As The City set fatal overdose records, US deaths declined

As 2023 marked San Francisco’s deadliest year for drug overdoses on record, newly released federal data showed that last year marked the first time since 2018 that reported overdose deaths declined across the country.

The National Center for Health Statistics said its preliminary data recorded 107,543 overdose deaths in 2023. That figure is down 3% from 2022 when there were 111,029 deaths reported. There were 810 fatal overdoses in San Francisco last year, an increase of about 25% from the 649 recorded deaths in 2022.

More than 80% of San Francisco’s overdose deaths in 2023 were due to fentanyl, but nationally, the new data showed that overdose deaths from opioids declined around 3.7%. Meanwhile, overdoses from other drugs such as cocaine and methamphetamine increased across the country.

So far in 2024, San Francisco is recording overdose deaths at a slightly lower pace than in 2023. While The City has recorded declines in overdose deaths for each of the past two months for which data is available, the 199 preliminary overdose deaths the Office of the Chief Medical Examiner recorded from January through March were only five fewer than the first three months of 2023.

Health-care workers gathered with public-health and community organizations outside the chief medical examiner’s office for a press conference Tuesday to share that there have been 3,026 overdose deaths in The City since January 2020 — more than twice as many COVID-19 deaths recorded in San Francisco during that time .

Speakers pointed to the 2022 closure of the Tenderloin Center , a safe-consumption site where patients used drugs under professional supervision, as a move in the wrong direction. They argued that law-enforcement crackdown’s on public drug consumption last year targeted people of color.

“We are putting people at overdose risk, and it is a policy decision,” said Fabian Fernandez, a medical student at UCSF and a member of the Do No Harm Coalition, a local organization made up of health-care workers.

“Public-health crises need public-health solutions,” Fernandez said. “We need to stop regressive forms of criminalization.”

The San Francisco Department of Public Health told the Examiner in a statement that the national numbers do not reflect regional differences, such as policy and the illicit drug market. Officials said the department is “working tirelessly every day to prevent overdoses, expand access to treatment, and get people on a path to recovery.”

The department cited the outbreak of fentanyl affecting cities on the East Coast before making its way over to the West Coast, and that “some regions of the country may have already seen their peaks, [but] other regions, including others on the West Coast, have not.”

In the meantime, efforts are underway across California to expand access to treatment medications for opioid abuse disorder, with Assembly Bill 2115 — authored by Assemblymember Matt Haney, who represents San Francisco — aiming to allow patients to take home certain dosages of methadone , a commonly used medication to treat opioid withdrawal and cravings.

In San Francisco, Supervisor Matt Dorsey and the Department of Public Health recently introduced legislation that would require pharmacies to carry prescriptions of buprenorphine , another medication used to treat opioid-abuse disorder that’s not subject to as many regulations as methadone.

But it’s unclear whether these efforts will be enough to curb the crisis in San Francisco.

“With a crisis as multi-faceted as today’s overdose crisis, it is generally difficult to identify only one reason why deaths vary from region to region across the country,” the Department of Public Health wrote to The Examiner. “The City has been making changes locally to address the crisis, but San Francisco needs more involvement from the State and Federal governments to help.”