San Francisco has tightened enforcement against street camping and public drug use as Mayor Daniel Lurie pursues what he calls a “services-first” but “accountability-driven” strategy on homelessness. City crews have stepped up encampment removals and police have increased drug-related arrests, while outreach workers direct people to shelter beds and treatment programs. Officials cite visibly cleaner corridors and lower complaint volumes as early signs the campaign is working. Lurie, who took office this year, says the city can “no longer accept the reality of two people dying a day from overdose” after fatal overdoses reached a record 810 in 2023. His administration has curtailed free syringe distribution, closed a supervised-use site in the Tenderloin and is linking new shelter placements to mandatory treatment offers. Advocacy groups and some health experts warn the crackdown risks pushing unhoused residents into more dangerous areas and undermining harm-reduction efforts that have operated in the city for decades. They argue the policy shifts criminalise poverty and overlook the shortage of long-term housing and detox beds. The debate places San Francisco at the centre of a national reassessment of progressive drug and homelessness policies, with other West Coast cities watching whether Lurie’s tougher stance delivers sustained public-health and safety gains.