San Francisco is bracing for a grim resurgence in accidental overdose deaths in 2025, reversing the promising decline witnessed in 2024.
The city recorded its deadliest year for overdoses in 2023, with a staggering total of 810 deaths. However, in July 2024, a glimmer of hope emerged when San Francisco reported the fewest overdose deaths in any month for four years, leading to an optimistic outlook.
Despite this temporary decline, public health experts now caution that the improvement may have been misleading. The apparent reduction in fatalities last year coincided with supply-chain disruptions that resulted in diminished availability of potent fentanyl. As a result, dealers reportedly sold drugs that lacked the potent effects of fentanyl, leading to a short-term drop in overdose numbers.
Stanford University’s Keith Humphreys noted, “We got to benefit from a supply shock, which is great, because thousands of people who would have been dead are alive. But it also means that it wasn’t the end. The markets reconfigured, and we can’t count on [overdose deaths] continuing to go down.”
Recent data from the San Francisco Department of Public Health indicates a troubling trend. In May 2025, 57 overdose deaths were reported, a figure that is likely to be revised upward, suggesting a potential total of 746 deaths for the year. This estimate significantly surpasses 2024’s recorded 635 overdose deaths and is alarmingly close to the 810 fatalities documented in 2023.
The resurgence in overdose deaths this year parallels a national uptick. Nationally, the Centers for Disease Control has noted increased overdose death rates in 2025, though their statistics lag behind local data. Similarly, in Seattle, the King County overdose statistics are reflecting a return to record-high levels of fatalities.
More concerning is the trend among suppliers, as they appear to be pivoting to new synthetic opioids that mimic fentanyl but pose even greater risks. A DEA agent in San Francisco revealed that some 2024 drug busts yielded products with minimal to no traces of fentanyl, with one case even revealing substances as inert as aspirin.
As this situation unfolds, Mayor Daniel Lurie may find it challenging to claim success for his “fentanyl emergency ordinance.” Political ramifications loom large for any increase in overdose fatalities under a mayor’s leadership, particularly after declaring a state of emergency that fails to deliver significant improvements.
Experts underscore that the rise in overdose deaths could reflect a broader national crisis, with San Francisco’s experience indicative of trends across the United States.
The impending challenges in tackling the overdose issue reinforce the urgency for comprehensive strategies to effectively address the crisis and prevent further loss of life.
Residents, advocates, and health professionals alike continue to stress the need for proactive measures in combating the crisis to ensure that the lives of countless individuals at risk can be saved moving forward.
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