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At least two major West Coast cities are rethinking so-called harm reduction policies that sought to address addiction, indicating that these areas are reshaping their drug strategy as the challenges of addiction continue.
While cities including San Francisco and Seattle previously used “safe” drug distribution policies such as foil and pipes that cannot be used to smoke fentanyl or other substances, these cities are now implementing a new approach that places new restrictions on the distribution of these substances.
The Seattle City Council passed its 2026 budget in November and included a provision that would “prohibit any City support for the purchase or distribution of illegal drug use paraphernalia, other than needles.”
This offer was inspired by City Council Member, Sara Nelson, who said that although she supports needle exchange programs because they reduce the spread of diseases such as HIV and Hepatitis C, she said that she does not see the benefit of using public resources to “help people to get higher” by distributing certain drugs.
Several packages containing drugs, possibly mixed with fentanyl, were displayed on the bed. (US District Court of Rhode Island)
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“However, I fail to see the harm that is being mitigated by distributing things like pipes and foil used to consume lethal drugs like meth and fentanyl,” Nelson said during the Nov. budget committee meeting. 16. “To me, it sounds like giving a loaded gun to a suicidal person.”
Seattle is not the only city taking these steps to reduce the way it distributes “safe” drugs in its community.
As early as 2025, San Francisco is introducing a new policy that will require individuals to receive treatment counseling — or be connected to those services for treatment options — before receiving any substance use services from the city or city-sponsored programs. In addition, the new policy prohibited providing these items in public places.
San Francisco has unveiled a new policy that will require individuals to receive treatment counseling before receiving any substance abuse services from the city or city-sponsored programs. (Jeff Chiu, File/Associated Press)
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The policy went into effect on April 30, and applied to any city-sponsored public health program that provides drug use equipment such as empty syringes and smoking aids.
“We can no longer accept the fact that two people die a day due to overdose. The status quo has failed to ensure the health and safety of our entire community, as well as those facing addiction problems. Fentanyl has changed the game, and we have been relying on strategies before this new drug epidemic, which ends today,” said the statement of the Mayor of San Francisco in April Daniel Lurie. “Our new policy will connect people to treatment faster, and that’s a big step in reclaiming our public spaces.”
The Seattle City Council and San Francisco mayoral races are not officially tied. However, both cities have overwhelmingly supported Democrats in state and local elections.
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Meanwhile, these drug policy changes are not popular with supporters of “harm reduction” policies. For example, Laura Guzman, executive director of the National Harm Reduction Coalition, said there may not be enough resources to comply with San Francisco’s new law.
“It forces or conditions people to get life-saving supplies, to have long conversations about treatments that may not be available,” Guzman said in April, according to CBS News. “People who know in this field – researchers, doctors – say this is not a good policy. We are actually against bullets because what we are trying to do is have the idea that there is no drug use on the streets. But it is not public health, it is not based on science. It is the exact opposite of what we know works.”
The Seattle skyline was taken from the Washington State Ferry in Seattle, Washington. (Jason Redmond/Reuters)
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Although both Washington’s King County, which includes Seattle, and San Francisco had fewer drug overdose deaths in 2024 than in 2023, the numbers for both cities are higher compared to 2019 before the COVID-19 pandemic.
For example, 635 people died from accidental drug overdoses in 2024 in San Francisco — down from 810 in 2023, but up from 441 in 2019, according to the San Francisco Office of the Chief Medical Examiner.
Drug overdose deaths have also decreased across the country. The Centers for Disease Control and Prevention reported in February a nearly 24% drop in drug overdose deaths in fiscal year 2024, compared to the previous fiscal year.
Meanwhile, the Trump administration has taken an aggressive approach to combating drug trafficking in the US. For example, President Donald Trump signed an executive order in December designating illegal fentanyl as a “weapon of mass destruction.”
