SF overdose deaths decline amid new push to expand treatment access

Fatal drug overdoses in San Francisco declined for the second time in three months this year, according to preliminary data released by the Office of the Chief Medical Examiner on Wednesday .

The City recorded 56 overdose deaths in April, down from 68 in March, 63 in February and 71 in January. Officials last month had tallied 66 deaths in February and 61 in March. It also represented a decline from the 71 deaths reported in April 2023, the year in which San Francisco recorded more overdose deaths than any other since officials began collecting data.

At this time last year, there were 275 deaths by April. In 2024, there have been 258.

The decline in San Francisco comes after national data published last week showed that 2023 saw the United States’ first decline in overdose deaths since 2018 while The City was suffering a record 810 deaths.

“While some regions of the country may have already seen their peaks in fentanyl overdose stats, other regions, potentially including the West Coast, may have not,” said Dr. Grant Colfax, director of the San Francisco Department of Public Health, on Wednesday. “The important thing to know is that there is an answer to fentanyl dependence, and that is treatment and recovery.”

The news coincides with a new push from local and state officials to expand access to substance use treatment, particularly in easing barriers to treatment medications for opioid-use disorder.

The Department of Public Health announced Tuesday that a new pilot telehealth program operating out of the Tenderloin successfully connected more than 55 people to prescription medication or residential treatment in its first four weeks of operation.

“We have found that when we have combined the evening telehealth with safe and stable shelter where people can start their medication and receive support, they are three times more likely to enter recovery,” said Dr. Joanna Eveland, the chief medical officer for DPH. “Under this pilot, many of the individuals who have committed to starting medication for their frontal-use disorder have been sheltered.”

Launched in March, the night telehealth program aims to address the overdose crisis in The City by making opioid-abuse treatment medication more easily accessible to unhoused residents struggling with addiction.

The pilot is a collaboration between Code Tenderloin, the San Francisco Community Health Center, the San Francisco Department for Homelessness and Supportive Housing, and Five Keys. The City’s Night Navigation street-care team, which is staffed by Code Tenderloin, primarily runs the program.

The team conducts overnight outreach from 7 p.m. to 3 a.m. in the neighborhood to connect people with shelter or other services. If people express interest in receiving treatment for substance-abuse disorders, they’re connected to doctors available from 8 p.m. to midnight through the new telehealth program.

The doctor can prescribe buprenorphine and send it to either a 24-hour pharmacy or another location for a next-day pickup. Patients who choose methadone have to be connected to licensed opioid-treatment programs, such as the Opiate Treatment Outpatient Program at Zuckerberg San Francisco General Hospital and Trauma Center, as methadone is more regulated than buprenorphine .

These medications are commonly used to treat opioid-use disorders, as they are able to help curb cravings and manage withdrawal symptoms.

Along with the prescriptions, people are then provided with places to sleep at the Adante Hotel, a city-run shelter at 610 Geary St. The next morning, they’re connected to case workers and given further medical and other support.

“Since 2020, DPH has been rapidly expanding our system to make drug treatment more accessible than ever and to serve more people in the treatment programs,” Colfax said. “We know from our outreach program that there’s a demand for medications to treat fentanyl addiction at night.”

Public-health officials said there were 173 total telehealth visits and 134 buprenorphine prescriptions, around one-third of which were filled.

“This is actually a high rate of people accepting medication on the street in the middle of the night,” Colfax said. “We actually found that talking to a doctor really made them much more willing to go into treatment and to get the prescription.”

Along with this program, the department and Supervisor Matt Dorsey introduced legislation this month that would require all pharmacies in The City to carry buprenorphine . There’s also a larger effort statewide to make these medications more accessible, such as state Assemblymember Matt Haney’s AB 2115, which would allow patients to take home certain dosages of methadone.