How much does drug addiction cost San Francisco? One supervisor wants to find out

He sent a letter to city controller Ben Rosenfield and chief economist Ted Egan on Monday asking for help determining what it would take to estimate the financial strain that untreated addiction places on the municipal budget.

Dorsey’s goal is to create a biennially-updated “right to recovery” report modeled in part after an Oregon study that found that government spending on substance use consumed nearly 17% of that state’s 2017 budget.

It’s the latest attempt by Dorsey, who is in recovery from drug and alcohol abuse, to address the city’s epidemic of overdose deaths driven largely by fentanyl. The city’s behavioral health budget for this fiscal year is $597 million, which includes mental health and addiction treatment, but that number doesn’t fully encapsulate what addiction costs the city.

Dorsey said in an interview that he would defer to the controller and chief economist about what exactly the analysis of untreated addiction costs should entail. But he said the estimate could look at such areas as the criminal justice system, emergency response and even impacts on the foster care system when drug users are unable to care for their children.

A former police spokesman appointed to the Board of Supervisors this year by Mayor London Breed, Dorsey previously said he wanted to create police “drug enforcement priority zones” around facilities that serve people with substance or alcohol use disorder.

Dorsey hasn’t yet introduced legislation that would create the enforcement zones. He said he’s still crafting details of his legislative proposal with the City Attorney’s Office and other city officials.

But independent of that effort, he hopes that an estimate of untreated addiction costs could provide valuable insights to his constituents in District Six, which includes the South of Market neighborhood that is one of the epicenters of San Francisco’s overdose crisis.

“As we debate costs to solve drug-related harms, I want a clear-eyed view of how much it’s costing San Francisco taxpayers right now not to solve drug-related harms,” he wrote in the letter.

A spokesperson for the controller’s office said it planned to undertake the “analytical scoping exercise” that Dorsey requested in his letter.

The letter comes as San Francisco leaders struggled to make inroads on the overdose crisis that has killed more than 1,500 people since 2020 — far more than the three previous years combined. Most recently, Gov. Gavin Newsom vetoed legislation that would have allowed San Francisco to set up a supervised consumption site for drug users, though city leaders want to have a local nonprofit set one up anyway.

Dorsey said the estimate on the costs of drug addiction would be useful when the Board of Supervisors and the mayor decide how to allocate the city budget.

“Ideally, it would be nice, as we’re starting the budget season, to have a number that we can count on and that is a clear-eyed view of what it is costing us not to solve these problems,” Dorsey said. “That will help me as an advocate for what we need to spend to solve these problems.”

The overdose crisis and its impact on public health and street conditions in District Six are factoring into Dorsey’s campaign for election this November, where his trying to defeat his main challenger Honey Mahogany.

Mahogany, who was chief of staff to Dorsey’s predecessor Matt Haney, called Dorsey’s letter “a very fancy way of saying prevention is the most cost-effective method of treatment.” She said she already knew that to be true because of her background in social work.

“It is certainly nice to have more data about these impacts, but ultimately, we already know the solutions: appropriately staffing and funding mental health services to prevent people from falling into crisis and getting them into treatment ASAP,” Mahogany said.

She said the city would be aided by the full implementation of the Mental Health SF legislation that the Board of Supervisors passed in late 2019 to overhaul San Francisco’s mental health and substance use treatment services. Haney, Mahogany’s former boss, co-authored the legislation.

“This for me highlights why it is so important to have an independent voice in City Hall … who has decades of experience doing this work,” Mahogany said in the text message. “We know how to fix this, and we need to hold the city accountable for its failure to do what it knows it needs to do.”

JD Morris (he/him) is a San Francisco Chronicle staff writer. Email: Twitter: @thejdmorris


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