<\/p>\n
Corey Sylvester walks past the names of people who lost their lives to addiction\u00a0outside San Francisco City Hall in 2023. More than 580 people died of a drug overdose in San Francisco from September 2024 to August 2025.<\/p>\n
Gabrielle Lurie\/The Chronicle<\/p>\n
San Francisco now has the second-highest rate of\u00a0fatal overdoses<\/a> among large county-level U.S. jurisdictions, according to the latest reliable federal data.<\/p>\n More than 580 people died of a drug overdose in San Francisco from September 2024 to August 2025, according to data from the U.S. Centers for Disease Control and Prevention. That meant San Francisco saw 70 deaths per 100,000 residents during that 12-month period, more than three times the national rate of 20.<\/p>\n Only the city of Baltimore<\/a>, one of the epicenters of the country\u2019s overdose crisis, had a higher rate: Out of every 100,000 residents, nearly 110 people died during that yearlong period.<\/p>\n Article continues below this ad<\/p>\n The CDC\u2019s data is based on preliminary reports from counties and cities not part of any county. The Chronicle\u2019s analysis did not include more recent data, which tends to undercount deaths due to delays in reporting.<\/p>\n It\u2019s not that San Francisco\u2019s overdose crisis is getting worse. In fact, overdose deaths are down<\/a> from their mid-pandemic peak in San Francisco and most of the U.S. Data from the San Francisco medical examiner\u2019s office<\/a>, which provides more comprehensive local reports than the CDC, shows that 624 people died from accidental fatal overdoses last year, down slightly from 635 in 2024. Preliminary data from this year indicates that fatalities may be on track to decline again.<\/p>\n San Francisco Chronicle Logo<\/p>\n Make us a Preferred Source to get more of our news when you search.<\/p>\n <\/p>\n Add Preferred Source<\/p>\n <\/a><\/p>\n But San Francisco\u2019s overdose death rate remains far higher than it was before the pandemic. By comparison, other hard-hit counties like Philadelphia<\/a> experienced much starker improvements last year.<\/p>\n Article continues below this ad<\/p>\n To take another example, Davidson County, which includes Nashville, had an overdose rate of nearly 100 per 100,000 residents in the 12-month period ending August 2022, giving it the second-highest rate of any jurisdiction with at least 500,000 people. By the same period ending in 2025, Davidson County\u2019s rate had dropped to 56.<\/p>\n San Francisco\u2019s rate, which surged to a record high of 90 in 2023, also declined \u2014 but only to 70.<\/p>\n The slower rate of improvement in San Francisco is part of a regional difference, experts say. Cities and counties on the East Coast and Appalachia, which were the first to see\u00a0fentanyl gain dominance in the illicit drug supply, have seen the steepest drops in deaths, while areas in the West have seen more moderate declines.<\/p>\n San Francisco, Portland and other West Coast cities will likely see deaths drop more quickly in the future, said Brendan Saloner, an addiction researcher at Brown University.<\/p>\n Article continues below this ad<\/p>\n \u201cUnfortunately, the change is happening too slow, slower than we\u2019d hope,\u201d he added.<\/p>\n Researchers have offered a variety of theories<\/a> as to why overdose deaths have dropped nationwide. Some have pointed to increased awareness about the hyper-potent opioid fentanyl, as well as harm reduction initiatives, such as growing access to the overdose reversal drug naloxone.<\/p>\n Others, including Saloner, believe that the supply of fentanyl has dried up<\/a> as countries continue to target the illicit drug trade, forcing dealers to sell less of the opioid or mix it with less lethal \u2014 but still highly dangerous<\/a> \u2014 alternatives. Some of those adulterants, such as xylazine and medetomidine, are already creating new challenges<\/a> for addiction specialists in Philadelphia.<\/p>\n Keith Humphreys, a professor of psychiatry who studies addiction at Stanford University, suggested a bleaker theory: Many of the people on the East Coast who were most vulnerable to a fentanyl overdose have already died. Those who have survived may have simply built up a tolerance to the most potent opioids, he added.<\/p>\n Article continues below this ad<\/p>\n Humphreys acknowledged that there\u2019s little city and county leaders can do about the drug trade. He supports policies that provide sober housing<\/a> for people seeking addiction treatment, as well as San Francisco Mayor Daniel Lurie\u2019s RESET Center, which will allow police to bring drug and alcohol users to a pilot facility. They\u2019ll only be allowed to leave once staff determine they\u2019re sober enough, an approach which has drawn some concerns<\/a> about the program\u2019s legality.<\/p>\n \u201cFew people will just spontaneously seek health,\u201d Humphreys said. \u201cOften there needs to be pressure in addiction, unlike depression or cancer, or something that feels objectively awful all the time.\u201d<\/p>\n Saloner said that while San Francisco has a decent safety net, it\u2019s struggled<\/a> to provide comprehensive treatment services to everyone who wants it. And he worries that if the Trump administration slashes<\/a> health care funding, it\u2019ll be even harder.<\/p>\n \u201cNo matter what happens with county and city policy, if the federal government creates a very hostile environment, that\u2019s going to have a lot of repercussions,\u201d he said. \u201cI have this pit in my stomach.\u201d<\/p>\n Article continues below this ad<\/p>\n","protected":false},"excerpt":{"rendered":"Corey Sylvester walks past the names of people who lost their lives to addiction\u00a0outside San Francisco City Hall…\n","protected":false},"author":2,"featured_media":272585,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[30],"tags":[1279,1570,13242,101,103,102,104,106,105],"class_list":["post-272584","post","type-post","status-publish","format-standard","has-post-thumbnail","category-san-francisco","tag-data","tag-health","tag-opioid-epidemic","tag-san-francisco","tag-san-francisco-headlines","tag-san-francisco-news","tag-sf","tag-sf-headlines","tag-sf-news"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/posts\/272584","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/comments?post=272584"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/posts\/272584\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/media\/272585"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/media?parent=272584"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/categories?post=272584"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/tags?post=272584"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}