San Francisco Continues Record Accidental Overdose Mortality Rate With Highest May Overdose Deaths

San Francisco office of the chief medical examiner has released their report on Accidental Overdose Deaths for the first five months of 2023. The preliminary number of accidental overdose deaths in May is 74, which brings the total for the year up to 346 — 100 more than the 246 that occurred by this same time last year. This is the worst May on record, surpassing the 70 accidental overdose deaths recorded in May 2020.

San Francisco is far outpacing its overdose mortality rates seen in previous years. Noticeable in the data is the dip in accidental overdose deaths in 2022, when the Tenderloin Center (TLC) was operational. Several factors may explain the decrease in accidental overdose deaths in 2022 and the subsequent increase this year. According to HealthRIGHT 360, these factors include the closure of the center – which offered overdose prevention services – and an escalation in punitive approaches, including the further criminalization of drug use and arrests of people who use drugs.

Based on the San Francisco Department of Emergency Management’s overdose reversal data, during the time that the TLC was open – January 18, 2022, through December 4, 2022 – an estimated 572 of the 7,186 overdoses in the rest of San Francisco (7%) led to death, whereas none of the 333 overdoses that occurred at TLC led to death. Though the datasets for the rest of San Francisco are still incomplete, the following table reflects the preliminary findings that were released by RTI International late last year.

Comparing Overdose Survival:

With and Without the Tenderloin Center in 2022

Table: HealthRIGHT 360 | Source: San Francisco Department of Emergency Management


# of Overdoses

Percent Died

Tenderloin Center

333 Total Overdoses

0/333 = 0%

Rest of San Francisco

2,447 EMS Reversals

+ 4,176 Peer Reversals

+ 572 Overdose Deaths

= 7,186 Total Overdoses

572/7,186 = 7%

To implement a comprehensive continuum of care grounded in public health, HealthRIGHT 360 recommends expanding non-discriminatory access to medication for addiction treatment, fact-based drug education, funding for peer-led programs and tenant-led overdose navigation in supportive housing, scaling up drug sobering centers and drug adulterant testing, supporting and resourcing syringe services programs, and implementing harm reduction interventions such as overdose prevention centers and safer supply.

Photo: Courtesy of HealthRIGHT 360


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