San Francisco’s accidental overdose deaths in 2025 fell 23.3% since the fentanyl crisis peaked, to the lowest level in at least five years, officials said.
A preliminary report by the Office of the Chief Medical Examiner showed 621 fatal accidental overdose cases in 2025, down from a high of 810 in 2023. It was the lowest number since 2020.
“Two years ago, more than 800 people died from overdose in San Francisco, every single one a tragedy,” Mayor Daniel Lurie said in a statement. “I ran for mayor to fix that, and we are finally moving in the right direction as a city with the lowest number of overdose deaths since the fentanyl crisis hit — but we have so much more work to do.”
Lurie’s “Fentanyl State of Emergency Ordinance” helped accelerate the opening of beds for addiction and mental health treatment and the approval of contracts for organizations aimed at providing substance abuse treatment.
He also shifted the city’s harm reduction strategies through his “Breaking the Cycle” plan by limiting the distribution of drug use supplies.
“We made San Francisco a recovery-first city, opened a crisis stabilization center, reimagined street outreach, and opened 600 new treatment-focused beds so people on the streets can get inside and get help,” Lurie said.
Lurie recently announced plans to open a Rapid Enforcement, Support, Evaluation, and Triage or RESET Center to get drug users off the street in the city.
The center will open this spring at 444 Sixth St. in the city’s South of Market neighborhood.
The center is intended to serve as an alternative to jail or hospitalization for individuals arrested for public intoxication. Crisis care company Connections Health Solutions will provide care at the center and connect these individuals with appropriate treatments. When they can care for themselves, they will be eligible for release from the center.
The San Francisco Sheriff’s Office and the city’s Department of Public Health will oversee the center’s operation.