We already knew that 2023 would be the deadliest year ever for drug overdoses in SF with nearly a month left to go in the year, but the Medical Examiner’s office now acknowledges we broke the previous record 2020 death toll by nearly 100.

It had frankly already been a foregone conclusion for months that 2023 would be San Francisco's deadliest year ever for fatal drug overdoses, as previous monthly overdose totals had been coming in at record numbers throughout the year. And the grisly milestone became official once November 2023’s overdose numbers came in, surpassing the previous record with a full month to go in the year. But the Chronicle reports today that the final 2023 total of SF fatal drug overdoses was 806, which we already knew would be the city’s highest total ever recorded, fueled largely by the ongoing fentanyl crisis.

The previous record for SF overdose deaths had been 726, recorded in 2020, which was largely a lockdown year. And while those deaths declined in 2021 and 2022, it seems this is probably no longer attributable to COVID-19 isolation.

Per the Chronicle, four out of five of these 806 overdose deaths at least partially involved fentanyl. Those fentanyl overdose deaths usually involved a combination of fentanyl and other drugs, and in many cases, people were using drugs they did not know were laced with the deadly fentanyl. It’s likely also a factor that there are new forms of fentanyl called “tranq” and fluorofentanyl, with tranq being resistant to the overdose reversal medication Narcan.

SF Mayor London Breed has been hyping her fentanyl crackdown, which may be producing more drug arrests, but has also coincided with the overdose death count going higher. So is the crackdown really working? In some ways yes, as the Chronicle also notes that while the crackdown has significantly eliminated the SoMa and Tenderloin daytime drug trade, it has also "shifted it to the nighttime.”

And while the 2022 Tenderloin Linkage Center created some controversy over supervised drug use, it also reversed 300 overdoses. Yet Mayor Breed chose to shut that center down after about a year.  

It’s important to note that fentanyl overdoses are not just a San Francisco problem. While national data is still preliminary, CNN points out that 2023 will also likely be a record year for fatal overdoses across the entire U.S. But obviously, certain localities are struggling with the fentanyl trade more than others.

Related: It’s Official: 2023 Is SF’s Deadliest Year Ever for Drug Overdoses [SFist]

Image: Ambulance from San Francisco Fire Department parked outside a store in San Francisco, California. The photo was taken October third, 2018. (Getty Images)