‘I’m Matt.’ For Some Politicians, Addiction Battles Drive Policymaking.

Around a long wooden table at San Francisco City Hall, nine people battling drug addiction swapped news on a recent Friday.

One woman got a new job for a tax preparation firm and said she hoped staying busy would distract her from her alcohol cravings. A man said his mother was dying and he was glad he could be there for her, cleareyed. Another was effusive about a promising first date.

One middle-aged man, in a finely tailored blue suit with a pocket square, then took a turn.

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

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

In past generations, prominent leaders with addiction problems rarely opened up about their drug abuse and sometimes went to great lengths to hide their personal challenges. But Mr. Dorsey and other politicians have increasingly embraced frankness as an important 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, homicides and car crashes combined. Others say that society has become more tolerant of people with personal struggles, which has made it easier to open up about drug addiction and mental health challenges.

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

In Washington State, Debra Lekanoff, a state representative, came forward about 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, Ore., another city coping with a drug overdose crisis, three men in recovery are running for City Council seats in November. They’re calling for more funding for sobering centers where people can safely come down from their highs, as well as more residential treatment facilities and abstinence-based housing.

Mike Marshall, one of the Portland candidates, has battled addictions to methamphetamines and alcohol. He said that the principles of Alcoholics Anonymous governed the recovery community for many years — especially the organization’s emphasis on privacy. But that has started to change, 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 more common for people to open up about their mental health struggles.

“The recovery community is nascent. We’re new,” said Mr. Marshall, the director of Oregon Recovers, a statewide group that aims to improve treatment options. “But there’s this idea of being out and proud about when it comes to recovery.”

If that language sounds familiar, it is because some people in the recovery movement have borrowed concepts that were successful for the L.G.B.T.Q. community decades ago. Mr. Dorsey, a gay man, sits at the same desk in the San Francisco board chambers that the gay rights leader Harvey Milk occupied in the late 1970s before being assassinated by a colleague at City Hall.

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

San Francisco’s leaders agree they must tackle the city’s devastating drug crisis that kills an average of two people a day, but they have not found much consensus. Some favor harm reduction strategies, which accept that people are going to use drugs and aim to protect them through wide distribution of Narcan to reverse overdoses and clean drug paraphernalia to prevent the spread of hepatitis C and H.I.V.

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

He is backing a measure on the Tuesday 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 enter treatment to continue receiving benefits.

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

People in recovery are split on the measure, however. Opponents include Gary McCoy, who worked as a political aide for a host of San Francisco politicians, including Representative Nancy Pelosi. He revealed in 2021 that he had nearly died from a meth addiction, was homeless and cycled in and out of jail. He has been sober for 13 years.

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

“Pushing a recovery first, abstinence-only approach only works for a small amount of people,” Mr. McCoy said, adding that many drug users have tried treatment programs numerous times and relapsed. Forcing them into another attempt likely will not 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 could drink socially without struggling with addiction.

He, on the other hand, 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 he began dabbling in party drugs that were popular in the gay community in San Francisco in his 30s.

“Crystal meth, GHB, ecstasy, Xanax to come down,” he said, noting he tried to be a “weekend warrior” who could sober up by Monday morning, but it did not work.

When he was the longtime spokesman for the San Francisco city attorney and a political consultant, he was open about being gay and H.I.V. positive but did not disclose his drug addiction.

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

But he relapsed during the pandemic lockdown, explaining that he gave into drugs to assuage his feelings of boredom and loneliness when he was isolated. He recalls that his brain felt foggy during his relapse and that he saw work emails in his sent folder that he had no memory of writing. He entered treatment again, missing work for two months. 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 Board of Supervisors seat in his district became open in 2022, he asked Mayor London Breed to appoint him. He told her that he had been sober for only 18 months but that he had rare insight into how to combat the drug crisis in San Francisco. She agreed, calling him “uniquely positioned” to understand San Francisco’s challenges and the impacts of city decisions on residents addicted to drugs.

As a supervisor, Mr. Dorsey has proposed more policing outside treatment facilities so that people seeking recovery would not have to push through drug dealers. He also has proposed making it easier to deport undocumented immigrants accused of dealing fentanyl. Neither idea advanced in the face of progressive opponents who accused him ofcontinuing the “war on drugs.”

Mr. Dorsey has many meetings at City Hall, 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, also has battled a crystal meth addiction — and had relapsed.

His partner is now living in a residential treatment facility 30 miles south of the city and can communicate with Mr. Dorsey only through handwritten letters.

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

But he said that others in recovery were giving him the support he needed. Whatever happened, he said, he would be OK.

“It’s helping me stay sane,” he said. “I’m grateful.”