Here's the situation: The city wants to expand drug-free requirements in its publicly funded supportive housing. Some medical professionals are pushing back, arguing that demanding sobriety as a condition of housing could push vulnerable people back onto the streets. It's the familiar harm-reduction-versus-accountability debate that has defined San Francisco's approach to addiction for the better part of two decades — an approach that, by virtually every measurable outcome, has failed.

Let's be honest about what's actually happening in a lot of these buildings. As one SF resident put it bluntly: "Have you seen the housing of someone in active addiction to hard drugs? They're not spending their money on furniture or cleaning products. The place is pretty much a soiled bed and whatever they've collected off the street. It's not a home."

That's not compassion. That's warehousing.

Another local, who identified themselves as being in recovery, offered a perspective the professional advocates rarely want to hear: "I'm far more on the tough love approach... Why should people in supportive housing have to share the space with addicts who aren't managing their condition?"

This is the crux of it. Drug-free housing isn't just about the person using — it's about every other resident in that building who is trying to get clean, who is trying to rebuild a life, and who shouldn't have to dodge fentanyl smoke in the stairwell to do it.

The doctors raising concerns aren't wrong that addiction is a medical issue. But the logical conclusion of their argument — that we should never condition any public benefit on behavioral expectations — is a policy framework that has turned entire neighborhoods into open-air drug markets.

San Francisco spends over $600 million annually on homelessness. Taxpayers aren't asking for miracles. They're asking for the absolute bare minimum: if we're giving you a free apartment, maybe don't smoke meth in it. The fact that this is a debate tells you everything about how upside-down the city's priorities have become.

Drug-free housing isn't cruelty. It's a floor. And it's long past time we built one.