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Fatal overdoses decreased in SF last year, and so did treatment admissions

A bed in SoMa RISE, a drug sobering center at 1076 Howard St. | Camille Cohen/The Standard

The number of people who fatally overdosed in San Francisco decreased for the first time in three years, but new data shows a drop in treatment admissions as well. 

A report by the Department of Public Health shows a continual decline in overall treatment admissions since 2015, a trend that health officials attribute to a changing state policy that restricts the city from providing treatment for out-of-town patients, as well as an increase in outreach operations and new approaches to treating substance use disorders. 

Meanwhile, the city saw 84 fewer overdose deaths in 2021 than in the previous year as data shows nearly 10,000 overdose reversals—more than double the amount of the previous year.  

Phillip Coffin, the director of the Department of Public Health Center on Substance Use and Health, estimated that about 100 lives were saved by overdose reversals that were documented last year. Coffin pointed to increased investments in harm reduction efforts as well as the waning effect of the Covid pandemic as likely contributors to the reduction in deaths.

More methamphetamine users are entering treatment, which Coffin called a “hopeful sign.” He added that the overall decrease in treatment admissions is largely due to the city integrating substance use treatment into primary care. 

“The way that we manage substance use disorders has really evolved over the last five to 10 years to involve a lot of primary care and really trying to remove the stigma and the siloed nature of substance use disorder treatment,” Coffin said. 

Stark disparities persist among the city’s Black population, which is overrepresented in the data. The department recorded a five-fold difference in the rate of overdose deaths among Black people compared with the general population.

The department says it plans to redouble efforts to reduce racial disparities, by increasing engagement with communities affected and expanding treatment options. 

The data comes out a week after the health department released an overdose prevention plan, which set a goal to reduce overdoses by 15% by 2025, responding to city leaders and addiction experts who said the city didn’t previously have a cohesive policy to address the crisis. 

The plan includes creating 110 treatment beds and expanding the inventory of the opioid antidote naloxone by nearly 30,000 kits annually. 

Alongside the department’s plans, however, came news that two related drug treatment nonprofits, Positive Resource Center and Baker Places, are planning to shutter some of their programs imminently because their finances had fallen into shambles. 

The department is working to transfer their patients to alternative treatment programs. 

Jeffrey Hom, director of population behavioral health at the Department of Public Health, said that the closures won’t affect the city’s goal of reducing overdose deaths. 

“We are, as a department, working to ensure a smooth transition and the consistency of all of those services,” Hom said. “We do not expect to deviate from our stated goals.”

David Sjostedt can be reached at