August in San Francisco repeats the worst recorded month for accidental overdose deaths

San Francisco, CA — The Office of the Chief Medical Examiner (OCME) has released their Report on Accidental Overdose Deaths for the first eight months of 2023. The preliminary number of accidental overdose deaths in August is 84, which brings the total for the year up to 563. This is 165 more than the 398 that occurred during the same period of time in 2022.[1]

Among those who have died of an accidental overdose this year, 385 were determined to have had a fixed address, and 355 were San Francisco residents, or 92 percent.[2] There is also a racial justice component to the overdose crisis. Despite Black San Franciscans comprising five percent of the local population, they have accounted for 32 percent of the accidental overdose deaths.[3]

Figure 1. Accidental Overdose Deaths, January – August

There were 84 accidental overdose deaths in August, which brings San Francisco’s 2023 total up to 563.

In the latest OCME report, the data for several months in 2023 also appears to have been adjusted. January, which was the worst month on record for accidental overdose deaths in San Francisco, was increased from 83 to 84, now tied by this past month, August. May decreased from 74 to 73 accidental overdose deaths; June increased from 54 to 57 accidental overdose deaths; July increased from 71 to 74 accidental overdose deaths. According to a statement by Chief Forensic Toxicologist Dr. Luke Rodda, the preliminary data are subject to change as the manner and cause of each death is finalized.[4]

A drastic increase in policing people who use drugs for no other crime, a significant reduction in people being sent to diversion programs, and no immediate plans for an expansion of sobering centers or implementation of wellness hubs as an alternative to criminalization has contributed to this staggering increase in fatal overdoses.[5][6]

The OCME report comes as new provisional drug overdose death counts were released by the US Centers for Disease Control and Prevention, which show that more than 111,000 people died from a drug overdose in the 12-month period ending in April 2023.[7] For this 12-month period, the US saw a 1.03 percent national increase in overdose deaths when compared to the same period of time ending in April 2022.[8]

The CDC data also shows that during this same 12-month period, California, the state with the most overdose deaths in the country, saw a 4.03 percent increase in overdose deaths statewide, an increase from 12,056 to 12,542.[9]

In October 2022, San Francisco’s Overdose Prevention Plan included the following goal: “Reduce fatal overdoses by 15 percent citywide by 2025.”[10] According to OCME data, San Francisco saw a 21.64 percent increase in overdose deaths during the 12-month period that was measured by the CDC, an increase from 596 to 725, well beyond the percent change at both the state and national levels – five times worse than the state rate, and 21 times worse than the national rate.

Dr. Nora Volkow, Director of the National Institute on Drug Abuse at the National Institutes of Health, speaking on the national trend, said, “I was expecting that overdose deaths would go down after the big jump during the COVID pandemic, as we resume our everyday life. So to me, it is very concerning that these numbers remain so elevated.”[11]

At this critical juncture, HealthRIGHT 360 calls for the need to support the San Francisco Department of Public Health in implementing evidence-based public health approaches to address the overdose crisis, including but not limited to: expand non-discriminatory access to medication for substance use disorder treatment and culturally affirming, voluntary treatment; provide fact-based drug education; fund peer-led programs and tenant-led overdose navigation in supportive housing; scale up drug sobering centers and drug adulterant testing; support and resource syringe services programs; and implement harm reduction interventions such as overdose prevention centers and safer supply.

About HealthRIGHT 360:
HealthRIGHT 360 is a non-profit provider of substance use disorder treatment, mental health services, and primary care to over 39,000 Californians annually. HealthRIGHT 360 provides care that is compassionate, non-judgmental, and evidence-based. We provide services, regardless of one’s ability to pay; inspired by our belief that healthcare is a right, not a privilege. Learn more about HealthRIGHT 360 and our programs at  

[1] Rodda, L. “Accidental Overdose Report, Jan 2023 – August 2023,” OCME Accidental Overdose Reports, Office of the Chief Medical Examiner, September 18, 2023.

[2] Ibid.

[3] Ibid.

[4] Ibid.

[5] Moench, M. “S.F. police crack down on public drug use ahead of Mayor Breed’s command center targeting dealers,” San Francisco Chronicle, June 2, 2023.

[6] Leonard, C. “‘Enormous rise’ in San Francisco overdose deaths in 2023,” San Francisco Chronicle, April 19, 2023.

[7] Moench, M. “S.F. arrests 58 drug users in a week as Breed cracks down. Sheriff targets open-air markets, usage,” San Francisco Chronicle, June 8, 2023.

[8] Neilson, S. “Brooke Jenkins has transformed San Francisco’s crime policies. Here’s what the data shows,” San Francisco Chronicle, March 29, 2023.

[9] US Centers for Disease Control and Prevention, “Provisional Drug Overdose Death Counts,” September 14, 2023,

[10] “Overdose Prevention Plan 2022,” Department of Public Health, City and County of San Francisco, October 6, 2022,

[11] McPhillips, D. “Overdose deaths continue to rise in the US, reaching another record level, provisional data shows,” CNN, September 13, 2023,

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