Drug overdose deaths plummet in San Francisco. What's changed?

SAN FRANCISCO — After surging during the COVID pandemic into a crushing nationalist wellness emergency, cause overdose deaths successful San Francisco plummeted successful 2024, according to preliminary information compiled by metropolis wellness officials.

The main aesculapian examiner’s bureau recorded 586 fatal overdoses successful San Francisco successful the archetypal 11 months of 2024. That represents a astir 23% decrease, oregon 174 less deaths, compared with the archetypal 11 months of 2023. In total, 810 radical died from cause overdoses successful 2023, the highest fig successful metropolis records.

The improvement mirrors some nationalist and statewide information showing overdose deaths connected the decline. Provisional information from the national Centers for Disease Control and Prevention bespeak a 14.3% decrease successful fatal overdoses crossed California erstwhile comparing the 12 months that ended successful July 2023 with the 12 months that ended successful July 2024. Fatal overdoses fell 16.9% nationwide during that period, according to CDC figures.

Los Angeles County wellness officials person not yet released fatal overdose figures for 2024. But the astir caller information besides showed progress: Deaths from cause overdoses and poisoning plateaued between 2022 and 2023, aft years of historical increases, according to the L.A. County Department of Public Health. In 2023, the region recorded 3,092 fatal overdoses, down somewhat from 3,220 deaths the twelvemonth before.

San Francisco nationalist wellness experts attributed the diminution successful fatal cause usage successful the metropolis to the wide availability of naloxone, a medicine commonly sold nether the marque sanction Narcan that tin rapidly reverse the effects of opioid overdoses, arsenic good arsenic buprenorphine and methadone, medicine medications that dainty opioid addiction long-term.

“We are cautiously optimistic that our nationalist wellness interventions are starting to spot results successful presumption of redeeming lives,” said Dr. Grant Colfax, manager of the San Francisco Department of Public Health.

Methadone prescriptions issued by the wellness section accrued by much than 30% and buprenorphine prescriptions by astir 50% successful the past year, Colfax said. The section precocious partnered with a “night navigator team” that works aft acheronian to connection treatment, including a telehealth program that rapidly connects radical who maltreatment opioids with healthcare providers who tin prescribe medications. The section has logged much than 2,300 calls since the programme launched successful March.

San Francisco has added astir 400 residential attraction beds to 2,200 existing spots successful caller years and tripled the fig of thoroughfare attraction workers successful the past 2 years, according to the nationalist wellness section and Mayor London Breed’s office.

Dr. Christopher Colwell, main of exigency medicine astatine Zuckerberg San Francisco General Hospital and Trauma Center, said helium has seen a notable summation successful the fig of radical unfastened to accepting attraction successful the past year.

“I deliberation a batch of patients are recognizing, much truthful successful the past twelvemonth than I’ve ever seen, however unsafe opioid usage upset is, watching their friends and colleagues die,” Colwell said. “I’ve seen a batch much willingness to astatine slightest person that discussion, and see it, than I did adjacent conscionable a mates years ago.”

Keith Humphreys, a Stanford University psychiatry prof who studies addiction, called the 2024 numbers a “big deal.”

“Both due to the fact that of the lives that are saved, but besides conscionable for the morale of each front-line worker, each harm-reduction worker, each attraction professional, each constabulary serviceman who has been despairing that this is ne'er going to get better,” Humphreys said. “This is simply a large boost.”

San Francisco, similar galore municipality areas, recorded a crisp emergence successful fatal overdoses successful the aboriginal years of the COVID pandemic, erstwhile authorities shutdowns made it much hard to straight code the instauration of fentanyl into the thoroughfare cause scene. For example, San Francisco counted 259 deadly overdoses successful 2018, erstwhile fentanyl archetypal deed the streets, and 441 fatalities successful 2019. A twelvemonth later, arsenic the metropolis efficaciously unopen down to dilatory the dispersed of COVID-19 and it became much hard to bash assemblage outreach, overdose deaths skyrocketed to much than 720.

Humphreys said the pandemic’s wane has besides made it easier to code immoderate of the societal factors underlying addiction.

“Everything astir COVID was unspeakable from a cause viewpoint. You had much reasons to usage drugs: sadness, isolation, bereavement, loneliness,” Humphreys said. “The benignant of structures that assistance radical get and enactment successful recovery, similar work, accountability, regular routines, societal obligations, each went down.”

Breed mislaid her November reelection bid to nonprofit enforcement and Levi Strauss heir Daniel Lurie, a effect wide attributed to elector vexation implicit homelessness and thoroughfare drugs. Still, Breed said the caller diminution successful overdose deaths is simply a testament to her administration’s determination to instrumentality a “harder stance” against illicit cause use, arresting dealers and mandating attraction for immoderate users.

Last March, for example, she sponsored a palmy ballot measurement to necessitate drug screening and treatment for radical receiving region payment benefits who are suspected of illicit cause use.

Colwell said that though past year’s numbers are a affirmative sign, opioid usage remains a superior problem. He stressed the value of adding attraction options specified arsenic buprenorphine and methadone, which are much effectual semipermanent than overdose reversal medications. And though helium appreciates the city’s efforts to put successful attraction beds and housing, helium said, “I don’t spell a time wherever I don’t consciousness similar we request more.”

He and different experts said it is important that the metropolis and Lurie proceed investing successful solutions, adjacent arsenic San Francisco faces a projected $876-million fund shortfall. Lurie has pledged to state a fentanyl emergency erstwhile helium takes bureau Jan. 8 and to “get tough” connected cause dealers.

“We’ve seen what tin beryllium helpful,” Colwell said, “and we request to support doing this.”