It’s now almost a foregone conclusion that 2023 will be the deadliest year on record for San Francisco overdoses, as a brief decline in accidental overdoses in SF has unfortunately reversed with 71 overdose deaths recorded in the month of July.

The San Francisco fentanyl scourge has had local health officials worried that 2023 could be the deadliest year on record for accidental overdoses. But there had been a decline in overdose deaths in the month of June, giving some hope that there was something we were doing right from a law enforcement or public health perspective.

That optimism should now be dismissed. The Chronicle reports that overdose deaths surged to 71 in July, a 31.5% increase in the number of such deaths we saw in June (54). That’s more in line with the month of May 2023, when 74 overdose deaths were recorded, the largest number since the Department of Public Health started recording overdose deaths by month and by drug type in 2020.  

But annual numbers go back at least to 2017, and 2023 is shaping up to be the deadliest overdose year on record, with currently 473 accidental overdose deaths. That’s on pace to easily surpass 2020, when SF saw 725 overdose deaths, as at our current pace we would see 811 overdose deaths in 2023.  

And of these overdose deaths, the Office of the Medical Examiner estimates that 80% of these are fentanyl-related. And this comes at a time when new potentially more deadly drugs are making their way into the supply, including the veterinary tranquilizer “tranq,” overdoses from which can not be treated with Narcan.

“It pains me to share that this is the highest overdose deaths San Francisco has experienced,” SF Public Health Director Dr. Grant Colfax said at a Tuesday press conference, according to KRON4. “And it correlates with this overtake of fentanyl into our drug supply.”


"Fentanyl has become cheaper, more potent and more available," he added, per KGO.

Public health officials are trying to bolster distribution of the overdose-reversing nasal spray Narcan, but that tactic alone doesn’t seem to be leading to a decline in deaths. There was initially some optimism that the state deployment of California Highway Patrol, state National Guard, and SF Sheriff's Department deputies would stem the fentanyl trade, but the numbers have gone the wrong direction since their deployment. And recalling the district attorney certainly hasn’t put any dent in the fentanyl trade, or in dealers’ behavior.

The Chronicle points out that the increase in overdoses also correlates with the closure of the Tenderloin Center, which allowed supervised and safe drug use. But supervised drug use draws the ire of state and federal governments, which is why the new “wellness hubs” plan has found itself stalled — with the mayor's office wary of legal backlash.

“With regard to safe consumption, we need to be real that the legal barriers continue to impede our progress in moving that forward through the government side because we know legally the city would take undue risk that’s currently unacceptable,” Colfax added on Tuesday. “So we look to our state and federal partners for those guidelines.”

Related: San Francisco On Track To Hit Grim Record of Most Accidental Overdose Deaths This Year [SFist]

Image: @SFPD via Twitter