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(Bloomberg) — San Francisco has long celebrated its progressive values and immigration sanctuary policies. A deadly fentanyl crisis is testing its commitment to those ideals.

Open-air drug markets dot a downtown already struggling to recover from the pandemic. A record number of people died from overdoses last year. Faced with a deepening emergency, city leaders have quietly embraced a controversial tactic to combat the epidemic: deportation.

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More than 100 people, mostly undocumented immigrants, have been charged in a federal crackdown on San Francisco’s open-air drug markets since last year, according to a review of cases and data from the US Attorney for the Northern District of California. Those prosecuted under the program are often given a stark choice between risking lengthy prison sentences or pleading guilty, which avoids major prison time and frequently leads them to face deportation proceedings. 

“For people who are willing to sell poison that is killing people, there’s no protection for you. There’s no sanctuary for you,” Mayor London Breed said in an interview. “Fentanyl is such a deadly drug. It requires that we take more extreme measures.”

The crackdown in a liberal bastion shows just how deeply fentanyl has entrenched itself in San Francisco and exacerbated some of the tech hub’s most vexing problems, from homelessness to downtown revival. It’s exposed a political liability both locally, with a mayoral election this year, and nationally, as Republicans point to the city where presidential candidate Kamala Harris rose to power as a symbol of failed Democratic leadership.

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Fairly or not, San Francisco has emerged as one of the most visible examples of the US fentanyl emergency that’s now centered on the West Coast. From the Mexican border to Seattle, and into Canada, deaths from synthetic opioids soared last year while moderating in most other parts of the country.

The powerful drug is made from precursor chemicals that are often shipped from China to Mexico, where they are turned into fentanyl and routinely trafficked into Los Angeles-area warehouses. From there the drug is often sent up the Interstate 5 highway, making its way to the streets of San Francisco, Portland and Seattle, according to Brian Clark, the top Drug Enforcement Administration official in San Francisco.

In San Francisco, fentanyl overdoses killed an unprecedented 656 people last year, a 43% increase from 2022. 

As the city tries to control the crisis, the deportations have sparked criticism from local advocates for circumventing San Francisco’s sanctuary policies, which prevent local law enforcement from coordinating with immigration authorities in most cases. Breed, running for reelection in November, said the deportations are a necessary correction to migrant protections, while still maintaining that the city is a safe haven.

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“We want to make sure that those people are protected and they’re supported,” Breed, 50, said of the city’s immigrant community. “For those people who cross those lines and commit these crimes, we do everything we can to hold them accountable.”

For the mayor, a San Francisco native, the drug issue holds particular resonance. Her sister died of an overdose in 2006. Her brother, who is currently in prison, also struggles with addiction, she said.

“I grew up in the crack epidemic,” Breed said. “Fentanyl is different. And it’s almost a guarantee of a loss of life and no shot at a second chance or recovery.” 

Economic Troubles

The effects of the drug crisis can be seen daily on San Francisco’s streets, where people in the throes of addiction huddle on sidewalks as dealers hawk pills and powder. That’s added to perceptions of blight and crime that have had a devastating effect on the downtown, where the office vacancy rate is a record 37% and retailers such as Nordstrom, Whole Foods and Uniqlo have shuttered their stores.

“Fifteen dealers will swarm you. It’s like an auction,” said Richard Rodrigues, who spent years on the streets surviving the worst of San Francisco’s opioid epidemic. He now lives in a residential treatment program run by HealthRIGHT 360, an addiction treatment provider.

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“Death becomes normal,” he said of his time living on San Francisco’s streets. “You’re walking over people.”

Even an Ikea that opened last year as a would-be symbol of San Francisco’s resurgence has struggled with the problem. Ingka, the franchisee that runs the Market Street store, has complained to city officials about open-air drug markets, streets in disarray, and an assault on an employee, according to emails obtained through a public records request.

“Everyday people are using drugs,” Ricardo Tapia, an Ingka operations manager, wrote in a May email to San Francisco police and a nonprofit group. Some people clashed with customers or garbage trucks; others started fires or tried to “sneak into our dock while tenants receive their deliveries.” The road “smelled terrible” due to human waste on the building’s exit doors. The conditions were leading to revenue loss, Tapia said.

Ingka said it is actively working with Ikea and city leaders to address these issues. The company is “confident and optimistic about the potential of Market Street and are committed to contributing to its revitalization,” a spokesperson said in a statement. 

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Taken together, the effects of fentanyl are shifting famously liberal San Francisco to the center. Beyond the immigration crackdown, Breed has moved more rightward on policing and pushed street sweeps of homeless encampments in the name of public safety.

Matt Dorsey, a San Francisco supervisor who is sober after struggling with his own drug addiction, said the city is seeing a “realignment of urban politics that is more centered and rooted in public order and public safety.”

“We can’t have disorder and unchecked drug markets going on because we’re adhering to some larger principle of ‘we don’t want to do something that Donald Trump is going to point to and say he likes,’” Dorsey said. “And if cities are to succeed, we Democrats have to be trusted to govern.”

Breed has embraced centrist policies as she fights for reelection against four other serious candidates, all of them Democrats. She supported a successful ballot measure to screen welfare recipients for drug usage. One of her rivals, Mark Farrell, has called for deploying the National Guard to patrol the city’s most troubled areas. (Michael Bloomberg, the founder and majority owner of Bloomberg LP, has donated $1.2 million in support of Breed’s reelection campaign.)

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“There’s a perception that San Francisco’s crime is all fueled by drug addiction,” said Randy Shaw, who heads the Tenderloin Housing Clinic, one of the city’s largest low-income housing operators, while noting that the most high-profile retail thefts are tied to organized crime rings. “It’s the same for Portland, Seattle, Los Angeles. It’s dramatically reshaped politics.”

Leaders Intervene

The crisis was one of the most pressing issues for Ismail Ramsey when he took over as the Biden Administration’s top prosecutor in Northern California in 2023. He said he met with community leaders including Breed and Nancy Pelosi, the former US House speaker and longtime San Francisco congresswoman, who asked him to intervene.

Outside his 11th floor office window, Ramsey would watch a daily scene of people suffering from drug addiction cleared from an alleyway so schoolchildren could pass by. “It was just people splayed out on the floor,” he said. “And then the yellow buses come in, and the kids go out and they play. It was just a very strange scene.”

He crafted San Francisco’s fentanyl crackdown soon after his confirmation, embarking on an unusual prosecution strategy, backed by surging law enforcement raids on drug dealers.

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US attorney offices typically target drug kingpins or corporate wrongdoing. Now, his office would focus on the low-level dealers often arrested with a few hundred dollars in their pocket. The strategy was meant to overcome the “revolving door” of dealers at San Francisco’s superior court, Ramsey said. “The same people being arrested and then coming right back and feeling like there was no accountability, no significant consequence.”

A central part of his strategy involves adopting low-level fentanyl or methamphetamine dealing cases that are first filed by the San Francisco district attorney, then offering these defendants a plea deal that sentences them to time served, plus a single extra day in custody. That additional day is used to hand the person over to US Immigration and Customs Enforcement for deportation proceedings.

Since its inception, the fast track program has included a 26-year-old mother of two from Honduras arrested by San Francisco police for selling $800 in fentanyl to undercover law enforcement, and a man arrested with 36 grams of fentanyl. A 50-year-old man arrested in July admitted to selling $5 worth of methamphetamine and had two small baggies of drugs in an Altoids container, San Francisco police said. He accepted a fast-track plea deal on Aug. 28 and was expected to be deported to Honduras, according to court filings.

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Ramsey’s office said in a statement that the plea deals are focused on deterrence rather than deportations. Under the agreements, drug dealers face a three-year stay-away order from San Francisco’s embattled Tenderloin neighborhood, where drug dealing is concentrated. If they return and are caught dealing again they could could face years of jail time.

“It is not immigration consequences, but the threat of a potentially long federal sentence,” that deters repeat drug dealing, Ramsey’s office said. “This is a real consequence to drug dealers that changes the calculus regarding whether they want to return.”

Still, the program has been controversial. “It’s all immigrants that they’ve been arresting, in the cases I’ve seen,” said Angela Chan, an assistant chief attorney with the San Francisco public defender’s office. “And their focus hasn’t been on the prosecution, but handing these individuals over to ICE.”

Hillary Ronen, a San Francisco supervisor representing the immigrant-heavy Mission District, called the deportations an “end run” over the city’s sanctuary policies. “Demonizing migrants is the oldest trick in the book,” she said.

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But it’s not only the city’s staunch progressives who have opposed the program. Federal Judge William Alsup, who has overseen some of the fentanyl cases, dismissed a plea agreement — saying convicted dealers should serve prison time. 

“It’s a not just lenient, but extremely lenient policy to skip over prison and go straight to deportation with a mere promise not to return,” Alsup said during a court hearing last year.

Harm Reduction

Ramsey’s strategy isn’t operating in a vacuum. San Francisco has increasingly turned to law enforcement after promoting a more compassionate approach to drug users. The city has long championed a strategy known as harm reduction meant to reduce deaths by providing people with clean syringes and safer spaces to use drugs, among other tactics.

The centerpiece was a city-sponsored overdose prevention site called the Tenderloin Center. It was a place where people could come for a shower, a meal and to smoke fentanyl under supervision. In 2022, staff at the Tenderloin Center reversed more than 300 overdoses. For Vitka Eisen, who heads HealthRIGHT 360, it was a resounding success. “We have to first stop people from dying,” said Eisen. “We can’t go back to doing things that we did 10 or 15 years ago.”

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Breed has helped funnel tens of millions of dollars toward overdose and drug addiction treatment. But she shuttered the Tenderloin Center, saying it had failed to connect people with addiction treatment and other services. As overdose deaths continued to rise in 2023, she told the board of supervisors that “compassion is killing people.” It was time for “tough love to change what’s happening on the streets of San Francisco.”

Now, Breed has touted the arrest of more than 3,500 drug dealers and users. The city’s jail has swelled to capacity in what Chan, the local public defender, called a “War on Drugs 2.0.” 

But San Francisco is also seeing signs that the fentanyl epidemic is easing. In July, there were 39 drug overdose deaths, the lowest count since the city started keeping a monthly tally in 2020.

“This is my home,” Breed said. “And I care about people living.”

—With assistance from Tanaz Meghjani, Peter Blumberg and Biz Carson.

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