Abstract
After reading our story on the Tenderloin district in San Francisco last week (https://onlinelibrary.wiley.com/doi/full/10.1002/adaw.33786), many clinicians responded to ADAW to let us know that they were “depressed” by the piece, and didn't see an exit ramp from the non‐stop fentanyl use and overdoses. Things have gone too far for many of the proposed solutions: treatment that people don't want, needed housing that nobody has money for, and quality of life that multiple comorbidities have made impossible. Advocates for drug‐user “autonomy” sent stories about how the small country of Denmark has dealt with the problem, criticized the San Francisco mayor's decision to shut down the safe injection site (Mayor London Breed did so in December because fewer than 1% of participants had been connected with treatment), and attacked Tom Wolf, who guided us through the Tenderloin in person, for his supposed abstinence‐based treatment philosophy (in fact he strongly believes in treatment with methadone and buprenorphine).
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