“I’m Matt.” For some politicians, the fight against addiction is the driving force behind policymaking.

Around a long wooden table in San Francisco City Hall, nine people battling drug addiction exchanged news last Friday.

One woman got a new job at a tax preparation company and said she hoped being busy would distract her from her craving for alcohol. A man said his mother was dying and he was glad he could be there for her with clear eyes. Another was effusive about a promising first date.

A middle-aged man, in a nicely tailored blue suit with a pocket square, then took his turn.

“I’m Matt,” he said. “I work in the building.”

It was Matt Dorsey, a member of the San Francisco Board of Supervisors and a regular participant in the weekly recovery meetings on the second floor. Mr. Dorsey, 59, has struggled with an addiction to crystal meth for a quarter of a century and has been sober for more than three years.

In previous generations, prominent leaders with addiction problems rarely opened up about their substance abuse and sometimes went to great lengths to hide their personal problems. But Mr. Dorsey and other politicians have increasingly embraced candor as a key part of the fight against the fentanyl and methamphetamine epidemics that have ravaged their cities.

Mr. Dorsey called the recovery movement “a sleeping giant” politically and said it has mobilized in San Francisco because of the drug crisis that has killed nearly 3,000 people in the city since 2020 — far more than Covid-19, murders and car accidents together. . Others say society has become more tolerant of people with personal problems, making it easier to open up about drug addiction and mental health issues.

“It is important that people in the early stages of recovery see that there is a better life on the other side,” Mr Dorsey said. “The fact that we are talking about our journeys is empowering.”

In Washington state, state Rep. Debra Lekanoff reported her addiction to opioids and alcohol in January and introduced a package of bills called Heal One Washington, which would fund substance abuse counseling and treatment facilities, including for Native American tribes .

In Portland, Oregon, another city struggling with a drug overdose crisis, three men in recovery are running for city council seats in November. They are calling for more funding for sobering centers where people can safely emerge from their peak, as well as more residential treatment facilities and abstinence-based housing.

Mike Marshall, one of the candidates from Portland, has battled addictions to methamphetamine and alcohol. He said the principles of Alcoholics Anonymous governed the recovery community for years — especially the organization’s emphasis on privacy. But that is changing, partly because more people feel they need to speak out to address the severity of the current drug crisis, and partly because it has become increasingly common for people to speak out openly about their mental health issues.

“The recovery community is on the rise. We are new,” said Mr. Marshall, the director of Oregon Recovers, a statewide group that aims to improve treatment options. “But there is an idea you can be proud of when it comes to recovery.”

If that language sounds familiar, it’s because some people in the recovery movement have adopted concepts that were successful for the LGBTQ community decades ago. Mr. Dorsey, a gay man, sits at the same desk in the San Francisco boardrooms where gay rights leader Harvey Milk lived in the late 1970s before he was assassinated by a colleague at City Hall.

Mr Dorsey was inspired by a call from Mr Milk for every gay person to come out. “I’m not quite done with recovery yet,” Mr. Dorsey said, “but I do think that if people are ready, it can really be meaningful.”

San Francisco’s leaders agree they must tackle the city’s devastating drug crisis, which kills an average of two people a day, but they haven’t found much consensus. Some favor harm reduction strategies that accept that people will use drugs and seek to protect them through the widespread distribution of Narcan to reverse overdoses and the cleanup of drug paraphernalia to prevent the spread of hepatitis C and HIV.

Others say the city needs to be more forceful in steering people to treatment and enforcing laws. Mr Dorsey supports harm reduction programs but says the city should emphasize recovery and increase police numbers to prevent public drug use and trafficking.

He supports a measure on Tuesday’s ballot, Proposition F, that would require welfare recipients suspected of drug use to be screened through a questionnaire and interview process. Those deemed by a professional to have a drug addiction would have to undergo treatment to continue receiving benefits.

Mr. Dorsey, a moderate Democrat who is among the most conservative leaders in liberal San Francisco, said fentanyl is so addictive that it is rare for someone to recover without some form of intervention.

However, people in recovery are divided about the measure. Opponents include Gary McCoy, who worked as a political aide to a host of San Francisco politicians, including Representative Nancy Pelosi. He revealed in 2021 that he almost died from a meth addiction, was homeless and cycled in and out of prison. He has been sober for 13 years.

Like Mr. Dorsey, Mr. McCoy believes it is important for politicians to disclose their addictions if they feel comfortable doing so (he has been mentioned as a possible candidate for the Board of Supervisors in 2026, although he would not confirm this). But he takes a more liberal stance than Mr. Dorsey on how the city should combat the drug crisis, and he works for a nonprofit that advocates for a harm reduction approach. Showing people how to use drugs more safely or guiding them to use less can also be important, he said.

“If we pursue recovery first, an abstinence-only approach only works for a small number of people,” Mr. McCoy said, adding that many drug users have tried treatment programs numerous times and relapsed. Forcing them to try again probably won’t work, he said.

Mr. Dorsey said his addiction began when he was a 14-year-old growing up in a happy middle-class family in western Massachusetts. His family members were able to drink socially without struggling with addiction.

On the other hand, he became a compulsive drinker of beer, wine, bourbon – whatever he could get his hands on. He described himself as an alcoholic and was able to get sober on his own in his 20s, but he said that in his 30s he began experimenting with party drugs that were popular in San Francisco’s gay community.

“Crystal meth, GHB, ecstasy, Xanax are coming,” he said, noting that he tried to be a “weekend warrior” who could get sober on Monday morning, but that didn’t work.

When he was a spokesman for San Francisco’s city attorney and political consultant for many years, he was open about his gay and HIV-positive behavior, but did not disclose his drug addiction.

When he applied to become a spokesman for the San Francisco Police Department in early 2020, he told Police Chief Bill Scott about his addiction to crystal meth. Mr. Dorsey was hired anyway.

But he relapsed during the pandemic lockdown, explaining that he turned to drugs to ease his feelings of boredom and loneliness while isolated. He remembers his brain feeling foggy during his relapse and seeing work emails in his Sent folder that he didn’t remember writing. He re-entered treatment and missed two months of work. So far it has stuck.

Every day he looks at a yellow widget on his iPhone that counts his time in sobriety. Three years. Four months. Twenty-four days.

When a seat on the Board of Supervisors in his district became available in 2022, he asked Mayor London Breed to appoint him. He told her that he had only been sober for 18 months, but that he had rare insight into how to combat San Francisco’s drug crisis. She agreed, calling him “uniquely positioned” to understand San Francisco’s challenges and the impact of city decisions on residents addicted to drugs.

As a supervisor, Mr. Dorsey has proposed more oversight outside of treatment centers so that people seeking recovery don’t have to go through drug dealers. He has also proposed making it easier to deport undocumented immigrants accused of dealing fentanyl. Neither idea emerged in the face of progressive opponents who accused him of perpetuating the “war on drugs.”

Mr. Dorsey has many town hall meetings, but none are more important to him than the Friday afternoon session of LifeRing, a secular, abstinence-based recovery group.

When it was his turn to share his news of the week, he sighed. He told the group that his partner, a 39-year-old man from Brazil, had also had a crystal meth addiction – and had relapsed.

His partner now lives in an assisted living facility 30 miles south of the city and can only communicate with Mr Dorsey through handwritten letters.

“My God, I miss him,” Mr. Dorsey told the group.

But he said others in recovery gave him the support he needed. Whatever happened, he said, he would be fine.

“It helps me stay healthy,” he said. “I am grateful.”