A grim tally released today by the medical examiner pegged the number of San Francisco overdose deaths at more than 450 from January through August, 2020. That exceeds the total recorded in all of 2019, which was 441. And this year’s data is preliminary, meaning these numbers only figure to grow. 

In 2018, the city recorded 259 overdose deaths; 222 were recorded in 2017. 

San Francisco is now on pace to suffer 675+ overdose deaths in 2020. And, again, this is only the preliminary data.

Fentanyl accounts for the lion’s share of this year’s 450 deaths, at 300+ (for reasons unknown, the medical examiner’s report, embedded below, does not include the actual numbers of deaths by overdose, instead providing rough figures on a graph). 

It was only on Aug. 31 that the city released the final 2019 tally. The fentanyl-driven surge in deaths was a foreboding sign of what was to come in 2020. 

2020 09_OCME Overdose Report by Joe Eskenazi on Scribd

“San Francisco has many innovative ways to care for people who use drugs,” said the Health Department’s Dr. Phillip Coffin in August. “But no American city has been able to withstand the arrival of fentanyl without increases like these.” 

Among accidental drug overdose cases through the first eight months of 2020, 70 percent of those treated had fixed addresses. That tracks with data recorded in past years, when users — who may have once used drugs in groups, and out-of-doors — instead died alone, indoors. 

A 2003 academic paper found that 68 percent of fatal heroin overdoses were among people who were using alone. The pandemic has only exacerbated this trend, as more and more people are isolated.

Fentanyl, however, is more unpredictable and powerful than heroin. And, adds Kristen Marshall, the manager of the DOPE project, which coordinates the city’s overdose response, it’s no shock that more people are using drugs during a time when so many Americans are suffering and feeling hopeless.

“These numbers are not a surprise to us,” Marshall says. The isolation required by Covid-19, she notes, is antithetical to how one would approach cutting down on overdose deaths. The onset of both Covid and fentanyl exacerbated “the root causes of overdoses: Homelessness, poverty, and wildly disparate health scenarios people of color are facing.”

The DOPE project disseminates the drug Narcan, which can revive someone suffering from a drug overdose. Marshall said in the vicinity of 1,800 people have been revived in San Francisco in 2020.

Supervisor Matt Haney, who oversees SoMa and the Tenderloin, said the city needs a Covid-like mobilization to take on a health crisis that has grown exponentially worse from year to year.

“I am angry. The city has known about this for years. It has gotten dramatically worse this year. We need urgency in our response,” Haney says. “We need massive street outreach. There should be more Narcan. There should be a clear and targeted law-enforcement strategy to stop the most deadly drugs. People should be able to easily access treatment. But the response this year has been more of the same. To save lives, we need a response that matches the crisis.”

“In my district, there are people who openly shoot up, all day and every day. Nobody intervenes. Nobody stops the drug-dealers, who are selling drugs that are deadlier than ever,” Haney continued. “It’s a complete free-for-all. People are left out there doing what they’re doing until they die.”

Data obtained by the Chronicle indicates that more than twice as many homeless San Franciscans have died in 2020 than in the year prior. Nationwide, drug overdose deaths are surging to record levels in this year.

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Managing Editor/Columnist. Joe was born in San Francisco, raised in the Bay Area, and attended U.C. Berkeley. He never left.

“Your humble narrator” was a writer and columnist for SF Weekly from 2007 to 2015, and a senior editor at San Francisco Magazine from 2015 to 2017. You may also have read his work in the Guardian (U.S. and U.K.); San Francisco Public Press; San Francisco Chronicle; San Francisco Examiner; Dallas Morning News; and elsewhere.

He resides in the Excelsior with his wife and three (!) kids, 4.3 miles from his birthplace and 5,474 from hers.

The Northern California branch of the Society of Professional Journalists named Eskenazi the 2019 Journalist of the Year.

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  1. We mobbed Potrero Del Sol on Sept 20 for young Nosey. He didn’t even know it was fent. Twenty fucking two. Shit ain’t right.

    Go to the park and check the paint,. Mission loved poured that day. I got hella video, but I didn’t know him so can’t post. I’ll get my shit to Vanessa when I get back to town.

    Our town. Our street. The trees stay.

    RIP, Nosey

  2. This is awful. How can the common citizen help if city intervention is not enough? What organizations are out there that we can volunteer or partner with?

    1. The truth is treating addiction has an abysmal failure rate. The only two programs with any success is AA and Codependency Anonymous. Their success rates are only about 3 out of 10. Our city leaders are incredibly naive and immature. Addicts are an incredibly difficult group and require intensive interaction.
      The city must realize that they need to support the professional’s and stop this home grown non-profit wanna be’s! They are just after our tax dollar and are virtue signaling. It does not matter how well intentioned they are. These people are carpetbagging our money because we are weak and too nice to tell them to keep packing.
      To help street disease is to treat addiction! The right way – not enabling!

  3. It is and old history. (The roots of the Opium War (or First China War) lay in a trade dispute between the British and the Chinese Qing Dynasty. By the start of the 19th century, the trade in Chinese goods such as tea, silks and porcelain was extremely lucrative for British merchants. The problem was that the Chinese would not buy British products in return. They would only sell their goods in exchange for silver, and as a result large amounts of silver were leaving Britain.In order to stop this, the East India Company and other British merchants began to smuggle Indian opium into China illegally, for which they demanded payment in silver. This was then used to buy tea and other goods. By 1839, opium sales to China paid for the entire tea trade.)

    So how is that so much drug is available on San Francisco streets? The goverment has to cut the supply or risk to have a illegal drug addict city where the citizens have one option to avoid to lose their children or any family member: evacuate San Francisco

  4. This is not Covid related this is San Francisco’s active outreach to drug addicts hiding in homeless clothing – the tent.
    Homeless (and we should start calling them by their majority population- addict/anarchist/aquirer) has increase 300%. Haney and the other city do gooders need to get treatment for their disease –
    Co-Dependency and realize they are enablers. In no way does the City have the financial resources to solve the nations addiction/mental health problem. Come this January, the city will be broke on a scale never seen. We are going to have to cut our budget by 50%. The party is over and so will be the open air enabled drug market. Even the homeless are going to want to move. No more money for crazy free stuff.
    Newsome needs to get off his hypocritical ass and address it as a State issue ( which it is because the majority of the are not from our community) and reopen Napa State mental hospital and release Setton and run it as a mental/addiction treatment facility.
    Our politicians are children and this isn’t bullshiting on the college campus quad! Go up and get real and spend what little money u have left on actual fixes – scrap the pie in the feel good programs.

  5. Cops don’t arrest drug dealers because Boudin won’t charge/prosecute. The tenderloin is an open air drug market.

    1. The tenderloin has less action than I’ve ever seen. It’s not Boudin’s doing, but you’re definitely talking out your ass.

    1. Narcan is not the solution, these individuals who are overdosing often have already used the narcan provided. SF General has a individuals who come in multiple times a week after overdose. This has been well documented. It’s just a matter of time until they die. Removing drugs and the dealers and aiding those with addiction is what will solve this problem.

      Pierre understands The issues.

  6. Joe, you’re one of the greats.

    But quoting a crocodile tear type like Matt Haney, or pretending this isn’t the direct result of the City’s deliberate inaction on the policing front, and laying it at the door of not enough funding to the various ineffective groups here . . . not great.