Alarming Rise in Fentanyl Overdoses in San Francisco, Medical Examiner Reports

New data released by the San Francisco Office of the Chief Medical Examiner was released on Monday, showing fentanyl overdoses to be on a severe rise, with three out of every four drug-related deaths in September having fentanyl involved.

According to the Drug Enforcement Administration (DEA), fentanyl, a powerful synthetic opiate drug, is 50-100 times more powerful than heroin. Known for its bright color of pills, which are often referred to as “rainbow fentanyl“, fentanyl is currently the most popular in abused synthetic opiates, which have been seen a drastic rise in abuse since the mid 2010’s. While opiate abuse and overdoses have been trending longer, fentanyl specifically has seen a rise due to its cheapness, it being more more powerful than comparable drugs, and easier to get following increased prescription restrictions on many commonly abused drugs.

For cities that have not been clamping down on drug overdoses in recent years that have coincided with the rise in fentanyl, such as San Francisco, the results have been devastating. In 2018, only 90 fentanyl overdose deaths were recorded in the city. In 2020, that number had exploded to 518, with 475 also being recorded last year out of a total of 650 overdose deaths. According to Monday’s report, San Francisco was at a total of 451 overdoses this year so far, with 319 involving fentanyl.

While only a quarter of all overdose deaths were of the city’s homeless, overdose deaths did tend to center around areas of high homeless and low-income areas – 21% of all deaths occurred in the Tenderloin district alone. The total numbers have proved to be so high, that, using recorded deaths from January 2020 to today, the number of overdose deaths in San Francisco nearly doubled total COVID-19 deaths, with 1,817 overdose deaths coming against 1,052 COVID deaths. Even with only fentanyl deaths being singled out, there are still more than COVID, with 1,312 being recorded since 2020.

“As somebody who is a recovering addict, who looks at a number and has looked at this number every month, knowing that I’m one bad decision from being there in that group, I know that I’m not alone in that recovering community from feeling that this is personal,” said Supervisor Matt Dorsey in a speech on Monday, where he proclaimed that the city’s fentanyl crisis was San Francisco’s worst public health crisis since the AIDS epidemic in the 1980’s. “The gravity of the ongoing public health calamity we face demands that we reject the failed status quo, and make real progress on strategies to incentivize recovery, disrupt open-air drug scenes, and hold street-level drug dealers criminally accountable.”

“No one is served by tired ‘drug warrior’ rhetoric that draws false equivalencies between yesterday’s draconian marijuana sentencing and today’s potently lethal opioids like fentanyl, which last month killed nearly three-quarters of the San Franciscans we lost to drug overdoses. We don’t need a war on anything. We need sustained public policies and programs, which are citywide, well coordinated, and based on successful approaches in other cities in the U.S., Canada and Europe that are showing us where real progress is possible.”

While there have been a large number of high profile arrests of fentanyl dealers in recent months throughout the Bay area, including one dealer who had so much fentanyl that he had enough to give everyone in the city an overdose, actions by the city and the SFPD have still fallen short, partially due to older accountability and arrest policies under previous DA Chesa Boudin sill being reversed.

“Fentanyl, along with other opiates and drugs like methamphetamines, have been seeing more and more crackdowns since the summer,” explained Bay Area political issue consultant Hannah Reed to the Globe on Tuesday. “But as we’ve seen with these statistics coming out, a lot more needs to be done. These are dozens of lives a month we’re talking about. San Francisco has always been soft on drug policies, with the city going after manufacturers, and yeah, we need public policies and treatment places in place, but we also need to see the drug supply see a significant pinch too. Right now the city appears to be heading to a hybrid of the two, but again, as the statistics show, we’re still seeing overdose deaths at about what they were. But it also hasn’t been too long with the different policy changes either, so maybe we will see improvement. It looks like we’ll see fewer overdose deaths again in total this year based on the current trends, so maybe we are too. It’s San Francisco. Things can change on a dime, you know?”

“One thing is clear though. It’s looking more and more like an epidemic here and we really need to stop the spread of fentanyl.”