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(a) San Francisco’s staggering loss of life due to accidental drug overdoses is a public health calamity unseen in our City since the height of the AIDS crisis, with 2023’s death toll of 811 total overdoses marking, as of then, the deadliest year attributable to illicit drug use in San Francisco history.
(b) As part of its response to this multi-dimensional crisis, San Francisco must find new and innovative ways both to support and enlist the support of its large, diverse, and vibrant recovery community, which has an essential and largely under-leveraged role to play in this crisis, to not merely save more lives but change them for the better.
(c) Although frequently overlooked in the local, state, and national contexts of a new and unprecedented fentanyl-driven drug crisis, alcohol-related afflictions among adults and adolescents remain a leading preventable cause of death nationwide, as well as in San Francisco, lagging only slightly behind tobacco and illegal drugs.
(d) Mutual-help recovery programs, including many modeled on the 12-Step approach pioneered by Alcoholics Anonymous (AA), are the most numerically successful interventions ever devised for recovery from alcoholism and addictions. For example, AA’s global reach was estimated as of 2023 to include some two million members, in more than 118,000 groups, spanning 180 nations. As of 2023, Narcotics Anonymous (NA) boasted more than 70,000 weekly meetings in 144 countries. A multitude of 12-step recovery traditions meet weekly in groups convened throughout San Francisco.
(e) Peer-reviewed research has found Twelve-Step Facilitation (TSF) to be more effective than many other treatments for increasing abstinence from alcohol and addictive substances and reducing intensity of use, with high-quality evidence suggesting that the approach also realizes substantial healthcare cost-savings among those with substance use disorders.
(f) Recent years have also witnessed significant growth in non-12-step, peer-run recovery groups, such as LifeRing Secular Recovery, which has included weekly meetings in San Francisco City Hall; Recovery Dharma, which is based on traditional Buddhist teachings and encourages meditation practices; and SMART Recovery (an acronym for “Self Management and Recovery Training”), which is an evidenced-informed recovery method grounded in Rational Emotive Behavioral Therapy (REBT) and Cognitive Behavioral Therapy (CBT) to support individuals with substance dependencies or problem behaviors.
(g) San Francisco boasts an enormously vibrant and supportive recovery community, with more than 560 weekly AA meetings within the city limits alone, and dozens more meetings, including in-person, online, and hybrid meetings, that span Narcotics Anonymous, Crystal Meth Anonymous, and other 12-step and non-12-step recovery traditions, with many people in recovery benefiting from more than one program. The strength of San Francisco’s recovery community can additionally be found in its longtime support of non-profit facilities open to a multitude of abstinence-based recovery traditions, which include the Dry Dock on Greenwich Street at Fillmore Street in the Cow Hollow neighborhood, and the Castro Country Club on 18th Street at Castro Street.
(h) Abstinence-based recovery from substance- and alcohol-use disorders holds enduring promise exhibited by few other chronic health conditions, according to one meta-analysis of decades of studies, which notes that for individuals who maintain abstinence from addictive substances for four to five years, their “risk of relapse drops below 15 percent, the level of risk that people in the general population have of developing a substance use disorder in their lifetime.” See U.S. Department of Health and Human Services, Office of the Surgeon General, “Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health,” Washington, DC: HHS, November 2016.
(i) Written materials and books are a foundational element in most mutual-help recovery traditions, and there is a compelling societal interest in lowering barriers to access to these resources, both in terms of cost and language access. Animated by this societal interest and the imperative of an unprecedented public health crisis, the Read to Recovery program is a groundbreaking step making San Francisco the first major U.S. city to offer free-to-keep universal access to written materials for programs serving those who seek to recover or maintain recovery from substance-use disorders, alcohol-use disorders, non-substance-related addictive disorders, and their related co-dependencies.
(j) In the General Election of November 8, 2022, more than 82% of San Francisco voters supported Proposition F, which renewed for another 25 years (through June 2048) the Library Preservation Fund, and specifically added authorization for the fund to be used to “acquire books and other materials and equipment.”
(k) Since the soft-launch of a pilot program in April 2023 through February 2024, Read to Recovery has shown great success in a limited rollout, distributing more than 3,000 books in support of San Francisco residents’ recovery journeys.
(Added by Ord. 168-24, File No. 240332, App. 7/12/2024, Eff. 8/12/2024)
For purposes of this Chapter 123A, the following definitions shall apply:
“City Librarian” means the City Librarian or the City Librarian’s designee.
“Library” means the San Francisco Public Library.
“Mutual-Help Program” means a program comprised of a group of people who share a problem, such as a substance-use disorder or non-substance-related addictive disorder, and come together to provide problem-specific help and support to one another. Mutual-Help Programs may include, but are not limited to, Alcoholics Anonymous, Al-Anon, Cocaine Anonymous, Co-Dependents Anonymous, Compulsive Eaters Anonymous, Crystal Meth Anonymous, Gamblers Anonymous, Gaming Addicts Anonymous, Heroin Anonymous, LifeRing Secular Recovery, Narcotics Anonymous, Overeaters Anonymous, Recovery Dharma, Self Management and Recovery Training (SMART Recovery), and Sex and Love Addicts Anonymous.
“Read to Recovery Program” means a program through which the Library provides free-to-keep written materials and books from Mutual-Help Programs for individuals who seek to recover or maintain recovery from substance-use disorders and non-substance-related addictive disorders.
(Added by Ord. 168-24, File No. 240332, App. 7/12/2024, Eff. 8/12/2024)
(a) Program Outline. The Library shall establish the Read to Recovery Program, through which the Library shall make available to the public a wide selection of written materials and books from Mutual-Help Programs for recovery from substance-use disorders and non-substance-related addictive disorders. Written materials and books offered through the Read to Recovery Program shall be available in all languages, as reasonably available to the Library for acquisition and distribution. No Library membership card may be required for an individual to obtain written materials and books offered through the Read to Recovery Program, and such written materials and books shall be free to keep.
(b) Implementation. The Library shall implement the Read to Recovery Program under the direction of the City Librarian, who may adopt rules and regulations that further the purposes of this Chapter 123A
. By no later than July 1, 2025, the Read to Recovery Program shall offer written materials and books at each of its Library branch locations, in addition to the Main Branch of the Library. Acquisition of written materials and books from Mutual-Help Programs shall be within the purview and discretion of the City Librarian. Mention of a specific Mutual-Help Program in this Chapter 123A
does not bind the City Librarian to acquire written materials and books from that organization, nor does failure to mention a Mutual-Help Program in this Chapter 123A
preclude the City Librarian from acquiring written materials and books from such an organization.
(c) Informational Campaign. The Library shall develop an informational campaign to educate the public on the Read to Recovery Program. Such campaign shall include, but need not be limited to, the use of print, online, social media, and public forums, and shall publicize the availability of free-to-keep written materials and books from Mutual-Help Programs. All forms of public notice provided pursuant to this subsection (c) shall comply with the requirements of the Language Access Ordinance, Chapter 91 of the Administrative Code, to provide vital information about the Library’s program in the languages spoken by a Substantial Number of Limited English Speaking Persons, as defined in Chapter 91.
(Added by Ord. 168-24, File No. 240332, App. 7/12/2024, Eff. 8/12/2024)
In enacting and implementing this Chapter 123A, the City is assuming an undertaking only to promote the general welfare. It is not assuming, nor is it imposing on its officers and employees, an obligation for breach of which it is liable in money damages to any person who claims that such breach proximately caused injury.
(Added by Ord. 168-24, File No. 240332, App. 7/12/2024, Eff. 8/12/2024)