More people in San Francisco died of overdoses in 2020 than any other year. The number of deaths then started to decrease over the course of this year, hitting a low in October.
But now, overdoses are going up again.
An official with the San Francisco Department of Public Health revealed to KCBS Radio in an exclusive interview there were more overdose deaths in November than in October, when the city had fewer deaths than any other month during the COVID-19 pandemic.
One drug is at the center of it all, according to officials.
"Fentanyl has really taken over the street market for opioids," Dr. Phillip Coffin, Director of Substance Use Research at the San Francisco Department of Public Health, told KCBS Radio in an interview.
Heroin and prescription opioids used to be more prevalent than fentanyl, but Coffin said that's now longer the case. San Francisco has been "saturated" with the drug, according to Coffin.
When deaths start to increase, as has been the case in San Francisco since last year, he said that's usually a sign of the drug's widespread reach.
"Nobody has found a way to stop fentanyl from being everywhere," Coffin explained. "When we saw our first outbreaks of illicitly manufactured fentanyl back in 2006, it was all coming from one factory. And when that factory was shut down, the epidemic ended. However, it comes from so many places now that controlling the supply has proved impossible."
Coffin said fentanyl is substantially riskier in terms of overdose and death in the event of overdose. There could only be a window of 5-15 minutes to save someone's life from a Fentanyl overdose, compared to an hour with heroin.
Amid social isolation and unstable market dynamics, overdose deaths rose last year during the COVID-19 pandemic. In all, 711 people in San Francisco died of accidental overdoses.
The monthly totals peaked early this year, with around 70 monthly deaths in January and February.
Forty people died of overdoses in San Francisco in October, but now?
"Preliminary estimates suggest that we are seeing an increase in November," Coffin said, estimating the total to be between the October low and the highs of the first two months of 2021 once figures are released.
Because of fentanyl's ubiquity, San Francisco public health officials have had to focus all of its substance use programs on combatting the drug. Coffin said the drug is so widespread, it's getting into the hands of people who don't intend to use it.
As many as a quarter of the city's overdoses are among those people, Coffin estimated, including people seeking party drugs or stimulants.
"It's really, really critical that anyone who’s accessing drugs that aren't through pharmacies and the medical system is carrying naloxone, the overdose reversal agent, and is aware of the risks of fentanyl," Coffin said, referring to the antidote known under the brand name Narcan.
If you need help, Coffin said the triage center at 1380 Howard St. is a good place to start.
