Misdiagnose a disease, and the results can be lethal. Case in point: San Francisco officials call the city’s drug-addiction crisis a homeless problem. Until recently, the city’s remedy has been to provide addicts with indoor spaces and drug-use gear—a strategy that has proven increasingly deadly. As of mid-December, San Francisco had 752 fatal overdoses in 2023, the highest number on record.
Two flawed schools of thought are to blame for these record numbers. San Francisco embraced California’s Housing First model, which gives the so-called homeless population unconditional, permanent housing. Meantime, the city’s Department of Public Health has leaned hard into a Harm Reduction policy rather than actively promoting recovery. Loath to stigmatize drug users, city officials are focused on developing campaigns designed to encourage safe drug use and to distribute drug supply paraphernalia, including foil for inhaling illegal fentanyl.
Placing people with serious addiction issues within four walls, alone, and without proper care and support has produced tragic consequences. According to the latest numbers, from 2020 to 2023, 451 people have died inside the city’s network of single-room occupancy hotels. Meantime, squalor and encampments continue outside as the drug trade flourishes.
Now, disruption has begun. The Way Out, an on-demand, recovery-focused homeless initiative of the Salvation Army in San Francisco, is vigorously challenging the city’s entrenched approach to addiction. The Way Out coordinates the Salvation Army’s local efforts into a complete recovery system. What it offers people in need is impressive, both in the scope of services and in its intention.
First, participants receive stabilization services and drug-addiction treatment at the Salvation Army’s Harbor Light Center. Immediate intake is available six days a week, with plans to expand to seven days soon. Recovery begins on arrival, including detox and six months of residential care with an evidence-based curriculum.
After that, participants can move into the Joseph McFee Center, a recovery-focused transitional-housing program for those completing drug treatment at Harbor Light or other centers in San Francisco. They can then obtain housing for up to two years, where they access on-site supportive services, case managers, career development, family reunification, and a savings program. While acclimating to a drug-free lifestyle, participants relearn positive values and behaviors, like developing a strong work ethic and giving back to the community.
Steve Adami, a recovering addict who spent more than 20 years cycling in and out of jails and prison, is The Way Out’s executive director. Adami got clean while incarcerated, then went on to earn a master’s degree in public administration, concentrating on public policy and criminal justice. He became the reentry division director of the San Francisco Adult Probation Department (SFAPD) and in May 2023 transitioned to The Way Out, where he was joined by Destiny Pletsch, former SFAPD reentry services manager, and Adrian Maldonado, former director of the Minna Project, a transitional housing facility for formerly incarcerated individuals that Adami and Pletsch created.
Because The Way Out is based on recovery, accountability, and service—core principles of The Salvation Army—it represents a radical departure from prevailing city programs. Instead of shuffling people indoors and giving them free needles, pipes, and foil, it actively leads people away from addiction and toward self-sufficiency.
The initiative removes the bureaucratic barriers that San Francisco has put in place for those seeking recovery. Getting into city-run detox and treatment programs is a tangled process, with maddening wait times. Those seeking help must pass through an assessment and referral process that can take weeks. In the interim, many lose hope and give up. Not so with The Way Out.
“We just want people to show up, and when they do, we’ll help them no matter where they are in their drug use,” says Adami. “We will take them from being broken, living on the streets, addicted to drugs, to reclaiming their lives. We’re seeing really good early results. The Way Out is designed to inspire change and restore hope. It’s done through helping people get off the streets in real time, so they can stabilize and heal. It teaches them how to live and gives them a couple years to practice living so they can reclaim their place in the community.”
One would think that a streamlined system designed to help people get off drugs would already exist in San Francisco, a city with a $14.6 billion budget. It doesn’t. “In today’s world, The Way Out is revolutionary, but in some sense, it is getting back to basics,” says Adami, who believes that the initiative will not only help individuals achieve health and independence but also change the city’s culture of permissiveness. Setting parameters about criminal activity is crucial, he says. Thus, The Way Out also emphasizes the importance of abiding by the law.
“There’s an appetite in the city for this,” he says. “We know this is the moment. Everyone wants a magic bullet to solve social issues. Housing first, take a pill, your problems will be solved—it doesn’t work like that. Recovery is the solution for addiction.”
The city’s technology giants are stepping in, pledging their support to The Way Out. Marc Benioff’s Salesforce donated an initial $1 million. “It was clear that the vision of The Way Out was critical to the portfolio of solutions available for dealing with our city’s crisis,” says Benioff. “We immediately agreed to make the seed investment and recruited others to join us as well.”
Garry Tan, venture capitalist and CEO of Y Combinator, is also an enthusiastic supporter. He lauded The Way Out as one of the city’s most important programs because “it opens the path to drug treatment, recovery, and a human flourishing that breaks the cycle of addiction and abuse that has taken hold of the most beautiful city in the world.”
It’s a pivotal election year in San Francisco. Daniel Lurie, the Levi Strauss & Co. heir and founder and former CEO of Tipping Point Community, is running for mayor. He’s an advocate for The Way Out. “They are transforming lives and enhancing the city’s livability by giving people a way out of homelessness and addiction,” says Lurie. “We need to invest in more programs like this here in San Francisco.”
Such optimism is refreshing for San Franciscans, who have grappled with despair and fear that nothing will change. “If you believe in people, invest in people. Don’t just move them from the street to a room,” says Adami. “We’re creating a movement where San Francisco is healthy, where everyone thrives.”