interviewed by CalMatters said they had been subject to two or three tests within a 10-day period despite spending years in the program without violations.\u003c/p>\n\u003cp>Recovery agreements reviewed by CalMatters also showed that they required nurses to attend chemical dependency support groups several times per week, as often as daily, even after years of proven sobriety.\u003c/p>\n\u003ch2>‘One paycheck away from disaster’\u003c/h2>\n\u003cp>Shortly after receiving the terms of her probation, which included random drug testing and daily check-ins, Sage was injured in a car accident that prevented her from working for a year. She had three kids at home, and her disability checks didn’t stretch far enough to cover the drug tests. In an email to her probation officer, Sage wrote that she wanted to comply and asked if there were other options available.\u003c/p>\n\u003cp>“It’s either put a roof over my head or pee for a drug test for something that happened four years ago,” Sage wrote to her probation officer in 2018.\u003c/p>\n\u003cp>It didn’t matter.\u003c/p>\n\u003cp>“Failure to submit biological fluid testing will be considered the same as a positive test and will be a violation of probation. There are no other options,” the probation officer responded via email.\u003c/p>\n\u003cfigure id=\"attachment_12019197\" class=\"wp-caption aligncenter\" style=\"max-width: 1568px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12019197\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/103124-Nursing-Rehab-MO-CM-04-copy.jpg\" alt=\"\" width=\"1568\" height=\"1045\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/103124-Nursing-Rehab-MO-CM-04-copy.jpg 1568w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/103124-Nursing-Rehab-MO-CM-04-copy-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/103124-Nursing-Rehab-MO-CM-04-copy-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/103124-Nursing-Rehab-MO-CM-04-copy-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/103124-Nursing-Rehab-MO-CM-04-copy-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1568px) 100vw, 1568px\">\u003cfigcaption class=\"wp-caption-text\">Former vocational nurse Bobbie Sage is petitioning the state to regain her professional license. \u003ccite>(Manuel Orbegozo for CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Sage testified under oath at an administrative hearing that her probation officer verbally told her to give up her house and live in her car if that was the only way to pay for the terms of her probation. During the eight months she was in the program, Sage said she became suicidal.\u003c/p>\n\u003cp>“I called my own family and wanted them to take my kids because I didn’t feel like I could take care of them,” she said. “I felt so horribly defeated and desperate by how I was treated.”\u003c/p>\n\u003cp>Her probation officer listed 148 failures to check in and 15 missed drug tests as part of the reason to revoke Sage’s license. Emails show that all of the violations on Sage’s record happened after she notified her probation officer that she couldn’t afford the costs.\u003c/p>\n\u003cp>“Most American families are one paycheck away from disaster. The board was perfectly fine to tell me to live out of my car, which I find disgusting,” Sage said.\u003c/p>\n\u003cp>This year, Sage petitioned to have her license reinstated. During a reinstatement hearing, Sage testified that she did not have a pattern of substance abuse, and instead, the 2014 DUI represented the worst of two very difficult years of her life as she tried to escape an abusive relationship.\u003c/p>\n\u003cp>“I just want to say that I have spent my life trying to change since that day,” Sage testified.\u003c/p>\n\u003cp>On Monday, the Board of Vocational Nursing and Psychiatric Technicians notified Sage that her license could be reinstated only if she resumed probation for three years and paid an additional $600 processing fee.\u003c/p>\n\u003cp>“I wish that somebody who has the ability to make a change will look at the whole program and say it’s time to revisit this and make some changes,” Sage said.\u003c/p>\n\u003cp>\u003cem>Supported by the California Health Care Foundation (CHCF), which works to ensure that people have access to the care they need, when they need it, at a price they can afford. Visit www.chcf.org to learn more.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "California nurses say an addiction recovery program managed by their licensing board has become a trap that drives them out of their careers and leaves them in debt.",
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"title": "'It's Living Hell': Nurses Say a California Addiction Recovery Program Ended Their Careers | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Bobbie Sage thought nursing would be her salvation. She was trapped in an abusive relationship with four kids and looking for a steady income. The day she graduated vocational nursing school, she took the kids and left their father.\u003c/p>\n\u003cp>Five years later, a DUI ruined her carefully crafted stability. Sage was waiting for a taxi outside a bar with another partner when he began hitting her, she said. She fled in her own car. A mistake with enduring consequences.\u003c/p>\n\u003cp>Sage was charged with a misdemeanor for driving under the influence of alcohol in 2014. She paid a fine and completed three years of criminal probation without incident, according to court documents. She thought that tumultuous period of her life was over until her state licensing board ordered her to complete an additional probation program for health professionals with substance use problems.\u003c/p>\n\u003cp>Sage couldn’t afford the drug tests at $300 a month or a fine of $3,140. She dropped out. She surrendered her vocational nursing license in 2019 and blames the program for ending her career.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Now, Sage is among dozens of health care workers who allege they’ve been mistreated under a California law governing workers with addiction and mental health problems. They say state regulations are needlessly punitive, overly bureaucratic and based on faulty addiction science. They call it a trap that prevents them from working and leaves many of them with thousands of dollars of debt.\u003c/p>\n\u003cp>“One misdemeanor is costing my entire life,” Sage said. “Punish me for something with my (nursing) license that I’ve done with my license.”\u003c/p>\n\u003cp>The 2008 law was supposed to protect patients after a series of audits and legislative hearings suggested licensing boards were doing a poor job of keeping impaired health workers off the job. It created uniform regulations for each board to follow that stipulate exactly how to deal with these workers, including extensive drug testing, travel restrictions and psychiatric evaluations meant to catch anyone who relapsed.\u003c/p>\n\u003cp>Some boards created recovery programs as an alternative to discipline. Workers could volunteer to join as a step toward their recovery or be asked to join by their licensing board as a substitute for public punishment. Others, including Sage, were ordered into a parallel probation program after an incident such as a DUI or other licensing violation.\u003c/p>\n\u003cp>Nurses say those provisions have become so burdensome and expensive that health care workers avoid the recovery program outright unless a licensing board asks them to join. As a result, the state is monitoring fewer workers than ever. Fewer than 400 people are enrolled, down from a peak of more than 900 in 2010.\u003c/p>\n\u003cp>The recovery program \u003ca href=\"https://calmatters.org/health/2024/12/medical-board-addiction-recovery/\">has never included doctors\u003c/a>, whose lobby resisted it because members believed it was too punitive, according to Gail Jara, executive director of \u003ca href=\"https://cppph.org/\">California Public Protection and Physician Health\u003c/a>, an organization dedicated to creating a new recovery program for doctors. The California Medical Board, which licenses most doctors, plans to push for an alternative program in the Legislature in the coming year.\u003c/p>\n\u003cp>“It’s living hell,” said an emergency room nurse interviewed by CalMatters who joined voluntarily. The nurse asked for confidentiality because she could lose her license for speaking out under the terms of her contract.\u003c/p>\n\u003cp>The nurse has been unable to find a job that meets the program’s strict work limitations for nearly two years despite clean tests. She has spent more than $8,000 on drug tests, according to receipts, several thousand more on medical and psychological evaluations, and more than $20,000 paying for health insurance because she lost her work insurance.\u003c/p>\n\u003cp>Dentists, physical therapists, veterinarians and other health workers whose professional licensing boards are overseen by the California Department of Consumer Affairs are subject to the state law. Nurses make up the majority of the participants, and complaints about the program have erupted at recent Board of Registered Nurses meetings.\u003c/p>\n\u003cp>Many say they’ve followed all the rules and still see no way out, even after years of demonstrated sobriety.\u003c/p>\n\u003cp>Officials at those meetings faulted minor changes they made to increase oversight, suggesting they went too far. Participants and addiction experts interviewed by CalMatters, however, say the law itself is the root of the issue.\u003c/p>\n\u003cp>“We’ve built systems that are completely onerous and agnostic of the value of a human life,” said \u003ca href=\"https://bouve.northeastern.edu/directory/amanda-choflet/\">Amanda Choflet\u003c/a>, dean of nursing at Northeastern University in Boston and an expert in nursing addiction programs. “It’s not even that the systems themselves are actively trying to keep people from being able to recover. It’s that the systems aren’t built for humans. They’re built in order to enact legislation.”\u003c/p>\n\u003cp>A group of consumer advocates that pushed for the law argues that it is doing exactly what it is meant to do — impose consequences on workers who can’t stay sober. Michele Monserratt-Ramos, a patient advocate with Consumer Watchdog, said licensing boards’ first duty is to protect the public, not shield health workers with substance use or mental health disorders.\u003c/p>\n\u003cp>Many of the requirements that nurses and other workers say are intolerable, such as work prohibitions, were designed to protect patients, said Monserratt-Ramos, whose fiancé died after an operation with a doctor who had a history of substance abuse. If health workers know addictive behaviors and other impairments will be scrutinized by their licensing boards, they’ll be less likely to do something harmful, she said.\u003c/p>\n\u003cp>“The safety net now is the consequences,” Monserratt-Ramos said.\u003c/p>\n\u003cp>The Department of Consumer Affairs did not make anyone available for an interview, stating that the regulations governing the program were written by a committee years ago and no experts were available. In a statement, the department said each health care board is independently responsible for implementing the program, and eight boards contract with an outside vendor, Maximus Inc., to do so.\u003c/p>\n\u003cp>The Board of Registered Nursing refused several times to make executive staff or board members available for an interview to address participants’ complaints. Individual board members also failed to return calls or emails from CalMatters. In a statement to CalMatters, board staff said they have already addressed such complaints and are working to address more.\u003c/p>\n\u003cp>Maximus, a publicly traded company worth $4.5 billion, did not respond to several interview requests. The vendor’s $12.4 million state contract expires at the end of December. The company did not bid for a new contract, and the Department of Consumer Affairs did not provide a reason why.\u003c/p>\n\u003cp>Sage says she worked hard to transform her life and move on from past abuse. She’s a licensed esthetician now and runs a successful studio in the Bay Area. Family and colleagues describe her as a hard worker, a natural caregiver and someone who doesn’t complain.\u003c/p>\n\u003cfigure id=\"attachment_12019194\" class=\"wp-caption aligncenter\" style=\"max-width: 1568px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12019194\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/103124-Nursing-Rehab-MO-CM-13-copy.jpg\" alt=\"\" width=\"1568\" height=\"1045\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/103124-Nursing-Rehab-MO-CM-13-copy.jpg 1568w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/103124-Nursing-Rehab-MO-CM-13-copy-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/103124-Nursing-Rehab-MO-CM-13-copy-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/103124-Nursing-Rehab-MO-CM-13-copy-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/103124-Nursing-Rehab-MO-CM-13-copy-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1568px) 100vw, 1568px\">\u003cfigcaption class=\"wp-caption-text\">Former vocational nurse Bobbie Sage reviews her case files in the lobby of her aesthetics studio in Pleasanton. Sage has kept the files after years of trying to navigate a disciplinary program for nurses with addictions that she was forced to attend. \u003ccite>(Manuel Orbegozo for CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>She admits she made a mistake but says she never had an addiction problem. CalMatters reviewed a letter Sage provided from a doctor confirming that she did not meet the criteria for alcoholism and has never been diagnosed as an alcoholic. Under state law, any medical professional with a DUI is presumed to have a \u003ca href=\"https://casetext.com/regulation/california-code-of-regulations/title-16-professional-and-vocational-regulations/division-25-board-of-vocational-nurse-and-psychiatric-technician-examiners-of-the-state-of-california/chapter-1-vocational-nurses/article-4-licenses/section-2524-disciplinary-guidelines-and-uniform-standards-regarding-substance-abusing-licensees\">substance abuse\u003c/a> problem, even if it is a one-time offense. The Department of Consumer Affairs said the Board of Vocational Nursing and Psychiatric Technicians, which oversees Sage’s license, does not offer a recovery program, only a disciplinary track.\u003c/p>\n\u003cp>“I haven’t been a perfect person in my life, but I’ve been a good person,” Sage said. “I’ve taken full responsibility, and I don’t believe we should keep punishing someone for a misdemeanor that happened 10 years ago.”\u003c/p>\n\u003ch2>Nurse demand changes at board meetings\u003c/h2>\n\u003cp>CalMatters spoke with six nurses in the recovery program, all of whom asked not to be named for fear of retaliation from their case managers and the Board of Registered Nursing, which authorizes their licenses. The nurses said while some of the policies they regarded as arbitrary have been rolled back — including a requirement to administer narcotics to patients — many of the problems are longstanding and systemic.\u003c/p>\n\u003cp>The nurses provided documents that supported their descriptions, including their contract agreements, medical records, and recordings of individual meetings with enforcement committees.\u003c/p>\n\u003cp>Common problems outlined by interviewed nurses include:\u003c/p>\n\u003cul class=\"wp-block-list\">\n\u003cli>Moving goal posts — All of the nurses interviewed by CalMatters said the requirements to complete the program kept changing, including work requirements and the need for clinical evaluations that could take months for the board to review, prolonging their time in the program. “I felt like I was going to be in this program indefinitely,” said a former acute care nurse who dropped out with what she says were five years of sobriety.\u003c/li>\n\u003c/ul>\n\u003cul class=\"wp-block-list\">\n\u003cli>Retaliation — Nurses said they felt like they were constantly in trouble and forced to stay silent for fear of losing their licenses. They were not allowed to travel to see family or attend their children’s sports games without approval from case managers. They would be held liable if no testing centers were open, even on holidays and weekends, and the inability to pay for a drug test counted as a positive result. “I felt so small. I didn’t feel supported. Every time I saw my case manager calling me, I felt like I was going to throw up,” a second nurse interviewed by CalMatters said.\u003c/li>\n\u003c/ul>\n\u003cul class=\"wp-block-list\">\n\u003cli>Forced attendance at religious recovery meetings — A third nurse who started using drugs after escaping a religious cult said her case manager made her go to a faith-based 12-step meeting despite state law prohibiting such a requirement. “I go. I sit on a church pew. I feel like I’m back in my church, and I have palpitations,” she said.\u003c/li>\n\u003c/ul>\n\u003cul class=\"wp-block-list\">\n\u003cli>Interference with personal medical decisions — A fourth nurse who was admitted to the program for alcohol and mental health struggles said she was prohibited from taking prescribed medication for attention-deficit disorder despite demonstrated sobriety and a medical evaluation showing her cognitive performance improved with medication. Another who was prescribed suboxone, a drug commonly used to treat people with opioid dependency, said she was forced to stop by program officials against the advice of her doctor.\u003c/li>\n\u003c/ul>\n\u003cul class=\"wp-block-list\">\n\u003cli>“Cookie-cutter” requirements — A sixth nurse who was addicted to opiates said it took two and a half years for a complaint about her drug use to be processed by the nursing board. In the meantime, she put herself through rehab and stayed sober. The board told her to “voluntarily” join the recovery program or be stripped of her license despite letters from her addiction specialist, the nurse said. According to documents reviewed by CalMatters, the frequency of her random drug testing and other restrictions were substantially similar to requirements imposed on nurses who were not sober at the time of joining the program.\u003c/li>\n\u003c/ul>\n\u003cp>In May, when nurses began flooding board meetings with sweeping allegations of mistreatment, Executive Director Loretta Melby said, “What you heard from Maximus today is there’s, you know, about 250 participants in that program. We don’t have 250 people in public comment.”\u003c/p>\n\u003cp>But as more nurses called in to raise issues, other board members registered concern. “It sounds like collectively, we the board made, and this program made some errors,” board member Alison Cormack said during a June meeting. In August, the nursing board voted to rescind program changes made by Melby and chief enforcement officer Shannon Johnson, including a requirement that nurses work directly with patients and administer narcotics.\u003c/p>\n\u003cp>In response to what nurses told CalMatters about ongoing problems with enforcement committees and employees of Maximus, the board’s staff sent this unsigned statement: “Board staff actively works with the vendor to address all concerns that are brought forth by participants.”\u003c/p>\n\u003cp>The statement added that “each participant is individually evaluated on a case-by-case basis” to determine the requirements of their recovery contracts, however the unsigned statement also acknowledged that previous participant contracts may not have accounted for an individual’s case history. Case managers and enforcement committee members must now examine each individual participant’s compliance with the program before making changes to their contracts, the statement said.\u003c/p>\n\u003cfigure id=\"attachment_12019196\" class=\"wp-caption aligncenter\" style=\"max-width: 1568px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12019196\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/103124-Nursing-Rehab-MO-CM-12-copy.jpg\" alt=\"\" width=\"1568\" height=\"1045\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/103124-Nursing-Rehab-MO-CM-12-copy.jpg 1568w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/103124-Nursing-Rehab-MO-CM-12-copy-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/103124-Nursing-Rehab-MO-CM-12-copy-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/103124-Nursing-Rehab-MO-CM-12-copy-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/103124-Nursing-Rehab-MO-CM-12-copy-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1568px) 100vw, 1568px\">\u003cfigcaption class=\"wp-caption-text\">Former vocational nurse Bobbie Sage reviews a requirement plan that she was forced to complete while part of a disciplinary program designed for nurses with addiction, in Pleasanton, on Oct. 31, 2024. \u003ccite>(Manuel Orbegozo for CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>During a board meeting, Maximus, the program vendor, denied that its staff forced participants to attend religiously based meetings, an objection raised by several people during public comment. In a statement to CalMatters, board staff also denied there was such a requirement.\u003c/p>\n\u003cp>However, the nursing board’s \u003ca href=\"https://www.rn.ca.gov/intervention/intreq.shtml\">own website\u003c/a> denotes “12-Step Group Attendance” as a program requirement. The 12-step structure was created by Alcoholics Anonymous, and several steps reference God. Recovery agreements provided to CalMatters by participants say they can attend groups other than Alcoholics Anonymous, but program participants say they can’t find non-religious or non-spiritual alternatives that meet the board’s requirements, which also include finding a sponsor, another Alcoholics Anonymous rule.\u003c/p>\n\u003cp>Program regulations also stipulate that positive drug tests are not dismissed even if they are the result of a valid prescription. Regulations mandate that an approved physician submit monitoring plans for participants to take prescription medication even for chronic conditions such as high blood pressure and diabetes. Some nurses said they avoid medical care outright because of the bureaucratic hoops they are required to jump through.\u003c/p>\n\u003ch2>Workers with addiction avoid program\u003c/h2>\n\u003cp>The majority of recovery program participants, 250, are nurses, Maximus Director of Clinical Services Ginny Matthews testified during a recent nursing board meeting. That means the state nursing board is monitoring less than 0.05% of its roughly 537,000 nurses. Other licensing boards are tracking far less.\u003c/p>\n\u003cp>The state does not track how many health professionals are disciplined and ordered to probation like Sage because of a drug or mental health impairment, but only 0.1% of the health care workforce is disciplined annually for any reason. Research shows between 10% to 12% of medical professionals will develop a substance use disorder during their lifetime.\u003c/p>\n\u003cp>That means the vast majority of health workers with addictions are flying under the radar, multiple addiction experts interviewed by CalMatters said.\u003c/p>\n\u003cp>“Where are all of the people who we know should be getting into these programs, and why aren’t they turning to our programs for help?” said Choflet, the Northeastern dean of nursing. “That’s the thing that should be the most concerning to these state boards.”\u003c/p>\n\u003cp>Dr. Karen Miotto, a long-time specialist in substance use disorders and treatment for physicians, said protecting patients should be everyone’s primary concern, but programs that lean heavily on punishment rather than recovery tend to discourage participation. When that happens, regulators are left in the dark.\u003c/p>\n\u003cp>“If you create it so that no one will come … then you can’t argue we’re doing the safest thing,” Miotto said.\u003c/p>\n\u003cp>In a 2018 presentation to the nursing board, Matthews of Maximus attributed the decline in participation, which began in 2010, to a drastic drop in self-referrals after the state implemented the current law designed to increase oversight of professionals struggling with addiction or mental health issues.\u003c/p>\n\u003cp>In a statement to CalMatters, Board of Registered Nursing staff said it “cannot speculate as to the reason(s) that enrollment is low,” but some nurses “may not want to participate in this specific program because it is overseen by their licensing agency, entails worksite monitoring, and there are costs associated with it.”\u003c/p>\n\u003cp>Nurses say the reason why numbers are dropping is obvious — the program is so intolerable that current participants tell their colleagues with addiction to stay invisible.\u003c/p>\n\u003cp>“We’re only the tip of the iceberg. When you become an addict, you recognize other people,” a nurse who spent three years in the program told CalMatters.\u003c/p>\n\u003ch2>What does evidence-based recovery look like?\u003c/h2>\n\u003cp>Rigorous monitoring and drug testing can be effective even if they are intrusive and inconvenient, experts on health care worker addiction told CalMatters.\u003c/p>\n\u003cp>Research shows that daily check-ins, random drug tests, attending recovery meetings, and years of monitoring all help health workers stay sober and care for patients safely. Requiring a professional to adhere to these conditions in exchange for keeping their license is known as leveraged treatment — the point being to balance recovery with public safety.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“Leveraged treatment, we know, is enormously successful,” Miotto said.\u003c/p>\n\u003cp>Some studies suggest more than 90% of health workers who complete recovery and monitoring programs are sober and working five years later. In comparison, about 75% of the general population will recover from addiction. Success among health workers corresponds with random drug tests and lengthier program requirements.\u003c/p>\n\u003cp>But there are limits to what is effective.\u003c/p>\n\u003cp>Participants are the most successful with daily check-ins, weekly group meetings such as those held by Alcoholics Anonymous, twice monthly drug testing and nurse support meetings, and at least three years of monitoring, according to the \u003ca href=\"https://www.ncsbn.org/public-files/OutcomesofSubstanceUseDisorderMonitoringProgramsforNursesJNR.pdf\">only study to assess nurse monitoring program characteristics\u003c/a>.\u003c/p>\n\u003cp>Requiring nurses to do more did not yield better results, according to the study, which assessed 14 state programs, not including California.\u003c/p>\n\u003cp>In comparison, California’s requirements are far more stringent.\u003c/p>\n\u003cp>\u003ca href=\"https://www.dca.ca.gov/enforcement/uniform_standards_4_2021.pdf\">State law\u003c/a> requires all health care professionals to be tested once per week the first year in the program. Minimum test requirements drop in ensuing years but still average three times per month.\u003c/p>\n\u003cp>Regulations allow an average annual maximum of two tests per week, and many nurses interviewed by CalMatters said they had been subject to two or three tests within a 10-day period despite spending years in the program without violations.\u003c/p>\n\u003cp>Recovery agreements reviewed by CalMatters also showed that they required nurses to attend chemical dependency support groups several times per week, as often as daily, even after years of proven sobriety.\u003c/p>\n\u003ch2>‘One paycheck away from disaster’\u003c/h2>\n\u003cp>Shortly after receiving the terms of her probation, which included random drug testing and daily check-ins, Sage was injured in a car accident that prevented her from working for a year. She had three kids at home, and her disability checks didn’t stretch far enough to cover the drug tests. In an email to her probation officer, Sage wrote that she wanted to comply and asked if there were other options available.\u003c/p>\n\u003cp>“It’s either put a roof over my head or pee for a drug test for something that happened four years ago,” Sage wrote to her probation officer in 2018.\u003c/p>\n\u003cp>It didn’t matter.\u003c/p>\n\u003cp>“Failure to submit biological fluid testing will be considered the same as a positive test and will be a violation of probation. There are no other options,” the probation officer responded via email.\u003c/p>\n\u003cfigure id=\"attachment_12019197\" class=\"wp-caption aligncenter\" style=\"max-width: 1568px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12019197\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/103124-Nursing-Rehab-MO-CM-04-copy.jpg\" alt=\"\" width=\"1568\" height=\"1045\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/103124-Nursing-Rehab-MO-CM-04-copy.jpg 1568w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/103124-Nursing-Rehab-MO-CM-04-copy-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/103124-Nursing-Rehab-MO-CM-04-copy-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/103124-Nursing-Rehab-MO-CM-04-copy-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/103124-Nursing-Rehab-MO-CM-04-copy-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1568px) 100vw, 1568px\">\u003cfigcaption class=\"wp-caption-text\">Former vocational nurse Bobbie Sage is petitioning the state to regain her professional license. \u003ccite>(Manuel Orbegozo for CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Sage testified under oath at an administrative hearing that her probation officer verbally told her to give up her house and live in her car if that was the only way to pay for the terms of her probation. During the eight months she was in the program, Sage said she became suicidal.\u003c/p>\n\u003cp>“I called my own family and wanted them to take my kids because I didn’t feel like I could take care of them,” she said. “I felt so horribly defeated and desperate by how I was treated.”\u003c/p>\n\u003cp>Her probation officer listed 148 failures to check in and 15 missed drug tests as part of the reason to revoke Sage’s license. Emails show that all of the violations on Sage’s record happened after she notified her probation officer that she couldn’t afford the costs.\u003c/p>\n\u003cp>“Most American families are one paycheck away from disaster. The board was perfectly fine to tell me to live out of my car, which I find disgusting,” Sage said.\u003c/p>\n\u003cp>This year, Sage petitioned to have her license reinstated. During a reinstatement hearing, Sage testified that she did not have a pattern of substance abuse, and instead, the 2014 DUI represented the worst of two very difficult years of her life as she tried to escape an abusive relationship.\u003c/p>\n\u003cp>“I just want to say that I have spent my life trying to change since that day,” Sage testified.\u003c/p>\n\u003cp>On Monday, the Board of Vocational Nursing and Psychiatric Technicians notified Sage that her license could be reinstated only if she resumed probation for three years and paid an additional $600 processing fee.\u003c/p>\n\u003cp>“I wish that somebody who has the ability to make a change will look at the whole program and say it’s time to revisit this and make some changes,” Sage said.\u003c/p>\n\u003cp>\u003cem>Supported by the California Health Care Foundation (CHCF), which works to ensure that people have access to the care they need, when they need it, at a price they can afford. Visit www.chcf.org to learn more.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Critics of San Francisco’s approach to the \u003ca href=\"https://www.kqed.org/news/tag/overdose-crisis\">overdose crisis\u003c/a> are pointing to a handful of nonprofits that give out aluminum foil, pipes and other supplies to drug users, arguing that they’re only making the problem worse. However, the programs, while they might seem counterintuitive, represent a key strategy for reducing harm and guiding people toward recovery, nonprofit leaders and health experts said.\u003c/p>\n\u003cp>Harm-reduction programs such as supervised consumption sites and needle exchanges have come under fire in the past. Last week, a report from the \u003cem>San Francisco Chronicle\u003c/em> drew attention to the Tenderloin’s Glide Foundation and other city-funded nonprofits for supplying people with foil, pipes and other materials used for smoking drugs such as fentanyl.\u003c/p>\n\u003cp>People who visit Glide can request these materials during its Syringe Access and Health Hub hours and at its mobile clinics, according to Glide’s senior director of health access services, Mike Discepola.\u003c/p>\n\u003cp>Once people are there, Glide CEO Gina Fromer said, they have access to recovery services, including a peer-led 12-step program, referrals to detox and inpatient treatment beds, medically assisted treatment options like methadone, and educational materials. In October, the nonprofit plans to open a mental health services clinic.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“Maybe you yesterday said, ‘I’m going to start recovery,’ and you didn’t because addiction is strong, addiction is a disease, it takes a lot to get to a place where you’re ready to get on that recovery spectrum,” Fromer said. “But we want to make sure when you’re ready, you have what you need.”\u003c/p>\n\u003cp>She told KQED that Glide’s decision to offer foil and other supplies “is really about saving lives and preventing disease, but also creating opportunities for recovery.”\u003c/p>\n\u003cp>Dr. Amer Raheemullah, the director of the Inpatient Addiction Medicine Service at Stanford Hospital, said such harm-reduction strategies not only make drug users safer but also can urge them to turn to treatment options when made available at the same location as other recovery services.\u003c/p>\n\u003cfigure id=\"attachment_11998108\" class=\"wp-caption aligncenter\" style=\"max-width: 1999px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11998108\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/240617-SyringeExchange-35-BL_qed.jpg\" alt=\"\" width=\"1999\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/240617-SyringeExchange-35-BL_qed.jpg 1999w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/240617-SyringeExchange-35-BL_qed-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/240617-SyringeExchange-35-BL_qed-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/240617-SyringeExchange-35-BL_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/240617-SyringeExchange-35-BL_qed-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/240617-SyringeExchange-35-BL_qed-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 1999px) 100vw, 1999px\">\u003cfigcaption class=\"wp-caption-text\">Contents of a harm reduction kit on June 17, 2024. The kit includes new syringes, fentanyl test strips and Narcan. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“The idea is to reduce harm, but then also have this interaction with somebody who’s actively using to slowly nudge them toward treatment,” he told KQED. “That can be through counseling, like a skilled counseling interview that’s been shown to be effective, but it can also simply be by co-locating treatment in the same place that they’re getting these needles or these other harm reduction tools.”\u003c/p>\n\u003cp>One way to think about harm reduction, Raheemullah said, is to consider those struggling with addiction as having a neurological deficit.\u003c/p>\n\u003cp>Take someone with Parkinson’s disease, for example — “They might have an increased risk of falls. So, in order to reduce harm, we pad their house; we may make adjustments in their living situation, not to encourage falls, but to reduce the damage of falls if or when they occur. It’s the same with substance use,” he said.\u003c/p>\n\u003cp>Sharing and reusing needles can increase the risk of contracting HIV and Hepatitis C, which can lead to illness and, in some cases, death.\u003c/p>\n\u003cfigure id=\"attachment_11998115\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11998115\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/001_KQED_SOMABuprenorphineDelivery_03232023_qed.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/001_KQED_SOMABuprenorphineDelivery_03232023_qed.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/001_KQED_SOMABuprenorphineDelivery_03232023_qed-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/001_KQED_SOMABuprenorphineDelivery_03232023_qed-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/001_KQED_SOMABuprenorphineDelivery_03232023_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/001_KQED_SOMABuprenorphineDelivery_03232023_qed-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/001_KQED_SOMABuprenorphineDelivery_03232023_qed-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">A psychiatric clinical pharmacist with the San Francisco Department of Public Health packs a backpack with harm reduction supplies before making deliveries to SROs and Permanent Supportive Housing in San Francisco on March 23, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“The higher objective is to just reduce this harm that’s occurring, preserve life and not do too much damage for later down the line when people eventually accept treatment,” Raheemullah said.\u003c/p>\n\u003cp>There is also no proof that administering needles or other safe injection supplies increases the use of illegal drugs, he told KQED.\u003c/p>\n\u003cp>A randomized study of 600 people who injected cocaine, morphine and/or amphetamines found “no difference in the number of injections over time” for people supplied with sterile needles compared to those taught how to purchase them, according to the 2003 report out of the University of Alaska Anchorage.\u003c/p>\n\u003cp>The Center for Disease Control also said in a February 2024 report that 30 years of research has shown programs that provide access to sterile injection equipment “do not increase illegal drug use.”\u003c/p>\n\u003cp>Fromer said that Glide’s distribution of safer drug-use materials is one of the nonprofit’s many programs geared toward helping drug users — whether they have chosen recovery or not.[aside postID=news_11995842 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/SFOverdoseDeathDecline-1020x680.jpg']“Anybody walking through our door, we want to have resources and information available to them so they can decide what their recovery journey might look like,” she said. “Or, It might start next week, and we’re going to make sure that you’re not going to die in that week or catch HIV or Hepatitis C in that week.”\u003c/p>\n\u003cp>Providing clean materials lessens infectious disease spread and decreases overdose risk, Discepola said — if someone were to pick up used foil from the ground or borrow a pipe, they might not know what substances have come in contact with it.\u003c/p>\n\u003cp>“There could be very small quantities of fentanyl in a device, and if someone doesn’t know it and they think they’re smoking something else, then they could actually overdose and die,” he said.\u003c/p>\n\u003cp>Handing out clean foil or pipes can also encourage people to smoke instead of injecting drugs, which can be less dangerous because it doesn’t have the same disease transmission risks, Raheemullah told KQED. But there can be a risk in administering foil or pipes to people who have previously used drugs by snorting them, which is considered less addicting than smoking or injecting, he explained.\u003c/p>\n\u003cp>In general, providing sterile drug supplies is an important tool for addressing the opioid epidemic, he said.\u003c/p>\n\u003cp>Fromer said that Glide will continue to provide access to those materials — and encourage people to recover.\u003c/p>\n\u003cp>“We’re going to be talking to them about recovery; we’re going to hint toward recovery,” she said. “Every time you walk into Glide, you’re going to learn about recovery.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Critics of San Francisco’s approach to the \u003ca href=\"https://www.kqed.org/news/tag/overdose-crisis\">overdose crisis\u003c/a> are pointing to a handful of nonprofits that give out aluminum foil, pipes and other supplies to drug users, arguing that they’re only making the problem worse. However, the programs, while they might seem counterintuitive, represent a key strategy for reducing harm and guiding people toward recovery, nonprofit leaders and health experts said.\u003c/p>\n\u003cp>Harm-reduction programs such as supervised consumption sites and needle exchanges have come under fire in the past. Last week, a report from the \u003cem>San Francisco Chronicle\u003c/em> drew attention to the Tenderloin’s Glide Foundation and other city-funded nonprofits for supplying people with foil, pipes and other materials used for smoking drugs such as fentanyl.\u003c/p>\n\u003cp>People who visit Glide can request these materials during its Syringe Access and Health Hub hours and at its mobile clinics, according to Glide’s senior director of health access services, Mike Discepola.\u003c/p>\n\u003cp>Once people are there, Glide CEO Gina Fromer said, they have access to recovery services, including a peer-led 12-step program, referrals to detox and inpatient treatment beds, medically assisted treatment options like methadone, and educational materials. In October, the nonprofit plans to open a mental health services clinic.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Maybe you yesterday said, ‘I’m going to start recovery,’ and you didn’t because addiction is strong, addiction is a disease, it takes a lot to get to a place where you’re ready to get on that recovery spectrum,” Fromer said. “But we want to make sure when you’re ready, you have what you need.”\u003c/p>\n\u003cp>She told KQED that Glide’s decision to offer foil and other supplies “is really about saving lives and preventing disease, but also creating opportunities for recovery.”\u003c/p>\n\u003cp>Dr. Amer Raheemullah, the director of the Inpatient Addiction Medicine Service at Stanford Hospital, said such harm-reduction strategies not only make drug users safer but also can urge them to turn to treatment options when made available at the same location as other recovery services.\u003c/p>\n\u003cfigure id=\"attachment_11998108\" class=\"wp-caption aligncenter\" style=\"max-width: 1999px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11998108\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/240617-SyringeExchange-35-BL_qed.jpg\" alt=\"\" width=\"1999\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/240617-SyringeExchange-35-BL_qed.jpg 1999w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/240617-SyringeExchange-35-BL_qed-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/240617-SyringeExchange-35-BL_qed-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/240617-SyringeExchange-35-BL_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/240617-SyringeExchange-35-BL_qed-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/240617-SyringeExchange-35-BL_qed-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 1999px) 100vw, 1999px\">\u003cfigcaption class=\"wp-caption-text\">Contents of a harm reduction kit on June 17, 2024. The kit includes new syringes, fentanyl test strips and Narcan. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“The idea is to reduce harm, but then also have this interaction with somebody who’s actively using to slowly nudge them toward treatment,” he told KQED. “That can be through counseling, like a skilled counseling interview that’s been shown to be effective, but it can also simply be by co-locating treatment in the same place that they’re getting these needles or these other harm reduction tools.”\u003c/p>\n\u003cp>One way to think about harm reduction, Raheemullah said, is to consider those struggling with addiction as having a neurological deficit.\u003c/p>\n\u003cp>Take someone with Parkinson’s disease, for example — “They might have an increased risk of falls. So, in order to reduce harm, we pad their house; we may make adjustments in their living situation, not to encourage falls, but to reduce the damage of falls if or when they occur. It’s the same with substance use,” he said.\u003c/p>\n\u003cp>Sharing and reusing needles can increase the risk of contracting HIV and Hepatitis C, which can lead to illness and, in some cases, death.\u003c/p>\n\u003cfigure id=\"attachment_11998115\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11998115\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/001_KQED_SOMABuprenorphineDelivery_03232023_qed.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/001_KQED_SOMABuprenorphineDelivery_03232023_qed.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/001_KQED_SOMABuprenorphineDelivery_03232023_qed-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/001_KQED_SOMABuprenorphineDelivery_03232023_qed-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/001_KQED_SOMABuprenorphineDelivery_03232023_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/001_KQED_SOMABuprenorphineDelivery_03232023_qed-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/07/001_KQED_SOMABuprenorphineDelivery_03232023_qed-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">A psychiatric clinical pharmacist with the San Francisco Department of Public Health packs a backpack with harm reduction supplies before making deliveries to SROs and Permanent Supportive Housing in San Francisco on March 23, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“The higher objective is to just reduce this harm that’s occurring, preserve life and not do too much damage for later down the line when people eventually accept treatment,” Raheemullah said.\u003c/p>\n\u003cp>There is also no proof that administering needles or other safe injection supplies increases the use of illegal drugs, he told KQED.\u003c/p>\n\u003cp>A randomized study of 600 people who injected cocaine, morphine and/or amphetamines found “no difference in the number of injections over time” for people supplied with sterile needles compared to those taught how to purchase them, according to the 2003 report out of the University of Alaska Anchorage.\u003c/p>\n\u003cp>The Center for Disease Control also said in a February 2024 report that 30 years of research has shown programs that provide access to sterile injection equipment “do not increase illegal drug use.”\u003c/p>\n\u003cp>Fromer said that Glide’s distribution of safer drug-use materials is one of the nonprofit’s many programs geared toward helping drug users — whether they have chosen recovery or not.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“Anybody walking through our door, we want to have resources and information available to them so they can decide what their recovery journey might look like,” she said. “Or, It might start next week, and we’re going to make sure that you’re not going to die in that week or catch HIV or Hepatitis C in that week.”\u003c/p>\n\u003cp>Providing clean materials lessens infectious disease spread and decreases overdose risk, Discepola said — if someone were to pick up used foil from the ground or borrow a pipe, they might not know what substances have come in contact with it.\u003c/p>\n\u003cp>“There could be very small quantities of fentanyl in a device, and if someone doesn’t know it and they think they’re smoking something else, then they could actually overdose and die,” he said.\u003c/p>\n\u003cp>Handing out clean foil or pipes can also encourage people to smoke instead of injecting drugs, which can be less dangerous because it doesn’t have the same disease transmission risks, Raheemullah told KQED. But there can be a risk in administering foil or pipes to people who have previously used drugs by snorting them, which is considered less addicting than smoking or injecting, he explained.\u003c/p>\n\u003cp>In general, providing sterile drug supplies is an important tool for addressing the opioid epidemic, he said.\u003c/p>\n\u003cp>Fromer said that Glide will continue to provide access to those materials — and encourage people to recover.\u003c/p>\n\u003cp>“We’re going to be talking to them about recovery; we’re going to hint toward recovery,” she said. “Every time you walk into Glide, you’re going to learn about recovery.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>San Francisco saw its lowest monthly number of fatal overdoses in nearly two years in June, officials announced Monday, offering slight good news as the city \u003ca href=\"https://www.kqed.org/news/11991538/san-francisco-attributes-lower-drug-deaths-to-microdosing-addiction-medication\">battles a severe overdose crisis\u003c/a>.\u003c/p>\n\u003cp>According to preliminary data \u003ca href=\"https://www.sf.gov/sites/default/files/2024-07/2024%2007_OCME%20Overdose%20Report.pdf\">from the medical examiner’s office\u003c/a>, 48 people died of accidental overdoses last month. That’s down more than 15% from 57 deaths in June of last year, and it represents the lowest monthly total since July 2022, when the city reported 43 overdose deaths.\u003c/p>\n\u003cp>The data also show a decrease in overdose deaths in the first half of the year compared to 2023. While public health officials say the “heartening” numbers could result from citywide programs, a policy expert said wider drug use trends are likely making the difference.\u003c/p>\n\u003cp>Dr. Hillary Kunins, the director of behavioral health at the San Francisco Department of Public Health, spoke about the city’s increased access in recent months to the overdose-reversing medicine Narcan, as well as more street care teams and both telehealth and in-person treatment while announcing the June overdose data on Monday.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>However, Keith Humphreys, a drug policy expert and professor at Stanford University, believes that the downward trend likely has little to do with citywide policies.\u003c/p>\n\u003cp>“There’s certainly some sensible things going on — the biggest one: making anti-overdose medication widely available to as many people as possible,” he told KQED. “We’ve been doing that for years at a pretty high level — the good that did was baked in already, so I don’t think that would explain a change like this.”\u003c/p>\n\u003cp>Instead, Humphreys said, the trajectory mirrors \u003ca href=\"https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2024/20240515.htm#:~:text=Provisional%20data%20from%20CDC's%20National,111%2C029%20deaths%20estimated%20in%202022.\">national data\u003c/a> and likely suggests that more people who are using fentanyl are doing so knowingly rather than suffering “surprise overdoses” when they thought they were using another drug.\u003c/p>\n\u003cp>He pointed to a spike in overdose deaths that began around the time of the COVID-19 pandemic. In 2020, the city saw a then-record 726 deaths, according to data from the office of the medical examiner. That number dipped a bit in 2021 and 2022, though overdoses remained above pre-pandemic levels, and last year surpassed 2020 as the city’s \u003ca href=\"https://www.kqed.org/news/11972898/2023-was-san-franciscos-deadliest-year-for-drug-overdoses-new-data-confirms\">deadliest year\u003c/a> on record with 810 deaths.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" title=\"SF drug overdose deaths, Jan.-June 2023/2024 \" aria-label=\"Grouped Columns\" id=\"datawrapper-chart-tGJps\" src=\"https://datawrapper.dwcdn.net/tGJps/1/\" scrolling=\"no\" frameborder=\"0\" style=\"border: none;\" width=\"800\" height=\"547\" data-external=\"1\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>So far, there have been 374 overdose-related deaths in 2024. The figure is slightly lower than the number of deaths recorded during the same period in 2023, but it is still on track to come close to the year’s staggering total.\u003c/p>\n\u003cp>Humphreys said that the small reduction was not surprising, given that pandemic restrictions — \u003ca href=\"https://www.kqed.org/news/11973108/how-long-to-isolate-with-covid-in-2024-california-now-says-that-depends-on-symptoms\">though not COVID-19 infections\u003c/a> — have all but completely wound down. Nationwide, annual overdose deaths decreased last year for the first time since 2018.\u003c/p>\n\u003cp>“During the pandemic, we had increases [in overdoses] beyond anything we’ve had in the history of our country,” he said. “Which I think said a lot about the impact of isolation, stress, the destruction of social opportunities, the loss of jobs, all those kinds of things. Now, we’re getting the other side of it … the restoration of all those things is going to be good for human health,” including drug use and overdose.\u003c/p>\n\u003cp>Kunins agreed that the pandemic led to a spike in overdose deaths and “worsened health outcomes.”\u003c/p>\n\u003cp>The hopeful trajectory is also likely a reflection of heroin’s diminished presence in the illicit drug market, according to Humphreys. High numbers of heroin users suffered accidental fentanyl overdoses in recent years, according to Humphreys.\u003c/p>\n\u003cp>“When heroin is completely gone, people will know that what is being bought and sold is fentanyl,” he told KQED, noting that San Francisco is not at that point yet.\u003c/p>\n\u003cp>“We had a lot of surprise overdoses three years ago in San Francisco, a lot of people who didn’t think they were going to be exposed but were. Now we’re getting to a point where almost no one is surprised, and that should reduce overdoses.”[aside postID=news_11991538 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/GettyImages-955608454-1020x680.jpg']Fentanyl entered the drug market on the West Coast just before the pandemic, Kunins said. In the following years, heroin has made up a shrinking portion of overall overdose deaths. In 2020, 93 of the overdoses reported by the city involved heroin, nearly 12%. So far, in 2024, 20 overdoses included opioids, making up only about 5% of the total.\u003c/p>\n\u003cp>Despite the slight downturn in overall deaths, Kunins said overdose “is very much a crisis in our city and our country.”\u003c/p>\n\u003cp>How officials want to handle the crisis is expected to play a large role in city elections this fall. Three leading mayoral candidates — Mayor London Breed, former Mayor Mark Farrell and Levi Strauss heir Daniel Lurie — have all supported tougher policies surrounding drug use.\u003c/p>\n\u003cp>Farrell previously called for California National Guard members to be deployed in highly trafficked areas, like the Tenderloin and SoMa neighborhoods, and Lurie has expressed support for compelling drug users to enter treatment. In March, Breed placed two measures on citywide ballots expanding police powers and increasing screening and treatment requirements for drug users receiving welfare and touted increased drug-related arrests in May.\u003c/p>\n\u003cp>Both Humphreys and Kunins cautioned against implementing harsher policies. Humphreys said bringing in outside law enforcement likely wouldn’t be effective, while Kunins said that DPH’s priority is expanding treatment, not limiting it.\u003c/p>\n\u003cp>“Many of the regulations and structures surrounding access to medications for addiction treatment that are at the federal and state level really serve to limit access to treatments,” Kunins said. “Our goal is to decrease barriers into care, make it easier and more appealing for people to get into treatment, and to reach our overall goal of saving lives and supporting people to get into recovery.”\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>San Francisco saw its lowest monthly number of fatal overdoses in nearly two years in June, officials announced Monday, offering slight good news as the city \u003ca href=\"https://www.kqed.org/news/11991538/san-francisco-attributes-lower-drug-deaths-to-microdosing-addiction-medication\">battles a severe overdose crisis\u003c/a>.\u003c/p>\n\u003cp>According to preliminary data \u003ca href=\"https://www.sf.gov/sites/default/files/2024-07/2024%2007_OCME%20Overdose%20Report.pdf\">from the medical examiner’s office\u003c/a>, 48 people died of accidental overdoses last month. That’s down more than 15% from 57 deaths in June of last year, and it represents the lowest monthly total since July 2022, when the city reported 43 overdose deaths.\u003c/p>\n\u003cp>The data also show a decrease in overdose deaths in the first half of the year compared to 2023. While public health officials say the “heartening” numbers could result from citywide programs, a policy expert said wider drug use trends are likely making the difference.\u003c/p>\n\u003cp>Dr. Hillary Kunins, the director of behavioral health at the San Francisco Department of Public Health, spoke about the city’s increased access in recent months to the overdose-reversing medicine Narcan, as well as more street care teams and both telehealth and in-person treatment while announcing the June overdose data on Monday.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>However, Keith Humphreys, a drug policy expert and professor at Stanford University, believes that the downward trend likely has little to do with citywide policies.\u003c/p>\n\u003cp>“There’s certainly some sensible things going on — the biggest one: making anti-overdose medication widely available to as many people as possible,” he told KQED. “We’ve been doing that for years at a pretty high level — the good that did was baked in already, so I don’t think that would explain a change like this.”\u003c/p>\n\u003cp>Instead, Humphreys said, the trajectory mirrors \u003ca href=\"https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2024/20240515.htm#:~:text=Provisional%20data%20from%20CDC's%20National,111%2C029%20deaths%20estimated%20in%202022.\">national data\u003c/a> and likely suggests that more people who are using fentanyl are doing so knowingly rather than suffering “surprise overdoses” when they thought they were using another drug.\u003c/p>\n\u003cp>He pointed to a spike in overdose deaths that began around the time of the COVID-19 pandemic. In 2020, the city saw a then-record 726 deaths, according to data from the office of the medical examiner. That number dipped a bit in 2021 and 2022, though overdoses remained above pre-pandemic levels, and last year surpassed 2020 as the city’s \u003ca href=\"https://www.kqed.org/news/11972898/2023-was-san-franciscos-deadliest-year-for-drug-overdoses-new-data-confirms\">deadliest year\u003c/a> on record with 810 deaths.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" title=\"SF drug overdose deaths, Jan.-June 2023/2024 \" aria-label=\"Grouped Columns\" id=\"datawrapper-chart-tGJps\" src=\"https://datawrapper.dwcdn.net/tGJps/1/\" scrolling=\"no\" frameborder=\"0\" style=\"border: none;\" width=\"800\" height=\"547\" data-external=\"1\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>So far, there have been 374 overdose-related deaths in 2024. The figure is slightly lower than the number of deaths recorded during the same period in 2023, but it is still on track to come close to the year’s staggering total.\u003c/p>\n\u003cp>Humphreys said that the small reduction was not surprising, given that pandemic restrictions — \u003ca href=\"https://www.kqed.org/news/11973108/how-long-to-isolate-with-covid-in-2024-california-now-says-that-depends-on-symptoms\">though not COVID-19 infections\u003c/a> — have all but completely wound down. Nationwide, annual overdose deaths decreased last year for the first time since 2018.\u003c/p>\n\u003cp>“During the pandemic, we had increases [in overdoses] beyond anything we’ve had in the history of our country,” he said. “Which I think said a lot about the impact of isolation, stress, the destruction of social opportunities, the loss of jobs, all those kinds of things. Now, we’re getting the other side of it … the restoration of all those things is going to be good for human health,” including drug use and overdose.\u003c/p>\n\u003cp>Kunins agreed that the pandemic led to a spike in overdose deaths and “worsened health outcomes.”\u003c/p>\n\u003cp>The hopeful trajectory is also likely a reflection of heroin’s diminished presence in the illicit drug market, according to Humphreys. High numbers of heroin users suffered accidental fentanyl overdoses in recent years, according to Humphreys.\u003c/p>\n\u003cp>“When heroin is completely gone, people will know that what is being bought and sold is fentanyl,” he told KQED, noting that San Francisco is not at that point yet.\u003c/p>\n\u003cp>“We had a lot of surprise overdoses three years ago in San Francisco, a lot of people who didn’t think they were going to be exposed but were. Now we’re getting to a point where almost no one is surprised, and that should reduce overdoses.”\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Fentanyl entered the drug market on the West Coast just before the pandemic, Kunins said. In the following years, heroin has made up a shrinking portion of overall overdose deaths. In 2020, 93 of the overdoses reported by the city involved heroin, nearly 12%. So far, in 2024, 20 overdoses included opioids, making up only about 5% of the total.\u003c/p>\n\u003cp>Despite the slight downturn in overall deaths, Kunins said overdose “is very much a crisis in our city and our country.”\u003c/p>\n\u003cp>How officials want to handle the crisis is expected to play a large role in city elections this fall. Three leading mayoral candidates — Mayor London Breed, former Mayor Mark Farrell and Levi Strauss heir Daniel Lurie — have all supported tougher policies surrounding drug use.\u003c/p>\n\u003cp>Farrell previously called for California National Guard members to be deployed in highly trafficked areas, like the Tenderloin and SoMa neighborhoods, and Lurie has expressed support for compelling drug users to enter treatment. In March, Breed placed two measures on citywide ballots expanding police powers and increasing screening and treatment requirements for drug users receiving welfare and touted increased drug-related arrests in May.\u003c/p>\n\u003cp>Both Humphreys and Kunins cautioned against implementing harsher policies. Humphreys said bringing in outside law enforcement likely wouldn’t be effective, while Kunins said that DPH’s priority is expanding treatment, not limiting it.\u003c/p>\n\u003cp>“Many of the regulations and structures surrounding access to medications for addiction treatment that are at the federal and state level really serve to limit access to treatments,” Kunins said. “Our goal is to decrease barriers into care, make it easier and more appealing for people to get into treatment, and to reach our overall goal of saving lives and supporting people to get into recovery.”\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>After a Supreme Court’s decision this week jeopardized a massive nationwide settlement over Purdue Pharma’s role in the U.S. opioid epidemic, hundreds of millions of dollars that the deal earmarked for addiction treatment in California could be in limbo.\u003c/p>\n\u003cp>Some of the funds allocated for the state would go to services in San Francisco, which previously brought its own lawsuit against Purdue Pharma, best known as the manufacturer of OxyContin, and the billionaire Sackler family that owns it.\u003c/p>\n\u003cp>San Francisco’s case was put on pause when Purdue filed for bankruptcy in 2019 — launching settlement negotiations between the company and thousands of plaintiffs, including California. Under the settlement deal that was eventually struck in bankruptcy court, Purdue was dissolved, the Sacklers agreed to pay billions toward addressing the opioid crisis, and members of the family — among the wealthiest in the U.S. — were shielded from future liability. It was that last provision underpinning the deal that the \u003ca href=\"https://www.supremecourt.gov/opinions/23pdf/23-124new_nkp1.pdf\">Supreme Court majority took issue with (PDF)\u003c/a>, given that the Sacklers had never filed for bankruptcy.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>San Francisco would have only been eligible for funds through the state, which was in line for $486 million, according to Attorney General Rob Bonta. How those funds would be distributed to cities like San Francisco had not yet been determined.\u003c/p>\n\u003cp>What comes next for San Francisco and the thousands of cities, states, tribes and individuals with cases against Purdue and the Sacklers is still up in the air, according to UC Davis law professor John Hunt.\u003c/p>\n\u003cp>The bankruptcy court’s stay on these cases appears to still be in place, he said, and a renegotiation process could happen.\u003c/p>\n\u003cp>If these negotiations fall apart, Hunt said, the Sackler family might declare bankruptcy themselves, which would allow them to enter into a new settlement negotiation with plaintiffs. Otherwise, cases like San Francisco’s could be handled individually.\u003c/p>\n\u003cp>“I would expect that if they’re facing 2,600 individual plaintiffs, plus large cities, I think it’s pretty likely they would go into bankruptcy — that’s kind of what bankruptcy is to deal with,” he said. “On the other hand, they might fight it; they have the means.”\u003c/p>\n\u003cp>Whether entities would get larger payouts from individual cases could vary, Hunt said.\u003c/p>\n\u003cp>The San Francisco city attorney’s office is figuring out what will come next for its case, according to spokesperson Jen Kwart.\u003c/p>\n\u003cp>“We are still evaluating the decision, but it is unlikely to have an immediate impact on San Francisco’s case against Purdue Pharma or the Sackler defendants,” she said. “San Francisco’s case against Purdue and the Sacklers is pending before Judge Charles Breyer.”\u003c/p>\n\u003cp>In the past, money allocated to California in other major opioid settlement cases has been \u003ca href=\"https://californiaopioidresponse.org/opioid-settlements/state-funded-projects/\">used for \u003c/a>distributing naloxone, opioid education training and overdose prevention and harm reduction efforts, among other initiatives.\u003c/p>\n\u003cp>San Francisco has approved opioid abatement \u003ca href=\"https://www.sfcityattorney.org/2023/05/17/san-francisco-city-attorney-announces-230-million-settlement-with-walgreens-after-victory-in-opioid-litigation/\">settlements\u003c/a> with other drug manufacturing and distributing companies totaling more than $350 million. In 2023, the city won a $230 million settlement from Walgreens after a federal judge ruled the pharmacy chain could be held liable for filling hundreds of thousands of “red flag” prescriptions without investigation. The funds gained through that settlement are set to go to addressing the city’s opioid crisis.\u003c/p>\n\u003cp>While the Supreme Court’s decision means settlement negotiations in the Purdue Pharma case could continue and money to plaintiffs will be further delayed, Bonta said the ruling could be a good thing.\u003c/p>\n\u003cp>“Today’s decision will allow those that have suffered at the hands of the Sacklers to hold them accountable for their greed and willful misconduct,” the attorney general said in a statement on Thursday.\u003c/p>\n\u003cp>Last September, he and the attorneys general of Oregon and Connecticut filed a \u003ca href=\"https://oag.ca.gov/system/files/attachments/press-docs/23-124%20Letter%20of%20California%20et%20al.pdf\">letter (PDF)\u003c/a> with the Supreme Court saying they believed nonconsensual third party releases in the Purdue case would be unlawful.\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>After a Supreme Court’s decision this week jeopardized a massive nationwide settlement over Purdue Pharma’s role in the U.S. opioid epidemic, hundreds of millions of dollars that the deal earmarked for addiction treatment in California could be in limbo.\u003c/p>\n\u003cp>Some of the funds allocated for the state would go to services in San Francisco, which previously brought its own lawsuit against Purdue Pharma, best known as the manufacturer of OxyContin, and the billionaire Sackler family that owns it.\u003c/p>\n\u003cp>San Francisco’s case was put on pause when Purdue filed for bankruptcy in 2019 — launching settlement negotiations between the company and thousands of plaintiffs, including California. Under the settlement deal that was eventually struck in bankruptcy court, Purdue was dissolved, the Sacklers agreed to pay billions toward addressing the opioid crisis, and members of the family — among the wealthiest in the U.S. — were shielded from future liability. It was that last provision underpinning the deal that the \u003ca href=\"https://www.supremecourt.gov/opinions/23pdf/23-124new_nkp1.pdf\">Supreme Court majority took issue with (PDF)\u003c/a>, given that the Sacklers had never filed for bankruptcy.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>San Francisco would have only been eligible for funds through the state, which was in line for $486 million, according to Attorney General Rob Bonta. How those funds would be distributed to cities like San Francisco had not yet been determined.\u003c/p>\n\u003cp>What comes next for San Francisco and the thousands of cities, states, tribes and individuals with cases against Purdue and the Sacklers is still up in the air, according to UC Davis law professor John Hunt.\u003c/p>\n\u003cp>The bankruptcy court’s stay on these cases appears to still be in place, he said, and a renegotiation process could happen.\u003c/p>\n\u003cp>If these negotiations fall apart, Hunt said, the Sackler family might declare bankruptcy themselves, which would allow them to enter into a new settlement negotiation with plaintiffs. Otherwise, cases like San Francisco’s could be handled individually.\u003c/p>\n\u003cp>“I would expect that if they’re facing 2,600 individual plaintiffs, plus large cities, I think it’s pretty likely they would go into bankruptcy — that’s kind of what bankruptcy is to deal with,” he said. “On the other hand, they might fight it; they have the means.”\u003c/p>\n\u003cp>Whether entities would get larger payouts from individual cases could vary, Hunt said.\u003c/p>\n\u003cp>The San Francisco city attorney’s office is figuring out what will come next for its case, according to spokesperson Jen Kwart.\u003c/p>\n\u003cp>“We are still evaluating the decision, but it is unlikely to have an immediate impact on San Francisco’s case against Purdue Pharma or the Sackler defendants,” she said. “San Francisco’s case against Purdue and the Sacklers is pending before Judge Charles Breyer.”\u003c/p>\n\u003cp>In the past, money allocated to California in other major opioid settlement cases has been \u003ca href=\"https://californiaopioidresponse.org/opioid-settlements/state-funded-projects/\">used for \u003c/a>distributing naloxone, opioid education training and overdose prevention and harm reduction efforts, among other initiatives.\u003c/p>\n\u003cp>San Francisco has approved opioid abatement \u003ca href=\"https://www.sfcityattorney.org/2023/05/17/san-francisco-city-attorney-announces-230-million-settlement-with-walgreens-after-victory-in-opioid-litigation/\">settlements\u003c/a> with other drug manufacturing and distributing companies totaling more than $350 million. In 2023, the city won a $230 million settlement from Walgreens after a federal judge ruled the pharmacy chain could be held liable for filling hundreds of thousands of “red flag” prescriptions without investigation. The funds gained through that settlement are set to go to addressing the city’s opioid crisis.\u003c/p>\n\u003cp>While the Supreme Court’s decision means settlement negotiations in the Purdue Pharma case could continue and money to plaintiffs will be further delayed, Bonta said the ruling could be a good thing.\u003c/p>\n\u003cp>“Today’s decision will allow those that have suffered at the hands of the Sacklers to hold them accountable for their greed and willful misconduct,” the attorney general said in a statement on Thursday.\u003c/p>\n\u003cp>Last September, he and the attorneys general of Oregon and Connecticut filed a \u003ca href=\"https://oag.ca.gov/system/files/attachments/press-docs/23-124%20Letter%20of%20California%20et%20al.pdf\">letter (PDF)\u003c/a> with the Supreme Court saying they believed nonconsensual third party releases in the Purdue case would be unlawful.\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>A pair of \u003ca href=\"https://www.kqed.org/news/tag/san-francisco\">San Francisco\u003c/a> lawmakers on Monday outlined their plans to require the city to create more drug-free recovery housing in its push to house the unhoused population, building on a growing movement toward establishing sober housing for people trying to exit homelessness while struggling with addiction.\u003c/p>\n\u003cp>The legislation that San Francisco Supervisors Matt Dorsey and Rafael Mandelman plan to introduce Tuesday acknowledges that some permanent supportive housing projects are legally restricted to “drug-permissive,” harm-reduction approaches, which means they are required to accept applicants regardless of their sobriety and cannot evict residents solely for the use of illicit drugs.\u003c/p>\n\u003cp>Any unrestricted funding, however, would be required to go toward drug-free or “recovery-oriented” housing until at least 25% of units in the city’s broader initiative to provide permanent housing for the homeless population are drug-free.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Under California’s “Housing First” policy, there are no drug-free public housing options, a void that advocates argue is critical to fill.\u003c/p>\n\u003cp>“It’s not enough to get folks indoors and keep them alive until they die of overdose. The point is to get them indoors so we can support them in living long and full and productive lives,” Mandelman said at a news conference on Monday at City Hall announcing the legislation.\u003c/p>\n\u003cp>Joshua Brathwaite, a San Francisco-based recovery advocate, highlighted the urgency of the situation in a recent \u003ca href=\"https://a17.asmdc.org/press-releases/20240415-new-bill-ends-californias-ban-funding-drug-free-recovery-housing\">press release\u003c/a> from a California legislator aiming to allow state housing funds to go toward sober housing.\u003c/p>\n\u003cp>“I’ve been sober for 16 months, but I can’t find any available drug-free housing that can give me the programming and support I need to continue being sober,” Brathwaite said. “I’m in danger of relapsing and falling back into a cycle I fought so hard to get out of.”\u003c/p>\n\u003cp>California’s \u003ca href=\"https://www.hcd.ca.gov/grants-funding/active-funding/docs/housing-first-fact-sheet.pdf\">Housing First policy\u003c/a>, enacted in 2016, prioritizes rapid rehousing without prerequisites such as credit checks, criminal background reviews, income verification, or sobriety, with the goal of quickly moving people into housing before following up with addiction treatment, healthcare, mental health services and job training. Crucially, the policy prohibits state funding for sober housing.\u003c/p>\n\u003cp>As \u003ca href=\"https://www.cdph.ca.gov/Programs/CCDPHP/sapb/CDPH%20Document%20Library/2020-Overdose-Mortality-Data-Brief_ADA.pdf\">fentanyl use\u003c/a> surged nationwide, critics have argued that the state’s policy is too restrictive, limiting housing options for those attempting to avoid drugs. Addiction specialists contend that living in environments permeated by drug use can derail recovery efforts, even for highly motivated individuals.[aside postID=news_11990665 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/240405-District5BOSRedistricting-003-BL_qut-1020x680.jpg']“San Francisco needs different kinds of supportive housing for the diverse range of people who are homeless, including recovery-oriented housing for people with addictions,” Keith Humphreys, a Stanford psychology professor who served as senior drug policy advisor in the Obama administration, said Monday in a news release from Dorsey’s office. “Research shows that recovery housing helps residents cease substance use, find a job and stay out of jail.”\u003c/p>\n\u003cp>Although federal housing officials \u003ca href=\"https://www.usich.gov/sites/default/files/document/All_In.pdf\">revised their Housing First guidelines\u003c/a> to include provisions for drug-free recovery housing in 2022, California has yet to adopt similar measures, leaving a gap in support for those in recovery.\u003c/p>\n\u003cp>Assemblymember Matt Haney (D-San Francisco) is leading efforts to amend state law. His proposed bill, \u003ca href=\"https://legiscan.com/CA/text/AB2479/id/2927209\">AB 2479\u003c/a>, would allocate up to 25% of state housing funds for drug-free housing. The bill has passed the state Assembly and is now under consideration by the state Senate.\u003c/p>\n\u003cp>“Many people seeking recovery don’t want to live next to others who are still using drugs, and they shouldn’t be forced to. These drug-free recovery models allow for a community of people who are all on a journey to be fully sober to help keep each other accountable and make sure that they have the support needed to not fall back into drug use or homelessness,” Haney said in a \u003ca href=\"https://a17.asmdc.org/press-releases/20240415-new-bill-ends-californias-ban-funding-drug-free-recovery-housing\">press release\u003c/a>.\u003c/p>\n\u003cp>Meanwhile, some conservative groups and Republican lawmakers are advocating for the repeal of California’s Housing First policy, arguing that it has not effectively reduced homelessness. Assemblymember Josh Hoover (D-Folsom) has introduced \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202320240AB2417\">AB 2417\u003c/a>, which seeks to dismantle Housing First policies. The bill has yet to be heard by a committee and is unlikely to advance this year.\u003c/p>\n\u003cp>\u003cem>KQED’s \u003c/em>\u003ca href=\"https://www.kqed.org/author/kmonahan\">\u003cem>Katherine Monahan\u003c/em>\u003c/a>\u003cem> contributed to this report.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>A pair of \u003ca href=\"https://www.kqed.org/news/tag/san-francisco\">San Francisco\u003c/a> lawmakers on Monday outlined their plans to require the city to create more drug-free recovery housing in its push to house the unhoused population, building on a growing movement toward establishing sober housing for people trying to exit homelessness while struggling with addiction.\u003c/p>\n\u003cp>The legislation that San Francisco Supervisors Matt Dorsey and Rafael Mandelman plan to introduce Tuesday acknowledges that some permanent supportive housing projects are legally restricted to “drug-permissive,” harm-reduction approaches, which means they are required to accept applicants regardless of their sobriety and cannot evict residents solely for the use of illicit drugs.\u003c/p>\n\u003cp>Any unrestricted funding, however, would be required to go toward drug-free or “recovery-oriented” housing until at least 25% of units in the city’s broader initiative to provide permanent housing for the homeless population are drug-free.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Under California’s “Housing First” policy, there are no drug-free public housing options, a void that advocates argue is critical to fill.\u003c/p>\n\u003cp>“It’s not enough to get folks indoors and keep them alive until they die of overdose. The point is to get them indoors so we can support them in living long and full and productive lives,” Mandelman said at a news conference on Monday at City Hall announcing the legislation.\u003c/p>\n\u003cp>Joshua Brathwaite, a San Francisco-based recovery advocate, highlighted the urgency of the situation in a recent \u003ca href=\"https://a17.asmdc.org/press-releases/20240415-new-bill-ends-californias-ban-funding-drug-free-recovery-housing\">press release\u003c/a> from a California legislator aiming to allow state housing funds to go toward sober housing.\u003c/p>\n\u003cp>“I’ve been sober for 16 months, but I can’t find any available drug-free housing that can give me the programming and support I need to continue being sober,” Brathwaite said. “I’m in danger of relapsing and falling back into a cycle I fought so hard to get out of.”\u003c/p>\n\u003cp>California’s \u003ca href=\"https://www.hcd.ca.gov/grants-funding/active-funding/docs/housing-first-fact-sheet.pdf\">Housing First policy\u003c/a>, enacted in 2016, prioritizes rapid rehousing without prerequisites such as credit checks, criminal background reviews, income verification, or sobriety, with the goal of quickly moving people into housing before following up with addiction treatment, healthcare, mental health services and job training. Crucially, the policy prohibits state funding for sober housing.\u003c/p>\n\u003cp>As \u003ca href=\"https://www.cdph.ca.gov/Programs/CCDPHP/sapb/CDPH%20Document%20Library/2020-Overdose-Mortality-Data-Brief_ADA.pdf\">fentanyl use\u003c/a> surged nationwide, critics have argued that the state’s policy is too restrictive, limiting housing options for those attempting to avoid drugs. Addiction specialists contend that living in environments permeated by drug use can derail recovery efforts, even for highly motivated individuals.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“San Francisco needs different kinds of supportive housing for the diverse range of people who are homeless, including recovery-oriented housing for people with addictions,” Keith Humphreys, a Stanford psychology professor who served as senior drug policy advisor in the Obama administration, said Monday in a news release from Dorsey’s office. “Research shows that recovery housing helps residents cease substance use, find a job and stay out of jail.”\u003c/p>\n\u003cp>Although federal housing officials \u003ca href=\"https://www.usich.gov/sites/default/files/document/All_In.pdf\">revised their Housing First guidelines\u003c/a> to include provisions for drug-free recovery housing in 2022, California has yet to adopt similar measures, leaving a gap in support for those in recovery.\u003c/p>\n\u003cp>Assemblymember Matt Haney (D-San Francisco) is leading efforts to amend state law. His proposed bill, \u003ca href=\"https://legiscan.com/CA/text/AB2479/id/2927209\">AB 2479\u003c/a>, would allocate up to 25% of state housing funds for drug-free housing. The bill has passed the state Assembly and is now under consideration by the state Senate.\u003c/p>\n\u003cp>“Many people seeking recovery don’t want to live next to others who are still using drugs, and they shouldn’t be forced to. These drug-free recovery models allow for a community of people who are all on a journey to be fully sober to help keep each other accountable and make sure that they have the support needed to not fall back into drug use or homelessness,” Haney said in a \u003ca href=\"https://a17.asmdc.org/press-releases/20240415-new-bill-ends-californias-ban-funding-drug-free-recovery-housing\">press release\u003c/a>.\u003c/p>\n\u003cp>Meanwhile, some conservative groups and Republican lawmakers are advocating for the repeal of California’s Housing First policy, arguing that it has not effectively reduced homelessness. Assemblymember Josh Hoover (D-Folsom) has introduced \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202320240AB2417\">AB 2417\u003c/a>, which seeks to dismantle Housing First policies. The bill has yet to be heard by a committee and is unlikely to advance this year.\u003c/p>\n\u003cp>\u003cem>KQED’s \u003c/em>\u003ca href=\"https://www.kqed.org/author/kmonahan\">\u003cem>Katherine Monahan\u003c/em>\u003c/a>\u003cem> contributed to this report.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Oakland native De’andre Devereaux is no stranger to Treasure Island, a former military base along the Bay Bridge, halfway between Oakland and San Francisco. Up until about a year ago, he was unhoused, and the 55-year-old would spend afternoons on the quiet island panhandling for food and cash.\u003c/p>\n\u003cp>Devereaux now lives on the island, but his life couldn’t look more different. After choosing to enter treatment for a substance-use disorder last winter, he’s now living at a 70-bed sober, supportive living community that opened on Treasure Island in April. [pullquote size=\"medium\" align=\"right\" citation=\"De’andre Devereaux, resident of a HealthRight 360 program on Treasure Island\"]‘I’ve been in and out of rehabs since I was like 24 because I wasn’t ready to get my life together. I finally got tired, and I haven’t looked back … this changed my life.’[/pullquote]“I’ve been in and out of rehabs since I was like 24 because I wasn’t ready to get my life together,” Devereaux told KQED at a holiday party for residents in the program in December. “I finally got tired and I haven’t looked back, and I’m happy for that because this changed my life.”\u003c/p>\n\u003cp>Residents can enter the step-down program after completing a separate rehabilitation program and live there between nine months and two years. They are also connected with recovery coaches who assist with job readiness and navigating public benefits and medications. Everyone in the program simultaneously participates in outpatient recovery services.\u003c/p>\n\u003cp>The program helped Devereaux line up a job as an in-home service provider for older people and those with disabilities — a job he said he loves.\u003c/p>\n\u003cp>“It feels good doing that, giving back,” he said as holiday music played and neighbors mingled at the facility on Gateview Avenue. The Department of Public Health and HealthRight 360 operates the community, a statewide health care nonprofit that provides substance-use treatment.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>For most residents who spoke to KQED, having a safe place to call home and a supportive environment to help navigate the ups and downs of recovery has made the biggest difference in their journey with sobriety.\u003c/p>\n\u003cp>“The real thing is getting people off the streets and into a place where the fog can lift, you know? Because when you’re in a sober mind, and you finally do kick that drug, that’s a major thing,” said William Pecknold Jr., another resident. “I don’t know if everybody wants help, you know, but for those who do, this is where you can get it.”\u003c/p>\n\u003cfigure id=\"attachment_11970626\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11970626\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231220-TIRECOVERY-11-BL-KQED.jpg\" alt=\"A person wearing a hood stands beside a fence in a residential area.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231220-TIRECOVERY-11-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231220-TIRECOVERY-11-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231220-TIRECOVERY-11-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231220-TIRECOVERY-11-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231220-TIRECOVERY-11-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231220-TIRECOVERY-11-BL-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">William Pecknold Jr. stands in the backyard of HealthRight 360’s Recovery Residence program. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>As an ironworker, Pecknold has helped build the literal framework for prominent Bay Area structures like 131 Fremont Street in San Francisco. However, he struggled with alcohol addiction and later turned to methamphetamine when he was unhoused.\u003c/p>\n\u003cp>He got sober during a stay in prison, then quickly entered drug treatment programs after his release last December. The experience sent him down a new path, but, he said, everyone’s journey looks different. [pullquote size=\"medium\" align=\"right\" citation=\"William Pecknold Jr., resident of a HealthRight 360 program on Treasure Island\"]‘I don’t think it’s anyone else’s decision but the individual. I just know one thing for a fact. This place saved my life. It really did.’[/pullquote]“I don’t think it’s anyone else’s decision but the individual,” Pecknold said. “I just know one thing for a fact. This place saved my life. It really did.”\u003c/p>\n\u003cp>The residential step-down program is part of the city’s ongoing effort to increase the number of behavioral health care beds by 400, or 20% — a goal determined by the City’s \u003ca href=\"https://www.sfdph.org/dph/files/MHR/SFDPH_Behavioral_Health_Bed_Optimization_Report_FINAL.pdf\">Behavioral Health Bed Optimization Report\u003c/a> released in 2020.\u003c/p>\n\u003cp>The site is part of a broader behavioral health program that collectively currently offers 128 beds across the island. The step-down facility is scheduled to be rebuilt by 2028 as part of a multistory building with health services and housing overseen by the Department of Public Health.\u003c/p>\n\u003cp>Still, the program is not running at full capacity yet due to a lack of trained staff. As of Thursday, 87 people were using the broader program’s 128 beds. At the Gateview site, in particular, it has just over half of the staff it needs and only 39 residents for its 70 beds so far, according to officials at HealthRight 360. [aside label='More Stories on Housing' tag='housing']San Francisco is set to open three more projects across the city next year as part of the \u003ca href=\"https://www.sf.gov/sites/default/files/2022-06/SFDPH%20Bed%20Expansion%20Dashboard%206.22.22%20Final.pdf.pdf\">bed expansion\u003c/a>. That includes a 30-bed care facility for people with mental health and substance-use issues, a 10-person mental health program for transitional-age youth, and a 16-bed urgent care facility.\u003c/p>\n\u003cp>But the city’s goal to add more beds is an ever-moving target. While more beds have been added, \u003ca href=\"https://missionlocal.org/2022/08/despite-rosy-press-board-and-cares-continue-to-go-quietly/\">other behavioral health facilities and beds across the city’s network have shuttered\u003c/a> as the overdose epidemic and housing crisis collide.\u003c/p>\n\u003cp>Residents in the step-down program are encouraged and supported to move out after a period of time. However, some housing and healthcare advocates argue that temporary programs can destabilize residents who have to move frequently from place to place. Many point to permanent supportive housing as the ultimate north star for making a dent in the housing and addiction crisis. [pullquote size=\"medium\" align=\"right\" citation=\"Vitka Eisen, CEO, HealthRight 360\"]‘Our hope is that they can build their support in the earliest part of their recovery journey and their journey post-treatment.’[/pullquote]Eisen has been through residential treatment and said she views the issue as a “both-and,” arguing that there is a need for housing where people exiting drug detoxification or inpatient programs can build community, find work and secure longer-term housing.\u003c/p>\n\u003cp>“If we can develop permanent housing and affordable housing for people, that is the most important thing to do. But these services are unique. When people are just leaving intensive residential treatment, they’re less likely to be isolated here,” said Vitka Eisen, CEO of HealthRight 360. “Our hope is that they can build their support in the earliest part of their recovery journey and their journey post-treatment.”\u003c/p>\n\u003cp>\u003ci>Information on publicly available substance-use treatment in San Francisco and how to get care for yourself or a loved one can be found at \u003ca href=\"https://findtreatment-sf.org/\">findtreatment-sf.org\u003c/a>.\u003c/i>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Oakland native De’andre Devereaux is no stranger to Treasure Island, a former military base along the Bay Bridge, halfway between Oakland and San Francisco. Up until about a year ago, he was unhoused, and the 55-year-old would spend afternoons on the quiet island panhandling for food and cash.\u003c/p>\n\u003cp>Devereaux now lives on the island, but his life couldn’t look more different. After choosing to enter treatment for a substance-use disorder last winter, he’s now living at a 70-bed sober, supportive living community that opened on Treasure Island in April. \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“I’ve been in and out of rehabs since I was like 24 because I wasn’t ready to get my life together,” Devereaux told KQED at a holiday party for residents in the program in December. “I finally got tired and I haven’t looked back, and I’m happy for that because this changed my life.”\u003c/p>\n\u003cp>Residents can enter the step-down program after completing a separate rehabilitation program and live there between nine months and two years. They are also connected with recovery coaches who assist with job readiness and navigating public benefits and medications. Everyone in the program simultaneously participates in outpatient recovery services.\u003c/p>\n\u003cp>The program helped Devereaux line up a job as an in-home service provider for older people and those with disabilities — a job he said he loves.\u003c/p>\n\u003cp>“It feels good doing that, giving back,” he said as holiday music played and neighbors mingled at the facility on Gateview Avenue. The Department of Public Health and HealthRight 360 operates the community, a statewide health care nonprofit that provides substance-use treatment.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>For most residents who spoke to KQED, having a safe place to call home and a supportive environment to help navigate the ups and downs of recovery has made the biggest difference in their journey with sobriety.\u003c/p>\n\u003cp>“The real thing is getting people off the streets and into a place where the fog can lift, you know? Because when you’re in a sober mind, and you finally do kick that drug, that’s a major thing,” said William Pecknold Jr., another resident. “I don’t know if everybody wants help, you know, but for those who do, this is where you can get it.”\u003c/p>\n\u003cfigure id=\"attachment_11970626\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11970626\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231220-TIRECOVERY-11-BL-KQED.jpg\" alt=\"A person wearing a hood stands beside a fence in a residential area.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231220-TIRECOVERY-11-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231220-TIRECOVERY-11-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231220-TIRECOVERY-11-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231220-TIRECOVERY-11-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231220-TIRECOVERY-11-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231220-TIRECOVERY-11-BL-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">William Pecknold Jr. stands in the backyard of HealthRight 360’s Recovery Residence program. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>As an ironworker, Pecknold has helped build the literal framework for prominent Bay Area structures like 131 Fremont Street in San Francisco. However, he struggled with alcohol addiction and later turned to methamphetamine when he was unhoused.\u003c/p>\n\u003cp>He got sober during a stay in prison, then quickly entered drug treatment programs after his release last December. The experience sent him down a new path, but, he said, everyone’s journey looks different. \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>San Francisco is set to open three more projects across the city next year as part of the \u003ca href=\"https://www.sf.gov/sites/default/files/2022-06/SFDPH%20Bed%20Expansion%20Dashboard%206.22.22%20Final.pdf.pdf\">bed expansion\u003c/a>. That includes a 30-bed care facility for people with mental health and substance-use issues, a 10-person mental health program for transitional-age youth, and a 16-bed urgent care facility.\u003c/p>\n\u003cp>But the city’s goal to add more beds is an ever-moving target. While more beds have been added, \u003ca href=\"https://missionlocal.org/2022/08/despite-rosy-press-board-and-cares-continue-to-go-quietly/\">other behavioral health facilities and beds across the city’s network have shuttered\u003c/a> as the overdose epidemic and housing crisis collide.\u003c/p>\n\u003cp>Residents in the step-down program are encouraged and supported to move out after a period of time. However, some housing and healthcare advocates argue that temporary programs can destabilize residents who have to move frequently from place to place. Many point to permanent supportive housing as the ultimate north star for making a dent in the housing and addiction crisis. \u003c/p>\u003c/div>",
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"info": "\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />",
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"airtime": "SUN 7:30pm-8pm",
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"info": "Latino USA, the radio journal of news and culture, is the only national, English-language radio program produced from a Latino perspective.",
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"live-from-here-highlights": {
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"title": "Live from Here Highlights",
"info": "Chris Thile steps to the mic as the host of Live from Here (formerly A Prairie Home Companion), a live public radio variety show. Download Chris’s Song of the Week plus other highlights from the broadcast. Produced by American Public Media.",
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"meta": {
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"rss": "https://feeds.publicradio.org/public_feeds/a-prairie-home-companion-highlights/rss/rss"
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"marketplace": {
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"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
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"mindshift": {
"id": "mindshift",
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"order": 13
},
"link": "/podcasts/mindshift",
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"tagline": "Deeply-reported investigative journalism",
"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/On-Our-Watch-Podcast-Tile-703x703-1.jpg",
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"order": 12
},
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"title": "On The Media",
"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
"airtime": "SUN 2pm-3pm, MON 12am-1am",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/onTheMedia.png",
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"link": "/radio/program/on-the-media",
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"our-body-politic": {
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"title": "Our Body Politic",
"info": "Presented by KQED, KCRW and KPCC, and created and hosted by award-winning journalist Farai Chideya, Our Body Politic is unapologetically centered on reporting on not just how women of color experience the major political events of today, but how they’re impacting those very issues.",
"airtime": "SAT 6pm-7pm, SUN 1am-2am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Our-Body-Politic-Podcast-Tile-360x360-1.jpg",
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},
"link": "/radio/program/our-body-politic",
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5zaW1wbGVjYXN0LmNvbS9feGFQaHMxcw",
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},
"perspectives": {
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"officialWebsiteLink": "/perspectives/",
"meta": {
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"order": 15
},
"link": "/perspectives",
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"planet-money": {
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"title": "Planet Money",
"info": "The economy explained. Imagine you could call up a friend and say, Meet me at the bar and tell me what's going on with the economy. Now imagine that's actually a fun evening.",
"airtime": "SUN 3pm-4pm",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/planetmoney.jpg",
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