District 2 Supervisor

Confronting our overdose crisis

On a windy evening this spring, I stood in solidarity with community leaders for the Remembrance of Lights ceremony. This heartbreaking memorial for the 699 individuals San Francisco lost to overdose in 2020 took place from three locations: the Fillmore, Bayview, and Tenderloin, representing some of the neighborhoods that have been hit the hardest by our overdose epidemic. Over the course of the ceremony, we heard from people in recovery, formerly incarcerated individuals, and those who have lost family members to the disease of addiction about how this crisis — and the city’s shocking inaction — has impacted them. 

The evening was all the more somber because just one day earlier the San Francisco Chronicle reported that 2021 was already off to an extraordinarily deadly start: The city had recorded 61 fatal overdoses in January alone. 


It is no exaggeration to say that drug overdose in San Francisco is a humanitarian crisis. In addition to the surge from 259 overdose deaths in 2018 to 699 in 2020, the administration of Narcan, a drug that reverses overdose, was also at an all-time high last year. According to the Chronicle, Narcan was used to reverse overdose more than 10 times per day in the city last year, which is more than twice the rate we saw in 2018. This is no surprise to anyone who has walked our streets, as this situation is as visible as it is tragic. We are in freefall. 

It’s beyond frustrating that we keep doing the same things, over and over again, and expecting different results. Unsurprisingly, we are on track to suffer record overdose deaths for the second consecutive year unless we take action to reverse this trend. That’s why I’m committed to making sure it’s harder to get drugs and easier to get treatment in San Francisco. 

In February, I held a hearing on the findings of the Recovery Summit Working Group, individuals from all walks of life who have found recovery in spite of the deadly disease of addiction, often with very little support. It’s our responsibility to listen to and learn from those in recovery, to make sure that they are at the decision-making table, and to make their experiences the norm, not the exception.

The working group surveyed more than 400 current or former drug users, and found that 74 percent agreed that San Francisco needs more drug and alcohol treatment options, including abstinence-based programs, harm-reduction efforts, mental health counseling, and more. Sixty-nine percent agreed that we need longer residential treatment programs, 76 percent agreed that we need more treatment programs for youth, and 75 percent agreed that we need to increase opportunities to connect people in recovery with those working toward recovery.

To address those needs, the working group recommended expanding treatment options, centering the voices of people in recovery, extending treatment stays, creating specialized programs for youth between the ages of 16 and 25, expanding paid peer specialist opportunities, funding a Black-led abstinence-based program, and increasing awareness about the treatment services that are already available. My hearing was just a first step in making sure we are addressing addiction humanely and effectively, and I am continuing to engage the working group and our city departments to implement each of these badly needed policies.  

But we can’t only expand treatment options; we need to stop the flow of deadly drugs into San Francisco. 


The city’s overdose crisis comes as a direct result of the introduction of fentanyl to our streets. The San Francisco Police Department has reported that fentanyl is increasingly found in many other drugs, and that dealers actively seek out young people and individuals in recovery because they know just how addictive the substance is. Recent reporting in The New York Times likewise confirms that fentanyl, both alone and mixed with other drugs, had an outsized role in the sharp spike in overdose deaths our country experienced in 2020, especially among communities of color.

Some have said that our law enforcement agencies should be focusing on “kilos, not crumbs” when it comes to prosecuting drug dealers in San Francisco. But let’s be clear: so-called crumbs are just as deadly. Two milligrams of fentanyl — an amount small enough to fit within Abraham Lincoln’s face on a single penny — is enough to kill. 

The past year was uniquely deadly for overdose not just here, but across the country. Instead of blaming national trends, however, we should feel called to action. As Covid-19 has ravaged the United States, San Francisco has consistently had some of the best health outcomes of any major American city. We can still be the “City That Knows How” when we want to, and there is no reason to continue to allow people to die from overdose on our streets. Allowing this crisis to continue shows no compassion for those suffering from addiction, their families, or those who have to experience the destructive effects of addiction on our communities. 

When it comes to preventing overdose in San Francisco, we’ve heard enough excuses. We must start using every tool at our disposal — harm reduction, abstinence-based programs, accountability for dealers, and more — to confront this challenge. It’s deadly serious.

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