{"id":438296,"date":"2026-08-20T11:50:10","date_gmt":"2026-08-20T11:50:10","guid":{"rendered":"https:\/\/www.newsbeep.com\/us-ca\/438296\/"},"modified":"2026-08-20T11:50:10","modified_gmt":"2026-08-20T11:50:10","slug":"is-san-francisco-past-the-worst-of-the-opioid-crisis-public-health","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/us-ca\/438296\/","title":{"rendered":"Is San Francisco past the worst of the opioid crisis? | Public Health"},"content":{"rendered":"

Francisco Vargas said he first came across fentanyl around six years ago, when the highly potent drug was at its height in San Francisco\u2019s drug market.<\/p>\n

\u201cThe streets were flooded with it,\u201d he told The Examiner.<\/p>\n

He sayd fentanyl quickly became his sole priority, and he upended his life in the pursuit of it. For the next few years, he would become distanced from his family, lose his housing and his job, and overdose multiple times.\u00a0<\/p>\n

\u201cI was doing whatever I had to do to get money \u2014 stealing, begging, borrowing, whatever I could,\u201d he said.\u00a0<\/p>\n

It wasn\u2019t until about a year and a half ago \u2014 after a severe overdose at his grandmother\u2019s house left him in the hospital for three days \u2014 that he found the motivation to make a change. He reached out to Douglas Liu, a navigator with Code Tenderloin\u2019s street team<\/a>, whom he\u2019d connected with on the street before.<\/p>\n

Vargas said Liu got him into the Medical Respite and Sobering Center at 1171 Mission St., where Vargas received his first shot of Brixadi, a long-lasting buprenorphine injectable.<\/p>\n

\"Theopolis<\/p>\n

\"\"<\/p>\n

Theopolis Tolliver, right, gets help finding shelter where he can treat his fentanyl-use disorder from Douglas Liu of the Code Tenderloin Night Navigation Team in July 2024.<\/p>\n

Craig Lee\/The Examiner<\/p>\n

That was a \u201cgame changer,\u201d Vargas said of the medication used to treat opioid addiction. He said he\u2019d tried daily doses of the drug before, but being able to receive the injection made it easier to maintain his progress without daily reminders of where he was at.<\/p>\n

\u201cThat was, psychologically, for me something that would bring me down,\u201d Vargas said. \u201cIt still felt like a routine of an addict.\u201d<\/p>\n

Now, he\u2019s at a point in his recovery where he\u2019s weaned himself off the medication, started working as a safety ambassador for Heluna Health, a community-outreach organization, and last week secured his first apartment on his own.\u00a0<\/p>\n

\"Microdose<\/p>\n

\"\"<\/p>\n

Increased access to buprenorphine and other medications used to treat opioid-use disorder have been credited with helping reduce The City\u2019s overdose-death numbers.<\/p>\n

Courtesy San Francisco Department of Public Health <\/p>\n

Vargas is just one of thousands of San Francisco residents who have been affected by the opioid crisis in the past several years. While the crisis began more than 10 years ago, experts in The City point to the introduction of fentanyl as when the situation hit its peak, culminating in 2023.<\/p>\n

That year, San Francisco recorded 810 overdose deaths \u2014 the largest number since the Office of the Chief Medical Examiner began issuing monthly reports in 2020.<\/p>\n

But with the implementation of new programs and strategies addressing the crisis at different angles, the rate of overdose deaths has dropped significantly. Just last month, the number reached an all-time low at 34<\/a>\u00a0\u2014\u00a0the lowest monthly tally on record \u2014\u00a0according to preliminary data.\u00a0<\/p>\n

As The City marks that milestone with National Fentanyl Prevention and Awareness Day approaching Friday, public-health officials, clinical providers and addiction-medicine experts have been examining what elements have led to the abatement of the crisis both locally and nationally, what strategies have been most effective in the past few years, and how \u2014 no matter what \u2014 the answers are more complex than what was initially thought.<\/p>\n

\u201cSan Francisco is not an exception,\u201d said Dr. Dan Ciccarone, a professor of addiction medicine at UCSF and the author of a recent paper in the International Journal of Drug Policy on the state of the opioid crisis in the United States.<\/p>\n

Counties or municipalities seeing lower numbers of overdoses might want to take credit and cite whatever strategies they\u2019ve employed, but the downturn is a reflection of what\u2019s happening nationally, Ciccarone said.<\/p>\n

There are many reasons why the crisis has been easing, Ciccarone said.<\/p>\n

\u201cEpidemics come to an end,\u201d he said.<\/p>\n

There are reasons on both the supply and demand side of the situation, he said \u2014 the supply of fentanyl has become less easy to access and its quality has diminished, while the demand for the drug has gone down because there are fewer new users.<\/p>\n

\u201cIt’s burning itself out because the people who were so addicted to fentanyl that they couldn’t seek help, they’ve died off quicker than new people coming in thinking fentanyl is the new cool drug,\u201d Ciccarone said.<\/p>\n

<\/p>\n


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The Minna Natoma Streetscape Project will bring 800 feet of new street art to The City, along with pedestrian and infrastructure upgrades<\/p>\n

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San Francisco Historium Spotlight will explore The City\u2019s development with shows, cuisine, tours and more<\/p>\n

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\n \"GOP’s
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Republican challenger says he thinks the incumbent has done a poor job of protecting public safety and has the wrong priorities<\/p>\n

The drug itself is no longer in \u201cfashion\u201d and will likely stay unfashionable for a generation or two before it cycles back in again, he said. The use of other drugs \u2014 particularly stimulants such as methamphetamines \u2014 shows little sign of abating any time soon, he said.<\/p>\n

That\u2019s an area in which that the San Francisco Department of Public Health is looking for more solutions, according to Dr. Christy Soran, the deputy medical director of substance use services in behavioral health services at DPH.\u00a0<\/p>\n

\u201cWe struggle with a lot of people using stimulants who still are at risk of overdose \u2014 potentially because of unintentional exposure to fentanyl or other opioids, but also stimulant use itself,\u201d she said. \u201cThey tend to be older, and they tend to also have other underlying chronic diseases like cardiovascular disease. And over time, that builds up, and people most commonly pass away from cardiovascular complications of chronic stimulant use.\u201d<\/p>\n

The main tool that public-health programs have right now to treat stimulant use is contingency management, a behavioral model that offers incentives for stopping drug use.<\/p>\n

While there is some promise in research on the effectiveness of GLP-1 in curbing cravings, there\u2019s not enough known about their use yet.<\/p>\n

While the fentanyl crisis has eased since 2020, the department is still keeping a close eye on the drug market \u2014 other versions of opioids have been detected across the country, and at least one overdose death<\/a> this year has been attributed to cychlorphine, a synthetic opioid.<\/p>\n

\u201cFentanyl has taught us a lot about how quickly the drug supply can change, how just because it’s the same drug class, one opioid does not equal the other,\u201d Soran said. \u201cWe need to make sure we understand how that impacts overdose risk, withdrawal states, and treatment settings.\u201d<\/p>\n

One main area of focus has been on expanding access to treatment options, such as investing in telehealth services used by the department\u2019s street teams and including more drop-in services for medication-assisted treatment at DPH clinics, as well as at Zuckerberg San Francisco General Hospital.<\/p>\n

Finding the right medication and the right treatment for individuals \u2014 and making sure they\u2019re able to maintain their access \u2014 has been a huge priority.\u00a0<\/p>\n

\u201cI think our biggest successes have been really adapting all forms of medication treatment, making it as accessible as possible,\u201d she said. \u201cWe do better when we pair that with a safe space for people to be in, be that sobering centers, shelters, residential treatment.\u201d<\/p>\n

CEO Vitka Eisen of HealthRIGHT 360, a major provider of addiction treatment services in San Francisco, agreed that the increased emphasis on bringing treatment \u2014 medication-assisted treatment in particular \u2014 \u201cto people where they are\u201d has been one of the major factors that has contributed to the decline in overdose deaths.\u00a0<\/p>\n

\u201cThe city has increased its network, if you will, of places where people might touch care,\u201d she said.\u00a0<\/p>\n

But at the same time, she said, she\u2019s concerned that the current overdose numbers might not reflect the people who\u2019ve been priced out of The City in recent years, who\u2019ve left because of current homelessness policies, or who are currently incarcerated \u2014 especially because communities of color<\/a> and those experiencing homelessness are disproportionately affected by overdoses.\u00a0<\/p>\n

A study published in April<\/a>\u00a0\u2014 which included Dr. Philip Coffin, the director of the Center for Substance Use Health in San Francisco, as one of the contributing authors \u2014 reported that nearly half of overdose deaths between 2021 and 2023 in San Francisco occurred in people who had been recently homeless.<\/p>\n

Keeping these issues in mind, it would be too \u201ceasy\u201d to say that the decline is just because The City\u2019s current policies are working, Eisen said.<\/p>\n

\u201cI’m very cautious about that,\u201d she said. \u201cTo make easy assumptions about it, I think is risky.\u201d<\/p>\n

Ciccarone said he has been concerned about The City\u2019s progress as policies have shifted in the last year and a half away from harm reduction and towards abstinence and penalty-based tactics.<\/p>\n

Under Mayor Daniel Lurie, The City has enacted restrictions on the distribution of safe drug-use paraphernalia such as foil and straws, launched an involuntary-hold sobering center in SoMa for people arrested for public intoxication, and passed legislation requiring all new affordable-housing projects to be sober only.<\/p>\n

Favoring one strategy over another will create gaps in what individuals might need to engage with recovery, Ciccarone said, although he acknowledged that harm reduction wasn\u2019t a one-size-fits-all solution either and merited some criticism.\u00a0<\/p>\n

\u201cWe put our heads together, and we say, \u2018What works better in addressing substance use in San Francisco in a balanced approach?\u2019\u201d he said. \u201cHow do we approach both the arrest and supply side of the equation, but also promote treatment \u2014 what to do when treatment is not right for a given individual? How do we promote harm reduction? How does harm reduction link to treatment?\u201d<\/p>\n

Vargas said that now that he\u2019s been in recovery for over a year, he\u2019s known some of his former acquaintances and friends on the street who\u2019ve tried to go down the same medication path he did. The injectable didn\u2019t work for everyone. Some relapsed. But most, like himself, are doing well.<\/p>\n

\u201cIt’s the best thing out there that I know of,\u201d he said.<\/p>\n","protected":false},"excerpt":{"rendered":"Francisco Vargas said he first came across fentanyl around six years ago, when the highly potent drug was…\n","protected":false},"author":2,"featured_media":438297,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[30],"tags":[13260,80067,71091,101,85199,103,102,104,106,105],"class_list":["post-438296","post","type-post","status-publish","format-standard","has-post-thumbnail","category-san-francisco","tag-fentanyl","tag-opioid-crisis","tag-overdose-deaths","tag-san-francisco","tag-san-francisco-department-of-public-health","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\/438296","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=438296"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/posts\/438296\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/media\/438297"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/media?parent=438296"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/categories?post=438296"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/tags?post=438296"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}