SAN FRANCISCO, CA – Amidst the sustained increase in overdose deaths nationwide and record breaking local overdose deaths, it is with profound sorrow that we recognize the tragic loss of two clients within our San Francisco residential treatment programs. We know intimately the gravity of these incidents and the enduring trauma and pain they cause, and our hearts ache alongside grieving loved ones. In these unfortunate instances, as mandated by our licensing regulations in California, we have initiated timely reporting so that an investigative analysis can take place by both the San Francisco Department of Public Health and the California Department of Healthcare Services – as is standard protocol for incidents such as these.
Over the many decades of providing substance use disorder (SUD) treatment, HealthRIGHT 360 has risen to respond to the urgent crisis of the moment. We have been here through the hallucinogen years of the late 1960s, the freebase cocaine era, the crack years, and the meth menace. We have always responded and modified programs and services accordingly; however, we have never before experienced a substance with the potential toxicity of fentanyl and the fentanyl analogs that are dominating much of the available street drugs in recent years.
The most recent data from the Substance Abuse and Mental Health Services Administration (SAMHSA) reveals a staggering truth: in 2021 alone, 6,032 individuals nationwide died while in treatment. This underscores the need for modernization of care that does not stigmatize returns to substance use while utilizing all evidence-based interventions.
Our work has always been challenging. We have always taken responsibility for holding and helping heal the people who come to us for care with utmost seriousness. Within the walls of a treatment program, every overdose reversal is a triumph, but they are also traumatic. Counselors feel the very weight of another person’s life in their hands. After the administration of naloxone, the seconds that tick by feel like hours as they try to revive a person, praying that they regain consciousness, praying that the paramedics arrive. Praying. This may be a common experience for medical providers and paramedics, but it has not been so for treatment counselors. Until now.
Some may have questions about how drugs can make their way into a treatment program. While all of our residential treatment programs are abstinence-based, we fully understand that a linear recovery is not a reality for many. In addition to supportive services to give clients the tools to help manage the struggles of recovery, our programs have proven safeguards and protocols to help to keep contraband from our grounds. In the case where a substance is found, we immediately take the necessary steps based on the health, safety, and best interest of the client, other program participants, and staff members who care for them.
Given that SUD is defined by the National Institute on Drug Abuse as “a chronic, relapsing disorder,” it should not be surprising that sometimes people with a SUD may have a recurrence of symptoms while in treatment. Further, it should not be surprising that there is an uptick in drug use amongst people in treatment, especially as the community increases the level of coercion into treatment. We take reasonable precautions to prevent drugs from entering programs, but we are not a prison.
HealthRIGHT 360’s treatment programs are not supervised consumption facilities. Residential treatment programs remain abstinence-focused, as they have been for over 50 years. We consider medications for addiction treatment (MAT) to be a core element of care, in addition to evidenced-based behavioral interventions. There are, however, many questions we have regarding how we respond to recurrences of drug use while in residential treatment. We absolutely remain committed to providing safety, support, and validation for individuals who are frightened and triggered by others’ substance use. At the same time, we have worked through challenges of drug-use recurrence and helped see clients through to long-lasting success in transitional housing. And, we have discharged clients for recurring drug use only to have them die of an overdose on the streets within 24 hours of leaving a program.
This is the dilemma of frontline substance use treatment work. I know, as a system, we can and must do better, which means rethinking addiction treatment. In these times, we have no other option. Lives depend on it.
As we confront these challenges with compassion and resolve, we are immensely grateful to peers, staff, and community partners who are tirelessly engaging people who use drugs across San Francisco and beyond. We remain committed to providing the best possible care across an ever-changing landscape of drug use, and to continuously improve our policies, procedures, and practices to unconditionally meet people and connect them to accessible, meaningful, voluntary treatment services.
HealthRIGHT 360 extends our heartfelt condolences to all those affected by these tragic losses to overdoses within our residential treatment programs, as well as the larger community. We are deeply grateful for the ongoing support of our community as we navigate these challenging times together. Our dedicated, amazing, and brave frontline workers especially need your support to carry on through heartbreak.
Thank you for standing by us as we strive to make a difference in the lives of those we serve.
About HealthRIGHT 360:
HealthRIGHT 360 is a non-profit provider of substance use disorder treatment, mental health services, and primary care to over 39,000 Californians annually. HealthRIGHT 360 provides care that is compassionate, non-judgmental, and evidence-based. We provide services, regardless of one’s ability to pay; inspired by our belief that healthcare is a right, not a privilege. Learn more about HealthRIGHT 360 and our programs at https://www.healthright360.org/.
