Does the city’s homelessness crisis need a shift in language? District 6 Supervisor Matt Dorsey thinks so, and this week doubled-down on his effort to redefine the narrative when it comes to poverty and drug use.
Dorsey has been on a campaign to promote resources for people who remain drug-free while unhoused or living in poverty, while simultaneously criticizing existing programs and policies that provide support for people who need it, regardless of drug use.
This year, Dorsey has sponsored a new law that aims to increase public cash benefits for recipients who stay off drugs, and co-authored a bill that would funnel city subsidies away from conventional “permanent supportive housing” units that allow drug use, and put that money toward the development of sober living units, instead.
The latter plan runs counter to the purpose of the city’s current permanent supportive housing model. The program, which provides long-term rental subsidies and social services to disabled and chronically homeless people, operates under a “housing first” model, designed to get people off the street and plugged into services with as few barriers as possible.
Now, Dorsey wants to change the vocabulary of the city’s homelessness policy. On Tuesday, he announced plans for new legislation that would require the city to notify all residents of supportive housing units about “drug-tolerant” policies in their buildings. In a series of posts on X (formerly Twitter), Dorsey framed it as a way to keep people in recovery informed about the dangers around them.
“I accept full responsibility for fighting to legislate the term ‘Drug-Tolerant Housing’ into our Permanent Supportive Housing policies. Because for PSH residents struggling to recover from drug addiction, accurate language — rather than euphemisms — is no laughing matter,” Dorsey wrote. Dorsey went further, pointing a finger at the “professional advocates” for what he referred to as “meaningless euphemisms,” like “housing first” and “harm reduction.”
These terms, of course, are not euphemisms. Their definitions have been honed over decades of research, which has found that such programs can increase the amount of time people spend housed while decreasing their use of costly emergency services. Specific kinds of harm reduction, including offering social services to people without requiring abstinence from addictive substances, also has improved outcomes for the people who need help the most.
Dorsey argues that these terms obfuscate the real experiences of people in supportive housing buildings. But who, exactly, will benefit from being told that drug use is acceptable in the buildings they call home?
There has already been extensive reporting on the conditions in those units, including routine overdoses and horror stories of disrepair. It’s almost certain that anyone who lives in permanent supportive housing is already well aware of the drug use happening behind other closed doors.
Instead, Dorsey’s fixation on legislating new terminology reflects how the fight over homelessness in the city is as much about philosophy as it is about policy. A number of elected officials in San Francisco are now leaning into the politics of law and order, including a newfound enthusiasm for police crackdowns on encampments and drug users. Dorsey’s effort to codify “drug-tolerant housing” is a subtle part of that backlash against disorder in the city — and one that could further demonize and harm unhoused people.
To understand why Dorsey would care so much about a reform to language, it helps to consider the origin of housing first. The strategy took hold in the U.S. during the 2000s, as a response to a prior generation of “treatment first” policies that required unhoused people to get clean to qualify for housing.
The housing first strategy, in contrast, offers people safe environments to live in, along with social services, even if they consume drugs in those homes. By accepting the reality of addiction and relapse, these programs aim to help more individuals than abstinence-only programs can. California enacted a statewide housing first policy in 2016, which blocked state funds from being used for supportive housing that requires people abstain from drugs and alcohol.
“The housing first model just emphasizes how critical it is that people have a stable environment in which they can exist, so that they stabilize and then can work on substance use disorder or mental health disorders,” Christin Evans, a member of the city’s Homeless Oversight Commission, told Gazetteer SF.
Today, the loudest critics of housing first policies tend to be conservative, with groups like the Manhattan Institute, Cicero Institute and the Pacific Research Institute claiming that such strategies are effectively funding drug use and related crime. A similar conversation led to the passage of San Francisco’s controversial Proposition F, which mandates drug testing and potential treatment for people who receive welfare from the city.
Without a doubt, there is a problem. An investigation last year by the San Francisco Standard found that an average of three people a week died of drug overdoses in taxpayer-funded supportive housing buildings. Evans acknowledged that crisis, but argued that Dorsey’s rhetoric blames harm reduction for problems at permanent supportive housing buildings that are more accurately blamed on mismanagement and poor living conditions at city-managed facilities.
For example, Dorsey on Tuesday posted what he called “heartbreaking” testimony from a state assembly hearing on sober housing. In the video, a formerly unhoused speaker takes fault with elements of permanent supportive housing that have very little to do with personal drug use, noting how his former housing complex was “often dirty” and had “zero supervision or rehabilitation services” for residents, instead becoming a “haven for all manner of criminal activity.” He concludes his public comment by stating how difficult it is to find and access alternative housing options.
“No one is saying we shouldn’t have sober living services. Homelessness advocates accept that there should be appropriate settings for that,” Evans told Gazetteer SF. “But there is one subset of people who want sober living so they can avoid temptation. And there is a different issue of how some people are just kind of fed up with their neighbors who are disruptive and have behavioral health problems that may or may not be related to drugs.”
Evans notes that the city doesn’t have clear statistics on how many unhoused people here are actively in recovery or seeking sober housing, making it difficult to know what needs are going unmet need. Dorsey did not respond to multiple requests for elaboration on his legislative ideas.
“Dorsey’s notion of wanting to put so many eggs in one basket is premature, in my opinion,” Evans said. “What if someone relapses? Do they lose their housing? Or is there a transfer process? Where do they actually go? We need a safety net. We can’t lose progress by letting anyone exit back to the street.”
