Now, the state of California wants to step in. Yet despite a glaring lack of infrastructure to meet demand, there’s a growing movement in San Francisco and beyond to force more people who use drugs into treatment, largely in response to the number of people experiencing homelessness in California, which grew 31% from 2010 to 2020. Studies have shown that those without homes struggle to maintain even low-barrier addiction treatment options, like taking buprenorphine or methadone to stave off cravings and help with withdrawal. This shortage makes mental health and substance use recovery particularly difficult for people experiencing homelessness, the population everyone in San Francisco agrees most needs urgent help. For those looking for long-term residential step-down programs, such as those who’ve exited a 90-day program, there were just five beds open. Even as officials scramble to open more, however, it’s a constant fight against attrition, as longtime substance-use facilities are closing due to the high costs of operating in the city.Īs of Thursday, there were only eight slots available for people needing detox support and 13 in residential treatment programs. The department did not answer the Editorial Board’s question about how many beds are needed to fully address the demand for treatment, but Mayor London Breed has set the goal of adding 400 beds to the current supply. With the addition of 70 beds on Treasure Island, there are now 271 residential step-down beds, reserved for people exiting residential treatment who need ongoing case management and support. Of those, 58 are to help people experiencing withdrawal symptoms, and 234 are for residential rehabilitation treatment. The health department said that the city currently has 563 beds for substance use disorder treatment. Yet the city has only 2,550 mental health and substance use treatment beds combined. More than 3,000 had dual diagnoses and struggle with both issues at once. While not all need extensive treatment, thousands do, especially those who live on the streets the Department of Public Health identified 8,758 homeless people with either substance use disorder or mental illness in San Francisco last year. In 2021, the city had 11,691 people with substance use disorder enrolled in its health care plan. San Francisco has a severe shortage of treatment beds. And as insufficient as 90-day substance use treatment can be for creating lasting recovery, those who receive it are in some ways the lucky ones.
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