An uprising is taking place in San Francisco. In a city now known as much for its humanitarian crisis and social breakdown as for its steep hills and beautiful bridges, formerly incarcerated people, mostly black men, are refusing to be homeless, addicted, and unprepared for life and success.
On September 7, the Positive Directions Treatment, Recovery, and Prevention Academy, an alternative-sentencing program that serves up to 84 formerly incarcerated men, opened its doors. Program participants receive up to 30 months of transformational support in a structured residential setting, at no cost to them. Spearheaded by Steve Adami, director of the Adult Probation Department’s Reentry Division, and in partnership with Westside Community Services and Positive Direction Equals Change, the Academy works to help former prisoners live honorably and independently.
Almost everyone involved in the development of the Academy, as well as its current staff, has spent time behind bars and has direct experience with substance abuse, including Adami. Cedric Akbar and Cregg Johnson, both of the community-based mental-health agency Westside Community Services and Positive Direction Equals Change, are also leaders in the Academy and have past histories of incarceration and drug addiction.
While the Department of Public Health (DPH) and drug-normalization activists push ever-more extreme versions of harm-reduction and housing-first methodologies, the Academy takes a different approach. Its curriculum covers everything from money management to relationship and parenting skills. Participants learn how to adhere to the law and to get along with one another through mutual understanding and respect—essential skills for men who have been imprisoned and lived in a state of conflict for much of their lives. The Academy’s most radical feature, though, is its abstinence-only policy on drugs and alcohol. All other city-sponsored facilities are required to provide drug supplies and medication-assisted treatment pharmaceuticals such as methadone and buprenorphine (Suboxone), even to those trying to escape the bonds of their habits.
Nearly all the program’s participants are African-American. Black residents make up only about 5 percent of the city’s population but account for roughly half of the county jail population.
Distributing an endless stream of drug paraphernalia and sticking unprepared people into dilapidated single-room-occupancy hotels or “permanent supportive housing” (which includes little, if any, actual support) has proved disastrous—unless the goal is to ensure that people remain doped-up, subservient, and impoverished.
“They want us staying docile,” says Johnson. “We’re all tired of this shit. We have to holler until they hear us. The community is saying, ‘enough is enough.’ We are forcing policy to change. I hate to be anti-harm reduction, but a lot of people don’t want it. Harm reduction has lost its way. It used to be about HIV, Hep-C, but they’re overdoing it and making [addicts] too comfortable. People need some kind of guideline so they don’t drive off the road.”
Located in a pristine, recently renovated former hotel in Lower Nob Hill, the Academy originates from the desire of its founders for a place to obtain the necessary education and guidance that will put them on a path toward health and autonomy.
San Franciscans, currently in revolt against the conversion of other properties into permanent supportive housing because these buildings have descended into chaotic, crime-ridden drug dens, would likely welcome additional Academies. Unlike the free-for-all atmosphere of city-run housing, at the Academy participants must abide by firm rules. It’s a place that unifies rather than divides the surrounding community.
“We just want to coexist,” says Johnson. “We’re not asking others to change, but to allow other options so people have the freedom to choose. In San Francisco, people are saying they want something different.”
At this juncture, the Academy remains an island. DPH holds the purse strings for services, and it has prioritized the harm-reduction approach over other alternatives. Even the word “program” is rarely uttered by public-health experts because it evokes rules, a virtual obscenity in their policy world. As a result, there hasn’t been an abstinence-based program run by the city in years. Until now.
“We’re not operating off the vision of DPH,” says Johnson. “The generic, one-size-fits-all method works better for them, but it goes against our value system. There needs to be an abstinence-based program in every community.”
The need is great. Many incarcerated people are being released into the general public with a buprenorphine habit, regardless of whether they entered the prison system with a confirmed opioid addiction.
“A lot of these are young men,” says Johnson. “A 30-year old using heroin for six months or a year, let him kick. He’s strong, he can handle it. Are we aggressive? Yes, this is love. If we see someone jumping off the cliff we say stop, hey, don’t do that shit; it’s killing you. We’ve got to speak up.”
As the city contends with the nightmare of rampant crime, squalor, and record-breaking overdose deaths, some in local government are finally listening. Mayor London Breed is an unequivocal supporter of the Academy, as are two of the city’s 11 supervisors, Catherine Stefani and Ahsha Safai. It takes courage to join a revolution, but the reality has become too damning to ignore. “All the free needles and Narcan, they haven’t helped one person get up off the ground,” says Akbar.
Ultimately, the Treatment, Recovery, and Prevention Academy teaches men to stand on their own feet, an approach that runs counter to current fashion. “San Francisco wants you constantly dependent on the system,” says Akbar. “That’s not what we want.”
Photo by Wolfgang Kaehler/LightRocket via Getty Images