San Francisco may have turned the corner on its fentanyl overdose crisis, or at least, we saw substantially fewer overdose deaths in 2024 than in the record year of 2023, and 2024 had fewer SF overdose deaths than any year of the last five years.
It was all over the news in the year 2023 that San Francisco was seeing record levels of overdose deaths, fueled largely by the fentanyl crisis. And indeed, we finished the year 2023 with 806 fatal drug overdoses citywide, the largest number of overdose deaths the city has seen in any year. (And that number was revised upward to 810 overdose deaths).
But the SF Department of Public Health’s (DPH’s) monthly updates have been showing drops in those drug overdose death counts, and the drops were apparently not a mirage. Now that we have the final annual numbers, the Examiner reports that SF drug overdoses declined significantly in 2024, with 633 deaths, a 22% reduction compared to last year’s deadly count.
Those 633 deaths are actually the fewest overdose deaths San Francisco has recorded in any year since we’ve been tracking such deaths. Though that is a misleading claim, because the DPH only started tracking fatal overdoses in 2020. So it’s only a five-year sample size, but still, 633 deaths is the fewest in any of those five years — even if the number still seems quite high.
“[The DPH] has transformed the city’s substance use treatment,” outgoing DPH director Dr. Grant Colfax said in a statement to the Examiner. “Treatment saves lives.”
The Chronicle points out that SF’s overdose death reductions track with a similar national decline, so this is not just a San Francisco thing. National data for the year is not yet complete, but the last batch of numbers showed a 17% decline in overdose deaths nationwide compared to SF’s 22% decline from 2023 totals.
The SF DPH says their success comes largely from distributing opioid addiction medication to more than 1,300 unhoused people over the course of 2024. The department says they distributed substantially more methadone and buprenorphine to treat opioid addiction this past year than they had in previous years.
Other experts have suggested that the decline in fentanyl-related deaths may be attributable to a decline in the number of serious fentanyl users on the streets overall. As we discussed in November as these OD figures continued to decline, the population that is most vulnerable to dying from a fentanyl overdose may in fact be shrinking.
"As there’s more death and destruction, people are losing people they know, seeing this incredible damage... It lowers people’s willingness to initiate drug use," said one Stanford addiction researchers, Keith Humphreys, speaking to the Chronicle in November.
So this is progress, though maybe not enough. And new SF Mayor Daniel Lurie is vowing a whole new strategy to combat fentanyl, involving a supposed “state of emergency” declaration, so we’ll see how effective this is, or is not.
“The first thing we talked about was public safety, the second thing was the fentanyl state of emergency, and I’m really honored that I have five [Board of Suervisors] co-sponsors already,” Lurie said at a press conference last week after announcing his ordinance. “We are going to get this passed.”
Related: SF Sees Lowest Number of Overdose Deaths In a Single Month Since 2020 [SFist]
Image: Nobuyuki Kondo via Wikimedia Commons
