San Francisco, CA
San Francisco buys vodka shots for homeless alcoholics in taxpayer-funded program
The City of San Francisco is providing free beer and vodka shots to homeless alcoholics at taxpayer expense under a little-known pilot program.
The “Managed Alcohol Program” operated by San Francisco’s Department of Public Health serves regimented doses of alcohol to voluntary participants with alcohol addiction in an effort to keep the homeless off the streets and relieve the city’s emergency services. Experts say the program can save or extend lives, but critics wonder if the government would be better off funding treatment and sobriety programs instead.
“Established in countries such as Canada and Australia, a managed alcohol program is usually administered by a nurse and trained support staff in a facility such as a homeless shelter or a transitional or permanent home, and is one method to minimize harm for those with alcohol use disorder,” the California Health Care Foundation explains in an 2020 article describing the pilot program.
“By prescribing limited quantities of alcohol, the model aims to prevent potentially life-threatening effects of alcohol withdrawal, such as seizures and injuries.”
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A man pours liquor from a small bottle into a glass in the evening. San Francisco has funded a pilot managed alcohol program to provide free beer and vodka shots to homeless people with severe alcoholism. (Soeren Stache/picture alliance via Getty Images)
The San Francisco managed alcohol program, or MAP, was established during the COVID-19 pandemic to prevent vulnerable homeless people who were placed in isolation in hotel rooms from suffering from alcohol withdrawal. But the program, which started with 10 beds, has since been expanded into a 20-bed program that operates out of a former hotel in Tenderloin with a $5 million annual budget, the San Francisco Chronicle reported.
Alice Moughamian, the Nurse Manger of the Managed Alcohol Program and the San Francisco Sobering Center, explained in an October presentation that nurses provide clients with a motel room, three meals a day, and enough alcohol “to meet their addiction needs, but keeping someone at a safe level of intoxication.”
Initial success in stabilizing alcoholic patients prompted health officials to expand the pilot into a long-term program with 10 beds earmarked for “the Latinx and indigenous population,” while 12 additional beds are supported at the city’s traditional sobering center, Moughamian said.
Bryce Bridge, a social worker involved with the program, said during the presentation that once a client is identified as having alcohol abuse problems and admitted, they are assessed to determine individual needs. Clients are connected to a primary care doctor, provided resources to secure government identification if they lack a social security card or other documents and assisted with psychiatric care, wellness activities on site and other evidence-based treatments.
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A homeless encampment is seen in the Tenderloin District of San Francisco, California, United States on June 6, 2023. (Tayfun Coskun/Anadolu Agency via Getty Images)
“We actually connect them to different community-based organizations that assist us with conducting art groups, and poetry groups and just kind of help them explore ways that they can express themselves,” Bridge said.
Bridge also said marijuana use is “fairly common in our sites” and said there is no policy prohibiting marijuana consumption, though health providers monitor that activity to prevent ill health effects or interpersonal conflicts.
While relatively unknown until now, the program is under fresh scrutiny after Adam Nathan, CEO of an AI company and chair of the Salvation Army San Francisco, made several social media posts criticizing what he witnessed at the location.
“Inside the lobby, they had a kegs [sic] set up to taps where they were basically giving out free beer to the homeless who’ve been identified with AUD (Alcohol Use Disorder),” Nathan wrote on X after visiting the hotel in Tenderloin where homeless alcoholics are served.
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San Francisco’s managed alcohol program is run out of an old hotel on Eddy Street in Tenderloin. (Google Maps)
“It’s set up so people in the program just walk in and grab a beer, and then another one. All day,” he claimed.
“The whole thing is very odd to me and just doesn’t feel right. Providing free drugs to drug addicts doesn’t solve their problems. It just stretches them out. Where’s the recovery in all this?” he asked.
The Salvation Army promotes abstinence for alcoholics and provides free adult rehabilitation programs.
Public health officials called some of Nathan’s claims misleading. In a statement to the San Francisco Chronicle, the health department said alcohol is dispensed by a nurse and homeless people who aren’t participating can’t just walk in to the facility and get a free beer. The program operates in a former Tenderloin tourist hotel that has a bar, but on-site taps are “inoperable and unused,” the statement reportedly said.
Still, the program has also received criticism from none other than San Francisco Mayor London Breed, who said in February that harm reduction was “not reducing harm” but “making things far worse.”
San Francisco mayor London Breed has criticized harm prevention programs that provide addictive substances to substance abusers. (KTVU)
“Are we just going to manage people’s addictions with our taxpayer dollars in perpetuity forever? It seems like that’s basically what we’re saying,” said Tom Wolf, who is in recovery for heroin addiction, in a statement to the Chronicle. “I think we should be spending that money on detox and recovery.”
But recovery is not the point, according to Moughamian.
“Our goal at MAP is not to decrease the amount of alcohol that is consumed, or to taper someone towards abstinence, although both of these things have happened with clients in our program,” she said in the October presentation. “The goal is to mitigate the many health, legal and interpersonal harms associated with unsafe alcohol use.”
San Francisco health officials say the program has saved $1.7 million over six months in reduced hospital visits and police calls made by participants who previously heavily relied on emergency services. Officials said that after clients entered the program, visits to the city’s sobering center dropped 92%, emergency room visits declined more than 70%, and EMS calls and hospital visits were both cut in half, the Chronicle reported.
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City officials have previously said that just five residents who struggled with alcohol addiction had cost the city more than $4 million in ambulance transports over a five-year period, with as many as 2,000 ambulance transports during that time, according to the Chronicle.
The San Francisco Fire Department has spoken positively about the program, telling the outlet the managed alcohol program “has proven to be an incredibly impactful intervention” at reducing emergency service use for a “small but highly vulnerable population.”
Other countries, including Canada, Portugal and the U.K. have adopted managed alcohol programs at a much faster pace than the U.S. Canada has more than 40 such programs, according to the University of Victoria’s Canadian Institute for Substance Use Research.
A 2022 study of Canada’s managed alcohol programs found that homeless people suffering from severe alcoholism had a reduced risk of death and fewer hospital stays after participating.
It’s been nearly 300 days since Mayor Daniel Lurie announced a plan to clean up the 16th Street BART Plaza.
To mark the occasion, Mission Local is adding a new tool for tracking his promises: A dashboard, updated daily, that notes the arrests and citations issued by San Francisco police officers in a 300-meter radius around 16th and Mission streets.
Our dashboard uses daily incident reports filed by officers to track the enforcement of common violations, including drug-related offenses or disorderly conduct.
The San Francisco Police Department releases incident reports with a 24-hour lag. Our dashboard updates daily at noon to include the most current data: Arrests and citations issued the day before.
While the number of incident reports may form the basis of official crime statistics, it would be wrong to think of them as the “official” count, according to the SFPD. There are groups doing outreach work in the plazas, like Ahsing Solutions, that do not regularly release public data quantifying their activities, for example.
What this police data does show, over time, is where the police department is focusing resources and attention.
For example, reports show that in March 2025, after Lurie stated his intention to crack down around 16th and Mission streets, there was a massive spike in arrests and citations. This does not necessarily mean drug-related crimes increased in the vicinity, but simply that, spurred by the mayor’s statement, police officers began enforcing more proactively.
Use our interactive graphics to explore the number and reasons for arrests and citations issued, and keep tabs on trends in SFPD’s enforcement around the 16th Street BART plaza.
You can read our ongoing coverage of the crackdown on 16th Street plaza here.
Arrests and citations issued in last 6 months around 16th and Mission
You can access our archive, with arrests and citations data from 2018, here.
The calendar below shows a snapshot of the arrests and citations issued around a 300-meter radius of the 16th Street BART Plaza for the last six months.
The darker the date, the more arrests and citations took place that day.
The department continuously updates the status of incident reports as they are investigated, and it is possible that the official statistics reported by SFPD to the California Department of Justice may differ from our numbers.
The data below should be considered the most accurate moment-in-time representation of arrests and citations on the day they were filed. Hover over each date to see the reasons for each arrest or citation.
Drug incidents around 16th and Mission
Arrests and citations issued for drug-related offenses skyrocketed earlier this year, after Mayor Lurie made the plaza one of his targets to show how the city can make a difference.
Explore the number of drug-related arrests and citations issued by SFPD around 16th and Mission each month since 2018.
Data for the most recent month will always be incomplete (and consequently lower) because it includes only arrests and citations through yesterday, while previous months reflect full monthly totals.
Drug incidents at 16th and Mission vs. citywide
In most years, the area around 16th and Mission accounts for a majority of the Mission’s drug-related police enforcement.
In the spring of 2025, this area, which accounts for a mere 0.2 percent of the city’s geographical landmass, was responsible for nearly 27 percent of San Francisco’s drug incident reports that resulted in an arrest or citation.
During the pandemic, drug-related arrests and citations dropped to an all-time-low around 16th and Mission but it has recently surpassed pre-pandemic levels.
Most common incidents around 16th and Mission
The table below shows the top 15 offense categories at 16th and Mission, ranked by total number of arrests and citations, over the past 12 months. The sparkline — the small line chart — shows how each category has changed month to month, and the percentage compares the current year to the year before.
We use a rolling 12-month window (365 days from yesterday’s date), rather than a calendar year, so the data stays current. Because the dashboard updates daily, the most recent month will always be incomplete, but using a full year of data minimizes the impact of any one partial month on the overall totals.
More than a dozen people were injured when a cable car in San Francisco came to a screeching halt on Monday afternoon, rattling passengers inside, according to authorities.
A total of 15 people suffered minor to moderate injuries after the cable car abruptly stopped without warning and tossed around those onboard, the San Francisco Fire Department said on social media.
Two people were taken to the hospital with moderate injuries, 11 others were hospitalized with “minor aches and pains,” and two people refused assistance at the scene, authorities said.
Fire officials told ABC7 that an object might have been thrown at the cable car, causing the abrupt stop. Authorities have not officially released information on what led up to the incident.
Some of the cable car’s windows were completely shattered, according to photos of the aftermath. Video posted by fire officials also captured several ambulances crowded around the stopped cable car.
“Safety for our passengers on all Muni vehicles continues to be our top priority. We’ll be conducting a full review of incident details to ensure continued safety on the cable cars,” SFMTA said in a statement.
Cable cars first began running in San Francisco in the 1870s, and became designated as a National Historic Landmark in the 1960s.
Passengers on the famed tourist attractions do not wear seat belts and often hang off the cars, which are partially open-air.
The SFFD and the SFMTA will investigate the incident.
With Post wires
Here is a list of events this week.
- Monday/tonight! Introduction to E-Bikes. This is a San Francisco Bicycle Coalition, SFMTA/SFCTA-sponsored virtual class. Monday/tonight, December 15, 6-7 p.m. Register for Zoom link.
- Tuesday Bike It Forward Community Repair Night. Join the San Francisco Bicycle Coalition as they rehabilitate donated and abandoned bicycles and get them to folks who need them. Tuesday, December 16, 5-7 p.m. San Francisco Bicycle Coalition, 1720 Market Street, S.F.
- Wednesday Car-Free Happy Hour. This event is open to everyone, whether they’re car free, car light, car-free curious, or they just want to hang out with fellow urbanists. Wednesday, December 17, 5:30-7 p.m. Cornerstone Berkeley, 2367 Shattuck Avenue, Berkeley.
- Thursday Vision Zero Committee Meeting. This committee supports the work of improving street safety in San Francisco. Thursday, December 18, 1 p.m. Union Square Conference Room, Floor 7, SFMTA Headquarters, 1 South Van Ness Avenue, S.F.
- Thursday Transform Happy Hour with the New Executive Director. Come meet Transform’s new leadership, mingle with like-minded folks, and give your input for Transform’s next chapter. Thursday, December 18, 5:30-8 p.m. Line 51 Brewing Company, 303 Castro Street, Oakland.
- Friday Alameda Holiday Lights Ride and Christmas Caroling. Ride to see the holiday lights in Alameda. Friday, December 19, 6:30 p.m. meet, 7 p.m. roll out. Finishes at 10 p.m. MacArthur BART, 555 40th Street, Oakland.
Got an event we should know about? Drop us a line.
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