It’s hard to imagine that San Francisco, teetering on the edge of bankruptcy along with the rest of California, could have found another way to waste taxpayer money for another unsustainable program. Still, the City by the Bay has done it again.
San Francisco has launched a program that gives free alcohol to homeless alcoholics to “keep the homeless off the streets” and offer some relief to the city’s overworked emergency services.
The Managed Alcohol Program is not a supplement to sobriety programs aimed at treating those alcoholics. It’s a way to keep alcoholics functional by providing them with “limited quantities” of booze to prevent withdrawal symptoms.
MAP was established in 2020 during the COVID-10 pandemic when homeless alcoholics were kept in isolation at hotels and needed a splash of booze to keep alcohol withdrawal symptoms at bay. Homeless alcoholics are provided a bed, three meals a day, and “just enough” alcohol to satisfy their addiction and stave off withdrawal.
What started as a ten-bed program has expanded to a 20-bed facility in a former hotel in the Tenderloin district, now costing taxpayers $5 million a year. In addition, twelve more beds are available for MAP at another detox location. Ten of those beds are held for “Latinx and indigenous” people.
San Francisco social worker Bryce Bridge explained that once a client is admitted to the program, they are connected with a primary care doctor, helped to obtain government identification if necessary, and offered psychiatric care, wellness activities on site, and other treatments.
Bridge noted that marijuana use is common among clients at their sites, and there is no policy prohibiting its use for those in MAP.
It’s not all about taxpayer-funded happy hour, though. Bridge said clients are connected to community-based art and poetry groups to “help them explore ways to express themselves.”
As expected, the program is drawing heavy criticism. Salvation Army of San Fransisco’s chair, Adam Nathan, describes visiting the center and watching MAP clients walk into a room full of kegs to receive multiple free drinks all day. “Where’s the recovery in all this?” Nathan wonders. His organization follows a more traditional route for treating alcoholism, including supporting abstinence and providing rehabilitation.
Even wildly progressive San Fransisco Mayor London Breed notes that the program was not “reducing harm” for the program’s clients. It’s “making things worse.”
Alice Moughamian, the Nurse Manager of the Managed Alcohol Program and the San Francisco Sobering Center, stresses that recovery is not the end goal of the program. MAP doesn’t seek to “decrease the amount of alcohol” consumed by its clients. Instead, she describes the program as a way to “mitigate” harm that comes from using alcohol in an unsafe way, including the adverse health and social impacts experienced by alcoholics.
Public health authorities claim that Nathan’s observations were inaccurate. The alcohol served to MAP clients is “dispensed by a nurse,” and people can’t just wander off the street and grab free drinks.
So far, public health officials claim, the program has resulted in savings of $1.7 million over six months by reducing hospital visits and police calls made by clients who had relied heavily on emergency services. Officials stated that following clients’ entry into the program, visits to the city’s sobering center decreased by 92%, emergency room visits dropped by over 70%, and EMS calls and hospital visits were halved.
Previously, city officials indicated that just five residents who struggled with alcohol addiction had incurred more than $4 million in ambulance transport costs for the city over a five-year period, with up to 2,000 ambulance transports between them.
San Franciscans were not told about the program because the city’s health department was concerned over public perception of the MAP. Nathan points out that the program is “hidden away in an old hotel” and that there were never public hearings about MAP before it was adopted.
Several other countries, such as Canada, Portugal, and the U.K., have already implemented alcohol management programs. According to the Canadian Institute for Substance Use Research at the University of Victoria, Canada alone has over 40 such programs, which have contributed to a reduction in hospital admissions and deaths among homeless alcoholics.
For alcoholics, it’s a sweet deal. Three square meals, a free bed, and the ability to drink all day on the taxpayer dime? The happy hour in San Fransisco never ends.