In his first State of the City address, Mayor Daniel Lurie had one of the biggest “read my lips” moments of his first year in office. “We stopped freely handing out drug supplies and letting people kill themselves on our streets,” he boldly professed to hundreds of onlookers. But almost daily videos posted on social media by community advocate J.J. Smith tell a different story, from Gubbio Project in the Mission dispensing paraphernalia 720 feet from an elementary school to a van offering pipes, syringes, and body massages next to a park where children are playing.
I’ve written about Gubbio project before and have long called for their “wellness hub” (located inside the Episcopal Church of St. John the Evangelist in the Mission District) to be shut down due to drug use both inside and outside the site. Neighbors have complained to District 9 Supervisor Jackie Fielder and to Lurie about the constant fights, litter, drug use, noise, and overdoses to no avail.
The van doling out paraphernalia and free massages is run by Harm Reduction Therapy Center. Their contract as a “therapy center, primary care, mental healthcare provider” is funded by the city via — you guessed it — the harm-reduction-happy Department of Public Health, to the tune of $5.6 million.
The absurdity goes beyond offering massages to drug users and spending 75 percent of their nearly $6 million taxpayer-funded contract on salaries.
According to their 990 nonprofit tax filing for 2024, Harm Reduction Therapy Center (HRTC) had revenue of $4,618,647 with expenses of $2,726,066. Net income was $1,892,581 and net assets were $3,193,223. Compensation for executive was nearly 25 percent and “other salaries and wages” clocked in at nearly 50 percent. HRTC spent less than 12 percent ($546,642) on program services.
The absurdity goes beyond offering massages to drug users and spending 75 percent of their nearly $6 million taxpayer-funded contract on salaries. Their website is a hippy-dippy mishmash of addict coddling (“By first paying a great deal of attention to people’s basic needs and wants, HRTC has created a therapeutic milieu that attracts 100’s of people to seek therapy and other services”) replete with a mission statement rooted in the 1970s (“HRTC exists to transform substance use treatment by providing low-barrier, person-centered, integrated mental healthcare, as well as clinical harm reduction training, to people and organizations most impacted by the War on Drugs”).
In 2022, HRTC attended the National Harm Reduction Conference in San Juan, Puerto Rico, where Dr. Carmen Landau, chief medical director of the conference, died of a drug overdose in her hotel room. The coalition wrote a tribute to Landau on their website (“She performed her work with kindness and diligence — whether doing wound care for people who use drugs out of the back of a van or providing reproductive health and abortion care in the clinic”) while unashamedly asking for money (“As part of this tribute, we would like to also uplift the fundraising efforts to continue her work and legacy”).
Performing city work without a contract
A critical November 2023 performance audit of San Francisco Street Teams noted that HRTC was performing work for DPH’s Post Overdose Engagement Team, or POET, “without a signed, executed contract in place for such work for over 18 months.” According to DPH staff, the work conducted prior to the contract’s execution included “weekly street outreach; harm reduction counseling and outpatient substance use and mental health counseling at the DPH Maria X Martinez Health Resource Center; attending weekly team meetings; and leading a weeklong training in July 2022.”
The audit concluded that performing work under a contract that has not been fully executed “is a significant risk to the City. Written contracts are required by the City Administrative Code and are put in place to ensure that the City is protected legally from any negative outcomes that may arise from any given contractor, and that a contract meets all City administrative and legal requirements.” HRTC still got their signed contract worth millions, and the van was videotaped by Smith passing out paraphernalia and massages on Jan. 7, 2026.
What makes Lurie’s lie in his State of the City address even more egregious is that in April of 2025, he announced “a major shift in San Francisco’s response to the fentanyl crisis,” where individuals would have to receive treatment counseling or be connected to services to receive “safe” drug use supplies. “We can no longer accept the reality of two people dying a day from overdose.… Fentanyl has changed the game, and we’ve been relying on strategies that preceded this new drug epidemic, which ends today,” Lurie said, adding that his new rules applied to “all city-funded public health programs distributing drug use supplies, including sterile syringes and smoking kits.” The policy also mandated that any distribution of supplies be paired with “proactive treatment counseling and connections to care, requiring distribution programs to provide treatment referrals and on-site engagement to enable entry into services,” and also prohibited “the distribution of smoking supplies in public spaces.”
None of that is happening. In fact, other city-funded harm reduction organizations, including the San Francisco AIDS Foundation and GLIDE, openly defy Lurie’s policy nightly, passing out pipes and needles like candy on the streets of San Francisco, including to minors, without offering counseling or referrals to treatment.
The other half of Lurie’s statement, about San Francisco “no longer letting people kill themselves on our streets,” is also a complete lie. In 2025, there were 621 drug overdose deaths. After the announcement, Lurie touted what he considers his successes along with his future plans. “We made San Francisco a recovery-first city, opened a crisis stabilization center, reimagined street outreach, and opened 600 new treatment-focused beds so people on the streets can get inside and get help. This year, we’re launching a RESET Center to get drug users off the street and into treatment,” he stated. Unfortunately, none of these ideas will become solutions as long as the city continues to pay for and permit the widespread distribution of drug paraphernalia.
A needle exchange should be just that — turn in your used needles and get a one-for-one swap. Make drug users come to designated, indoor, city-run facilities where health care and recovery professionals are present — and stop distributing smoking supplies altogether. While there is still solid evidence that not sharing needles prevents diseases, I’m not buying the harm reduction industry’s weak excuses for handing out pipes and foil. You don’t see these paraphernalia concierge services in other Bay Area cities, and consequently you don’t see the open-air drug markets, drug tourists in the fentanyl fold, or daily body bags wheeled into medical examiner vans, either.
It’s past time for Lurie to stop talking and get tough. That includes arresting and prosecuting drug users who have committed other crimes to pay for their habits and supporting harsher penalties for drug dealers, including prison and deportation. If Lurie doesn’t get tough and residents don’t see results, he is three State of the City addresses away from being a one-term mayor.