What does “recovery first” actually mean, and why does it matter?
A reflection from our Recovery Reimagined Circle Talks with Matt Dorsey and Jo-Hanna Ivers, Phd.
Some help is built to keep people alive but not to help them get well. Staying alive matters, more than anything. But when that becomes the whole goal, something quietly drops out of the picture: the hope that we can actually get well, and that recovery is worth building toward.
That missing belief is exactly what a piece of San Francisco legislation called the recovery first ordinance set out to restore. We want to spend some time with it here, because it puts words to something a lot of us have felt for years without quite being able to name.
A policy north star
The recovery first ordinance was authored by San Francisco Supervisor Matt Dorsey, who is himself a person in long-term recovery. He has described the law plainly: it makes long-term recovery the official goal of the city's entire approach to substance use. The primary aim of drug policy in San Francisco becomes a healthy, self-directed life free of illicit drug use.
Matt borrowed the shape of the idea from an older San Francisco policy called transit first, which committed the city to developing in a way that encouraged people to use public transit. Recovery first does the same thing for drug policy. It sets a single direction that every city department is meant to point toward, so that all the separate pieces of the response share one common goal: helping people get off drugs and stay off, when that is what they want.
Why naming it changes things
It would be easy to read a law like this and think, it is just words. Matt would partly agree. He has said the ordinance does not have much in the way of legal teeth. But he has also said its real force is the effect it has on how a whole city thinks and acts. Once recovery is the stated goal, everyone working in the system knows what they are working toward. That shared understanding is not nothing. It is the difference between a response that quietly assumes people cannot change and one that is built around the belief that they can.
One line of his has stayed with us. He said that when San Francisco's drug policy aligns with what any of us would wish for a loved one struggling with addiction, then the city will have a drug policy worthy of its name. That is the whole idea in a sentence. Most of us, if someone we loved were in the grip of addiction, would want every door to recovery held wide open for them. Recovery first is an attempt to make public policy match that private, human wish.
The part the system tends to miss
There is one more thread in this that we don't want to lose, because it is one we know firsthand. Matt made the case that people in recovery are not just the recipients of all this. We are one of the strongest resources a city has for solving the crisis in the first place.
The recovery community supports its own. People in recovery show up for each other, sponsor each other, carry each other through the rough patches. Not because anyone pays them to, but because someone once did it for them. Matt called the recovery community a force multiplier, and pointed out that this support costs taxpayers nothing. It is an ethos that runs through 12-step programs, through secular recovery, through recovery dharma, through every recovery path he has encountered. We keep what we have by giving it away.
A policy that ignores that is leaving its best ally on the sidelines. A policy that names recovery as the goal, and then connects people to the community that already knows how to carry one another, is working with the grain of how people actually get well. That, more than any single clause, is why a law like this matters.
From lived experience to legislation
Supervisor Matt Dorsey represents District 6 on the San Francisco Board of Supervisors, an area at the center of one of the most complex drug crises of any city in the Western world. He is, by his own account, one of very few members of the board ever to be publicly out as a person in recovery, and he has spoken openly about his own setbacks along the way, including a relapse in recent years. He authored the recovery first ordinance and continues to carry related legislation on drug-free supportive housing. This conversation was part of Recovery Reimagined's Circle Talks, an occasional open series featuring voices from across the recovery world.
About Matt and Jo-Hanna
Supervisor Matt Dorsey, San Francisco Board of Supervisors (District 6)
A person in long-term recovery and author of the Recovery First ordinance, which made long-term recovery the official goal of San Francisco's drug policy. One of the few members of the board to speak publicly about being in recovery.
More about the Recovery First legislation: Read here
Professor Jo-Hanna Ivers, Trinity College Dublin
Leads the MSc in Addiction Recovery and heads the newly established Addiction Research Network Ireland.
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