04/30/2026
Today MADAAD toured San Francisco’s new RESET Center at 444 6th Street.
This is the city’s newest attempt to respond to the fentanyl crisis—an alternative to jail or the ER for people arrested for public intoxication, designed to stabilize them, monitor them, and ideally connect them to treatment. It’s a 24/7 facility, overseen by the Sheriff’s Office with health staff onsite, and run by Connections Health Solutions as part of the Mayor’s “Breaking the Cycle” initiative.
Walking through it, you can see the intention.
It’s clean. Structured. Calm.
Chairs for observation. Intake rooms. Staff presence.
A space that is trying to say: “You matter enough to be cared for.”
And that matters.
For too long, we’ve had people cycling between sidewalks, ERs, and jail cells with no real interruption in the pattern. This is an attempt—finally—to insert something different.
And we are hopeful.
But we would be failing our community if we didn’t say this clearly:
It is not enough.
This is a pilot program, focused only on SOMA—one of the hardest-hit areas in the entire country. It has limited capacity (around two dozen beds), and it is designed primarily as a short-term sobering and stabilization site—not long-term treatment.
What we saw today is a system that can pause the crisis for a few hours…
but not yet one that can break it.
Because the real gap isn’t just getting people off the street for a night.
It’s what happens next.
* Where do they go when they leave?
* How quickly can they access real treatment?
* What happens to those with severe fentanyl addiction who need more than observation?
* And how do we scale something like this when the need is citywide—not just one neighborhood?
We’ve seen versions of this before. Some helped. Some didn’t.
And the difference always comes down to one thing:
Do people actually get connected to meaningful, ongoing care?
That’s the measure. Not intake. Not appearances. Outcomes.
There’s also a harder truth here that people don’t want to talk about:
This model starts with arrest.
People are brought in involuntarily, held until they are sober, then released—hopefully with a connection to services.
That’s a significant shift in San Francisco’s approach. And whether you agree with it or not, we need to be honest about what it is—and whether it truly leads to recovery, or just another version of the same cycle.
So here’s where we land tonight:
We are encouraged.
We are watching closely.
And we are not lowering the bar.
Because our goal is fewer funerals.
Fewer mothers burying their children.
More people actually making it to recovery—and staying there.
RESET is a start.
But if we stop here, we will fall short of the very people this was built to serve.
— MADAAD
