City continues to ramp up overdose prevention efforts in 2023 with the expansion of treatment and availability of the antidote for opioid overdose 
January 18, 2023


Contact: SFDPH Media Desk 


San Francisco, CA – Accidental overdose deaths in San Francisco decreased in 2022, according to preliminary data, marking the second consecutive year that drug mortality rates dropped in the City despite climbing rates across the country, the Department of Public Health (SFDPH) announced Wednesday. 


The preliminary data, which is provided by the Office of the Chief Medical Examiner, indicates that San Francisco recorded 620 accidental drug overdose deaths in the 2022 calendar year, compared to 640 deaths reported in 2021 and 725 in 2020. Black individuals continued to be disproportionately impacted by overdoses. Preliminary data shows that overdose death rates among Blacks are more than five times the citywide rate, on par with 2021. The 2022 data shows a 14 percent decrease from the 2020 number when drug overdose rates were at all-time high in San Francisco, in large part due to the COVID-19 pandemic and the growing presence of the deadly synthetic opioid known as fentanyl. 


“Fentanyl continues to disrupt and destroy lives in our City and while the overdose numbers have gone down, they still remain far too high,” Mayor London Breed said. “San Francisco remains committed to finding innovative solutions to the ongoing opioid crisis while also focusing on the accountability work with our public safety agencies to get drugs off our streets.” 


Fentanyl is the leading driver of drug overdose deaths in the United States, as well as San Francisco. Of the 620 deaths in 2022, 72 percent were attributed to fentanyl. A small amount of fentanyl can be fatal and people who use drugs may be unintentionally exposed to it in other drugs such as heroin, cocaine, and methamphetamine. 


“Fentanyl has had a devastating impact on communities across the country, including San Francisco,” said Dr. Grant Colfax, Director of Health. “We are addressing the crisis head on with a multitude of tactics, including growing our substance use treatment services and programs, expanding access to medication, and hiring more outreach staff to engage even more people suffering on our streets and in our neighborhoods.” 


There were 107,622 drug overdose deaths in the United States in 2021, an increase of nearly 15 percent from the 93,655 estimated in 2020, according to the Centers for Disease Control National Center for Health Statistics. The 2022 estimates have not been made available, but national trends show few signs of the crisis abating. 


Since fentanyl first became prevalent in local drug supplies in 2018, SFDPH has been tackling the crisis from multiple angles. Last year, Mayor Breed and SFDPH created an Office of Overdose Prevention and implemented an Overdose Prevention Plan to coordinate efforts to reduce overdose deaths and mitigate the negative impacts of drug use on individuals and communities.


“The decline in deaths is encouraging and shows that we can save lives with the programs and policies we are implementing in San Francisco,” said Dr. Jeffrey Hom, who oversees the Office of Overdose Prevention. “This is not about a single intervention, but a comprehensive public health approach to save more lives and to reduce the profound racial disparities that exist among those dying of overdoses across the City.” 


Expanding access to substance use health care and life-saving medications, training City employees and partners on how to recognize and respond to overdoses, and opening more overnight treatment spaces are among the tactics that have demonstratively shown to have made an impact in San Francisco. 


SFDPH continues to expand access to treatment and care for substance use citywide. This year, SFDPH will open 70 residential step-down beds to offer recovery-settings for people leaving residential substance use disorder treatment and establish weekend hours at the Behavioral Health Access Center to facilitate entry to residential and other substance use disorder treatment. 


Across the City, more than 3,200 people received buprenorphine treatment for opioid addiction in 2021, a 12 percent increase from the previous year, and 2,700 individuals received methadone. The Office Based Buprenorphine Induction Clinic, located at 1380 Howard St., treated 575 patients with buprenorphine in 2022, a 164 percent increase from the number of patients in 2021.  


In 2021, SFDPH and its community partners distributed more than 33,000 kits of naloxone, the life-saving antidote for opioid overdoses. In 2022, the San Francisco AIDS Foundation, which collaborates with SFDPH in its distribution of the medication, distributed more than 40,000 doses of naloxone alone and reported 5,127 reversals.  Additionally, SFDPH trained more than 2,000 people on how to recognize and respond to an overdose in the last three months of 2022 alone.


SFDPH will also continue to scale up overdose prevention efforts this year by hiring additional overdose prevention staff, increasing its activities in supportive housing facilities in partnership with the Department of Homelessness and Supportive Housing and the DOPE Project, leading naloxone trainings and distribution in collaboration with the Entertainment Commission, and supporting the expansion of treatment for stimulant use disorder.


In 2024, SFDPH will open a new crisis stabilization unit to provide short-term, urgent care for people experiencing a mental health and/or substance use crisis. 


“Every new or expanded program is another opportunity to make an impact on individuals and families affected by the overdose crisis,” said Dr. Hillary Kunins, Director of Behavioral Health Services at SFDPH. “Making sure that we reach people most at need and provide the most effective treatment possible will continue to be a priority for as long as drug-related deaths remain pervasive in our communities.” 


View the Accidental Overdose Report here.