In San Francisco, people who are extremely drunk on the streets are locked in jail and released once they sober up. But a new plan, supported by the mayor, could force them to stay in jail or choose mandatory treatment for up to six months. Chronic offenders are often homeless. Critics worry it’s a short-term solution to a complex problem, and that it violates offenders’ rights. What’s the best way to deal with drunk people on city streets?

Mandatory Treatment for Chronic Drunkenness? 6 September,2012forum

Bevan Dufty, director of Housing Opportunity, Partnerships and Engagement (HOPE) for the City and County of San Francisco
Jeff Adachi, San Francisco public defender
Jo Robinson, director of Community Behavioral Health Services for the San Francisco Department of Public Health
Keith Humphreys, professor of psychiatry and behavioral sciences at the Stanford School of Medicine, whose research focuses on the prevention and treatment of addictive disorders

  • Beth Grant DeRoos

    Don’t you need to look deeper to see why a homeless person stays drunk? 

    What if its because they have dental problems and the alcohol dulls the pain? What if its because they want to block out pain in general, from being dissed by people, dealing with physical abuse etc?  Would six months in rehab be enough?  And once they get out of rehab then what?  They have to have hope of a better future. What’s the educational level of most homeless, alcoholics?

  • George

    When talking about drunkenness laws I think it’s worth looking at European countries for inspiration. Most do not have laws against public intoxication, and their societies don’t seem to suffer.

    It makes sense for people to be jailed if they’re being belligerent or causing a scene – but less so for stumbling around and being silly.

  • Amir

    for a great way to come out of all of our addictions Check out vipassana meditation at, be happy.

    • Kathleen

      I have recommended Vipassana to many of my patients…yes, it is the ultimate therapy for addiction (all types). May all beings be happy!  Thanks Amir!

  • Ginny

    Please understand the difference between alcoholism and a habit. Those with the ‘obsession’ have the course of jails, institutions and death unless they ‘choose’ to get sober. Please don’t underestimate a persons’ ability to get themselves sober. Harm reduction is not treatment. I believe a six month ‘spin dry’ is a worthy effort that offers the alcoholic a moment of clarity to say yes to recovery and accept the help. Is SF General ready for this? Remember a person can die by their alcohol withdrawals.

    • Ginny

      Its the detox that kills them via seizures. Not necessarily the return to drinking after getting clean.

  • Kathleen

    My name is Katheen, I have been an ER nurse for almost 20 years and have cared for many drunks.   Most of the time, these patients are brought in by ambulance and require a pretty pricey work up (IV fluids, CT of head  etc).  Most of these patients come back time and time again.  Some say they want to get cleaned up, some say they do not.  I think a wet house is the way to go and more resources for those who want to get clean.  I have been saddened deeply when I have cared for a drunk who, once sobered up, expresses the desire to go into rehab, but it is the middle of the night and there is no place to send him or her.  It breaks my heart.  we need more services for people like this.

  • Michelle

    I twitched when I heard “60% success rate” in regards to 12-step programs. Please don’t use results obtained through a study which referred veterans to 12-step programs in order to make statements which infer that these same results can be applied to the population. Veterans are trained to work in teams, follow orders, and be personally responsible for their actions as a course of their duties, and it is these differences in their backgrounds that could confound the data. To use the results found in their performance within 12-step programs as a justification for setting up a specific policy for the rest of society – most of whom did NOT serve time in the military – is a misuse of data.

    • Knh

      Greetings Michelle:

      Keith Humphreys here, the figure was 60% less use of drugs and alcohol in VA study.  Other randomized clinical trials of AA have been done with other populations and also found positive results.

  • Zee

    Any practical tips for what to do NOW about alcoholics who just CANNOT find space in detox/rehab programs? So many give up trying to get help because it is so hard to access it.

  • M a delloue

    i have worked on an acute psych unit for many years and the numerous clients who cam in for detox were written a diagnosis of “depression” since many insurance co. do not pay for detox..therefore the # of etoh abusers is not accurately reflected…

  • Mayoko

    Mr. Duffy and Ms. Robinson articulated very clearly why this program should be tried. This is not an attempt to jail drunks. It is a possible solution to the VERY REAL problem of the CHRONICALLY drunk and drugged people who are costing this city (you and me) millions of dollars a year in emergency response. We own a business at 7th and Folsom and a week doesn’t go by that we don’t witness a paramedic/ fire truck/ ambulance being called due to a dangerous situation on the atreet. It is not humane to leave these people on the streets and their rights should not supersede the rights of the general public.

  • Finnabennacht

     We should put them in a matrix where they are allowed to drink beverages that they think is alcohol and the cocoon makes their eyes blurry and throws their balance off but in reality they are just in a virtual reality machine and harmless and not doing any damage to their own bodies.

  • Nicben415

    Many alcoholics need to hit a bottom before they have the desire to sober up, i.e. consequences due to their drinking. Going to jail is one for many, although not all. But, this program gives people a choice. Although you see people stay drunk day after day, many of these people want treatment. Asking for help is the hardest thing to do for an alcoholic. Rehab is a great introduction to the new life they may never have a chance a getting on their own. Under the current process, a drunk goes to jail, is drunk the whole time he or she is there, consequences are slight. Then, they are released to go back to the same place the police found them to do the same thing day after day. Breaking the cycle is an alternative to what we know does not work for the drunk, the community, the hospitals, and law enforcement. Contempt before investigation will get no results.

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