DATE:
November 4, 2025
14
TO:
Board of Supervisors
SUBJECT
Title
ENHANCING HOMELESSNESS SUPPORTS THROUGH EXPANDED WITHDRAWAL MANAGEMENT SERVICE ACCESS (DISTRICTS: ALL)
Body
OVERVIEW
The County of San Diego (County) Health and Human Services Agency (HHSA) and Behavioral Health Services (BHS) are charged with supporting a robust and accessible specialty behavioral health continuum of care throughout the County. This continuum, as it pertains to substance use disorder treatment, includes inpatient and outpatient drug treatment, specialized long-term care, community-based care, crisis diversion, and residential services inclusive of withdrawal management. Withdrawal management services, often referred to as "detox", provide supportive medical care for individuals experiencing withdrawal symptoms as they cease or reduce the usage of addictive substances. These programs include 24-hour, non-medical, residential substance use treatment, recovery, and ancillary services for adults over the age of 18.
Gaps in withdrawal management service capacity exist within the County's continuum of care. This insufficient capacity hinders the County's ability to address ongoing substance use crises, especially among populations experiencing homelessness. There are 102 withdrawal management service beds available for the Medi-Cal population throughout the region, and only four of those beds are located in County District 1, where a significant proportion of individuals experiencing homelessness reside. Gaps in withdrawal management accessibility also contribute to delays in care for thousands of residents with substance use disorders and contribute to more than 27,000 substance use related emergency department visits annually. Additionally, over a third of individuals entering BHS care for a substance use disorder present with a housing need, and data show that engagement in treatment and recovery services increase the likelihood of becoming housed. Expanding these service...
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