San Francisco, California — Following a brief decline in overdose fatalities, San Francisco is witnessing a troubling resurgence in deaths linked to opioid use, particularly fentanyl. Concerns have intensified as experts note that the illicit drug supply chain has adapted, complicating local and national efforts to combat the crisis.
In early 2024, Jorge Morales moved into an apartment in a high-traffic drug zone. Despite securing a federally subsidized housing voucher, his mother, Ana Duran, feared for his safety, especially given his history with schizophrenia. Tragically, just weeks after his birthday, Jorge was found dead in his apartment from a fentanyl overdose. “It’s very painful,” Duran lamented, emphasizing the abundant opportunities for substance abuse surrounding him.
This spike follows a year where overdose deaths in San Francisco had declined significantly, a change officials had termed “remarkable.” However, recent statistics reveal an average of 60 overdose-related deaths per month from December to May, nearly doubling rates reported from the previous summer and fall. This reversal parallels alarming national trends, with the Centers for Disease Control and Prevention reporting increases in drug overdose fatalities across the country.
Experts have pointed to a variety of factors contributing to the rising numbers. Keith Humphreys, an addiction researcher at Stanford University, suggested that a temporary shortage of fentanyl in 2023 had initially helped reduce fatalities. Yet, as supplies have stabilized, the availability and potency of fentanyl have increased, leading to renewed health risks for users. “We can’t count on overdose deaths to keep dropping,” he said, underlining the need for ongoing vigilance.
Local law enforcement has noted a marked uptick in drug purity, accompanied by more potent synthetic opioids like carfentanil, which can be lethal in small doses. Bob Beris, a special agent for the Drug Enforcement Administration, reported that earlier, many drugs falsely labeled as fentanyl contained little to no actual narcotics. However, current findings reveal a troubling return to high-potency formulations, where unsuspecting users may inadvertently consume deadly doses.
In response to the crisis, Mayor Daniel Lurie’s administration is pursuing a dual approach of increasing arrests among drug users while expanding access to treatment and temporary housing. Critics argue that enforcement strategies could inadvertently exacerbate the situation, as a recent study linked drug seizures to spikes in overdose deaths in nearby areas. This raises complex questions about the impact of supply disruption on user behavior.
Dr. Daniel Tsai, head of the San Francisco Department of Public Health, acknowledged the urgent need for a more responsive behavioral health system that prioritizes timely access to treatment. He emphasized that progress requires a multipronged strategy, including enhancing medication-assisted treatment and ensuring continued care for those in recovery.
Since January 2024, prescriptions for buprenorphine, a key medication for opioid addiction treatment, have increased by 40%. However, it remains unclear how many recipients are actually utilizing the medication to combat their addiction. Through initiatives aimed at distributing naloxone, the overdose reversal drug, and improving access to detox and residential treatment, local health officials hope to reverse the current trend.
As Duran continues to grapple with her son’s loss, she reflects on the changes in his well-being after moving to a city rife with drugs. She now finds solace knowing she no longer has to fear for his safety and has found a way to honor his memory by returning to El Salvador. “It’s really painful,” she said, but her faith gives her strength, believing her son is in a better place.