San Francisco Overdose Deaths up in November, But Still Less Than Last Year’s Toll

Forty six people died by overdose in San Francisco last month, slightly more than the previous month but still fewer than the same time last year.

Overall, San Francisco has experienced about 20% fewer overdose deaths to date this year than in the same period of 2023. Over the course of 2024, the number of monthly deaths has largely ticked down from a high of 71 in January. October saw the lowest number of overdose deaths: 35.

San Francisco Department of Public Health Director Dr. Grant Colfax credited the declines, in part, to increased treatment options in San Francisco, in particular, an increase in injectable treatments that only need to be administered once a month.

“We believe this decrease can be partly attributed to the gains we have seen in new clients starting medications for opioid use disorder and in our other treatment programs,” he said. “These are life-saving medications that reduce the risk of death from overdose by as much as 50%. That is why, in this era of fentanyl, we have been focused on getting more people into drug treatment and on the road to recovery. This means getting people off the streets and into treatment.”

Colfax said San Francisco has significantly increased prescriptions over the past two years for medications used to treat opioid disorder, including buprenorphine and methadone. And, he said, the city has seen a sharp reduction — 50% — in how long it takes to get people into residential substance abuse treatment programs, resulting in a 35% increase in participation in those programs.

“We know that everyone’s path to recovery is unique and that different treatments work for different individuals,” Colfax said, noting that both buprenorphine and methadone reduce opioid cravings.

“But many of these medications typically require patients to take multiple doses a day or, in the case of methadone, make daily visits to a clinic for supervised administration,” he said. “That is why injectable buprenorphine can be a game-changer for some people.”
San Francisco hit a high of 810 overdose deaths in 2023.

While there are many contributing factors to the decline since then — including the drug supply and potency — Dr. Hillary Kunins, SFDPH’s director of behavioral health, agreed that the once-monthly injectable medications are making a difference by providing flexibility and reducing other barriers to treatment.
“Unfortunately, there remains significant stigma associated with receiving treatment for a substance use disorder,” she said. “And we know that some of our patients declined to enter or stay in treatment for fear of the prejudice that could come with getting into and staying in treatment.”

Kunins said over the 1,700 patients who have received buprenorphine treatment this year, about 13% have opted for the injectable treatment.

Kunis said that heading into the new year, the health officials will continue to increase treatment options for people with substance use disorders, like injectable and oral buprenorphine, methadone, and other medication treatment, as well as contingency management — behavioral therapy that rewards good behavior — or residential treatment.

“We want to increase availability and accessibility and embrace new, innovative and medically effective treatments as they become available,” she said.