The overdose death count in San Francisco has declined since the height of the pandemic, but we’re still one of the most affected cities in the nation, behind Houston and Philadelphia.

The San Francisco Office of the Chief Medical Examiner (OCME) has been releasing monthly data on drug overdoses, amidst the spike in overdose deaths of the pandemic era. And to better understand these numbers, the Chronicle has been running a series breaking down demographic and geographic data about these overdoses and deaths to better understand the problem.

The latest installment of the Chronicle’s data shows one somewhat encouraging sign; the 501 overdose deaths (thus far) in 2022 show a decline from the two previous years, when we saw 711 deaths in 2020, and 625 in 2022. But the larger and more troubling problem remains that the arrival of fentanyl on the scene has created a new normal where overdose deaths are substantially higher than in 2018 and prior, and may stay that way.

If you think the Oakland area has a worse fentanyl overdose problem than SF, you’d be wrong. The Chron found that San Francisco county has the highest fatal fentanyl overdose rate of any county in California ("Among counties with population of 100,000 or more"). Second place is Sonoma County, and Nevada County is third. Other counties with the highest fatal fentanyl OD rates are Kern, San Luis Obispo, and Riverside Counties, displaying an odd and difficult-to-explain phenomenon where highest rates of fentanyl overdoses are happening in San Francisco, and otherwise largely rural counties.    

In terms of race, SF overdoses are overwhelmingly affecting the Black community. Overdose victims in San Francisco are four times more likely to be Black than white, and nearly seven times more likely to be Black than Latinx.

And how does San Francisco size up nationally? Not well. “San Francisco had the second highest overdose rate in 2020 after Harris County, which contains the city of Houston,” the Chron’s analysis found. “It had the second highest death rate from fentanyl overdose, after Philadelphia.”

Related: 50 People Per Month Have Died of Drug Overdoses In SF This Year, and Most Were Not In the Tenderloin [SFist]

Image: Randy Laybourne via Unsplash