The San Francisco Sheriff’s Office is tasking its emergency unit with arresting and compelling treatment for people who use drugs or are intoxicated in public, city leaders announced Thursday.

The plan comes shortly after Mayor London Breed last month told the Board of Supervisors that “force” needs to be part of the city’s response to drug use. The sheriff’s plan includes deploying 130 additional deputies to the Tenderloin and South of Market neighborhoods, two areas where drug use, sales and overdoses are concentrated in the city.

The deputies will work overtime for a six-month deployment beginning this month.

“In many cases, individuals suffering from drug addiction only seek help when they hit their lowest point, and the sad truth for many is that the low point is incarceration,” Sheriff Paul Miyamoto said at a press conference Thursday morning outside City Hall.

The Emergency Services Unit at the sheriff’s office will work with the Mayor’s Office to increase arrests for drug sellers as well as people using drugs outdoors and in public settings, particularly those who are deemed to pose a threat to themselves or others.

A man in an official uniform with a starred badge pinned to it speaks into an array of microphones from an outdoor lectern, flanked by law enforcement officers and others. — Sheriff Paul Miyamoto speaks during a news conference outside City Hall Thursday morning. (Beth LaBerge/KQED)

Law enforcement including the San Francisco Police Department, the California Highway Patrol and the National Guard in recent months have renewed focus on the Tenderloin and SoMa, two areas that have become central to ongoing debates over how to respond to challenges around outdoor drug use and sales, homelessness and substance use disorders.

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“Part of the solution is making sure we have enough law enforcement on the ground in the Tenderloin, South of Market and in the Civic Center area to make sure drug dealers understand that their behavior will not be tolerated any longer in this city and that those who are struggling with addiction get the help they so desperately need,” District Attorney Brooke Jenkins told reporters at Thursday’s press conference.

But public health experts have historically decried the notion put forward Thursday that jails can rehabilitate substance use disorders for many. And incarceration can make life much worse for some people seeking employment or housing upon release.

Some fear the approach mimics tried-and-failed approaches to cracking down on drugs in the past, which led to outsized incarceration for members of Black and brown communities.

“Rounding up individuals for being under the influence is another war-on-drugs tactic that we know from decades of experience and research will not be effective in addressing our city’s public health crisis,” said San Francisco Public Defender Mano Raju in a statement following Thursday’s press conference. “Our jails, which already subject people to frequent lockdowns, little contact with family, and no sunlight, are not well-equipped to treat individuals with substance use disorder.”

A woman in a purple suit speaks into an array of microphones from an outdoor lectern, flanked by law enforcement officers and others. — San Francisco District Attorney Brooke Jenkins speaks during Thursday’s press conference. (Beth LaBerge/KQED)

Numerous studies show that efforts to criminalize drug use can also lead to increased overdoses once targeted operations subside, and even immediately after individual arrests themselves.

In Indianapolis, researchers found that opioid overdose deaths doubled within a 500-meter radius of each drug arrest. “Elevated fatal and nonfatal opioid overdoses were sustained over one, two and three weeks,” reads a report published June 7, 2023, in the American Journal of Public Health.

One reason for the uptick in overdoses, the paper explains, is that disrupting the drug supply can drive drug users to find new suppliers who may have tainted substances, and pushing people to use drugs alone or secretly can lead to more erratic drug use.

Earlier this week, Breed applauded arrests made on 25 people for public intoxication with drugs or alcohol in the Tenderloin and SoMa. But, The San Francisco Chronicle reported, none of them accepted drug treatment upon release from jail.

[aside label='Related Coverage' tag='overdose,overdoses,fentanyl,fatal-overdoses,fentanyl-overdoses']Law enforcement officials on Thursday expressed awareness that arrests alone won’t fix the problematic drug use or crime trends. They suggested that it was part of a broader effort.

“While it’s an unpopular stance to take, arresting and putting people in jail, it can be a critical gateway to help and needs to be a part of the multipronged approach,” Miyamoto said. “We’re not advocating for harsher punishments or increased incarceration for those who are struggling with harmful choices. There needs to be a multipronged approach to these problems, not just a single focus on harm reduction and treating this as a health crisis.”

Although the six-month-long deployment will be focused on SoMa and the Tenderloin, the sheriff said it could potentially reach into other neighborhoods. The deputies will patrol in marked vehicles and on foot, Miyamoto said. In a press release, officials said that deputies “undergo extensive, specialized training for handling situations that require intervention for destructive or criminal behavior.”

The latest push to criminalize drug use in the Tenderloin and SoMa comes amid a staffing shortage in both SFPD and the Sheriff’s Office. Also on Thursday, city leaders held a hearing on those staffing challenges, for which some have called for additional funding to resolve.

“We have to be funded properly. We have to be staffed properly, and we definitely are working toward getting in that direction,” Police Chief Bill Scott said Thursday at the press conference. “But that doesn’t happen without our elected officials supporting us.”

KQED reporter Billy Cruz contributed to this story.

This story has been updated.

Paul MiyamotoPaul Miyamoto

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