S.F. surpasses deadliest year for drug overdoses. This is the grim toll

Fatal overdoses have risen at especially alarming rates among Latino and Black people, the latest figures show.

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San Francisco has surpassed its deadliest year for accidental drug overdose deaths, a dreaded milestone reached a month before the new year and propelled by the prevalence of fentanyl.

In the first 11 months of 2023, San Francisco recorded 752 deaths, newly released data from the medical examiner’s office indicates. That’s 26 more than the previous peak of 726 deaths in all of 2020. Deaths recorded in December will drive this year’s total higher. 

Accidental overdose deaths have climbed in 2023 despite efforts by Mayor London Breed and Gov. Gavin Newsom to disrupt the drug trafficking market and crack down on dealers. The grim toll highlights the challenging task of reining in a crisis fueled by fentanyl, a synthetic opioid up to 50 times stronger than heroin and a drug that is also sometimes taken in conjunction with other drugs.

“The fentanyl crisis is a national crisis,” said Dr. Hillary Kunins, director of San Francisco’s Behavioral Health Services, during a Thursday news conference at the Department of Public Health. More than 80% of San Francisco’s accidental overdose deaths this year have involved the powerful substance, data shows.

“We are not alone, and I’d characterize our current period with some uncertainty,” Kunins said about whether the city would continue on an upward trajectory of overdose deaths.

In November, the most recent month for which data is available, 57 people died of drug overdoses, down from 65 in October. August was the city’s deadliest month on record, when 87 deaths were recorded, according to the data. The monthly numbers remain preliminary and sometimes increase or decrease slightly with further investigation by the city’s medical examiner.

recent examination of death reports by the Chronicle revealed that a rising number of people who fatally overdose in San Francisco have both fentanyl and a stimulant in their systems — a trend that some researchers are calling a “fourth wave” of the overdose epidemic.

Breed has called for a more “aggressive” approach for people struggling with fentanyl addiction and directed police to arrest more drug users and dealers. Critics have blasted the mayor for shifting toward a heavier reliance on policing to address what they argue is a public health crisis. 

Many of those same critics have pressed the mayor to open a supervised drug-use site in San Francisco — a model used in cities around the world and in New York to prevent overdose deaths — but the mayor is hesitant because it’s illegal under state and federal law. The city’s controversial Tenderloin Linkage Center, which provided such a space, was open for about a year before closing in December 2022.

Jhase D. White, who is living outside in the Tenderloin, said he started smoking fentanyl about two years ago. Since then, he said, he remembers experiencing at least one overdose, which a friend reversed using naloxone, commonly known by its commercial name Narcan. He also was arrested by San Francisco police for open drug use, but that didn’t stop him from using. 

White said he got hooked on opioids following several motorcycle crashes that left him in pain. After losing his job and apartment, he switched from painkillers to fentanyl, he said. 

“Ultimately, I just need a better quality of life and have some inspiration to live healthier,” he said, adding that he’d like to get clean but doesn’t know how. 

Earlier this year, Newsom brought in the California National Guard and state police to partner with San Francisco police to curb fentanyl trafficking downtown. 

In October, the governor and Breed launched a new task force to begin investigating opioid-linked deaths similarly to homicides. Then last month, Newsom proposed a ban on xylazine, a veterinary tranquilizer turned street drug known as “tranq.” Xylazine has contributed to 30 accidental overdose deaths in San Francisco this year, according to the data from the medical examiner.

Fatal overdoses have risen at especially alarming rates among Latino and Black people, the data shows. Between January and November, 140 Hispanic people died from accidental drug overdoses, a 63% increase from the same period in 2022. About 230 Black people died from overdoses during the 2023 period, a 47% jump from 2022. The number of white people who died from overdoses rose 4% between the two periods, from about 270 to 280.

Facing a competitive reelection campaign next year, the mayor placed a measure on the March ballot to mandate drug screenings and treatment for San Francisco welfare recipients struggling with addiction.

Click here to read the full article in the SF Chronicle


  1. S.F. Supervisor Dean Preston states that the drug crises is caused by capitalism.

    71 people died in July in San Francisco from “accidental overdoses” 473 just died. Whats the distinction?
    I’ve read all four articles and no-one has an answer.

    A little history from the “Opium Wars” of the 1840s might
    enlighten a few.

  2. Trump suggests the death penalty for drug dealers. Why not, if they can be linked to deaths from their distribution?

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