The Tenderloin of today, however, isn't so much about the once-underground gay culture or gambling - but rather about crime, addictions, and drug dealing that spill out well beyond the 50 blocks that make up the district.
50 BLOCKS: Stories from SF's Tenderloin neighborhood
For those who are able to get off the streets of the TL, there is hope.
We want to introduce you to a survivor of Tenderloin, Brad Reiss. After years of addiction and crime, Reiss left the streets and started a nonprofit passing out essentials to people living on the street -- things like socks, hygiene kits, and clean clothes.
Reiss spent a large part of his adult life living in the Tenderloin, but he did manage to escape it eventually. And you're not going to believe what it took.
Getting shot by the police.
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That is what it took to get him off the streets. But is that how bad things have to get to change lives in the Tenderloin?
We hope not.
Earlier this week, we were talking about a video of kids getting off a bus and walking past drug users. Can this neighborhood change? That's the multi-million dollar question.
If you ask Mayor London Breed, she'll say yes. And you don't have to look any farther than to who she appointed to replace District Attorney Chesa Boudin.
Brooke Jenkins has already said she will be hard on drug dealers. But remember, the Tenderloin has been a neighborhood of vice for generations. It's not about crackdowns -- we've had crackdowns before. It's about real meaningful action and getting people help for their substance abuse issues.
Reiss has been clean for 16 and a half years.
And now?
"I'm out here and supplying essentials for the folks that are struggling with their illness," Reiss said.
Before that, he was in and out of jail so many times that "I can't count it, you know, well, over 15 times," Reiss said.
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Matier: So you'd get arrested? You went into jail for going to prison?
Brad Reiss: Correct.
Matier: Did it do any good?
Reiss: I think it did. For me, it did, you know, interrupted the cycle of addiction. And we call it step zero. You know, before you can take a first step. There's gotta be, there's got to be a step zero, which is the end.
Matier: What do we see on the streets today?
Reiss: Well, we see people who can't take care of themselves there.
Matier: What do you see on the streets? Because you come back and help?
Reiss: Yeah, what I see as people suffering, I see people with lots of pain, you know, and as far as the incarceration goes, I know you can't lock up pain for any long periods of time, but some separation from the drug to get them separated to give them an opportunity to do something different, I feel as mandatory.
Matier: But what's changed here on the streets?
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Reiss: What's changed here is that fentanyl is, is industrialized, right? And it's flooded our streets. It's so inexpensive that San Francisco is a hub, and people come over from the Bay Area to basically die here.
Matier: They're buying it and they're dying here, right?
Reiss: Yes.
Matier: And it's going out to the suburbs now?
Reiss: It has been.
Matier: The Tenderloin itself, you know, this 50 block area, you've known it for 17 years, you've known it when you were an addict. You know it now that you're working, and you're back here as volunteer, is this. Some people said it's become a containment zone that the city's just said, if it's going to happen, let it happen here. So it doesn't spread? Is it you think that's real?
Reiss: I think that might be real, but I don't think....but the truth is, is that it is here, and they're trying to contain it here. But if you go to any other neighborhood, some of the other neighborhoods in San Francisco, it spilled over. So we have, we have fentanyl, it's flooded, not just in the Tenderloin itself, the Market. It's the Mission District.
Matier: Do you think the city can change that? What would you do to try to change it and make this back to a place where families and people like those kids across the street can go to school without being escorted?
Reiss: Yeah, I think we need to work together, all the agencies, and I really think that we need to industrialize, you know, the treatment for this addiction that people are suffering from.
Matier: What do you mean, industrialized?
Reiss: Industrialized on a bigger scale. I mean, because everything that's coming here is coming here on a bigger scale. So I think to meet that challenge, we need to industrialize the solution to what the problem is.
Matier: When you were on the streets and using drugs... did you see the number of overdoses that we've seen now?
Reiss: No, nothing like this. Nothing like this.
Matier: What's changed?
Reiss: The synthetic drugs.
Matier: Do you think that this would be allowed in any other neighborhood to this extent in San Francisco?
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Reiss: No, it wouldn't, there wouldn't. Why did they let it happen here? Because it's been going on here. And it's just become, you know, it's become we've normalized it.
Matier: If you had one suggestion, one change you can make to make it better?
Reiss: Well, that would be one change. I think we need to start caring about our people, the people who are suffering, and give them opportunities. That might not be pleasant, at first to them. But I guarantee you, their loved ones are going to feel a little different about - you know - the energies that we spend on trying to save people. This is really, at this point, more about saving people's lives than it is about caring about people's feelings.
Matier: Some people say, right, you have to hit rock bottom. Do you believe that and what was yours?
Reiss: Yes. I think like I said earlier, you know, you've got to get to a step zero before you can take it. You know, it's pretty simplistic. It sounds simplistic in the language use, but it's so much deeper than just the language when did you hit rock bottom, but I hit rock bottom and 9-2-05. I was shot twice by the San Francisco Police Department. And basically, you know, I went to General Hospital to have a shot because I was a criminal. And I was doing things that were against the law in San Francisco. I was selling drugs, you know, another criminal behavior.
Matier: It took you being shot to get off the street? You could have been dead.
Reiss: Correct. I mean, I was killing myself already. I just had a little extra help from the San Francisco PD. You know, so I needed a little extra help and people need a little extra help. And help is not always what you might interpret it as help, but to continually leave people unaddressed in their addiction has not worked, and it will never work.