San Francisco Overdose Deaths Fall to Lowest Level Since Pre-Pandemic

San Francisco’s overdose deaths last month reached a four-year low, falling to a level not seen since before the COVID-19 pandemic, according to preliminary data released Wednesday by the medical examiner’s office.

The city reported 39 deaths from accidental overdose in July, the first time the figure has dipped below 40 since January 2020. That represents a 50% year-over-year reduction from last July, when 79 overdoses were reported.

The decline continues a trend seen in the first half of the year, offering some hope after 2023 marked the deadliest year on record for overdoses in San Francisco, with 810. Through June, the city was still on track to get close to last year’s total, but after July, the annual figure is on pace to be 706 — lower than in 2023 and 2020, the year with the second-highest total.

July was the fourth consecutive month with a year-over-year decline in overdose deaths after June’s total marked the lowest monthly figure since 2022.

This year to date, overdose deaths are 15% lower than they were during the same period last year.

Policy expert Keith Humphreys told KQED last month that the trend was likely due to factors reflected in the national decline of overdose deaths — like fading heroin use and the waning COVID-19 pandemic, which he said likely accelerated some overdose deaths that otherwise could have occurred years later.

While health officials called the drop in deaths a “hopeful sign,” they said wider access to overdose-preventing medications is still needed.

“California needs to make more regulatory changes around methadone access in order to make a greater impact locally,” Dr. Grant Colfax, the director of the San Francisco Department of Public Health, said during a press conference on Wednesday. “We must continue to break down the outdated and cumbersome and, frankly, sometimes ridiculous bureaucratic barriers that make treatment hard to access and to maintain.”

He said that methadone and buprenorphine, synthetic opioids used to treat opioid use disorder, reduce the risk of death by up to 50% in some cases and reduce cravings and withdrawal symptoms. Currently, more than 2,500 people are in methadone treatment through the Department of Public Health.

Dr. Hillary Kunins, the city’s director of behavioral health, said that methadone is the most regulated medication in the country.

“The stigma and barriers caused by this overregulation prevent people from entering and staying in treatment,” she said. “Can you imagine requiring a person who has heart disease to be physically present at a special cardiac clinic every day to take their medication? That’s what new methadone patients need to do to get their daily medication.”

In California, methadone can only be dispensed from a licensed opioid treatment program or methadone clinic.

New federal policy changes make the treatments more accessible. Patients can initiate methadone treatment via telehealth and receive up to three days’ worth of methadone from a hospital at a time. They can also be prescribed methadone by a nurse practitioner or physician’s assistant and get the treatments from a hospital or other health clinic.

Assembly Bill 2115, written by Assemblymember Matt Haney (D-San Francisco), would align California with the federal regulations.

“The state must adopt the federal rules before people wanting to start methadone treatment can benefit,” Kunins said. “We implore our California state legislators to pass AB 2115. Making methadone more accessible in California will save lives.”

KQED’s Gilare Zada contributed to this report.