San Francisco tied its own record for the most fatal overdoses in a single month in August, setting a deadly pace of an average of five deaths every two days from drugs.

With 84 people dying in August, the city is on track to lose more lives from drugs in 2023 than any other year on record, according to preliminary data released Monday. In total, 563 people have died from drug overdoses this year, though 112 of those deaths remain unverified as the Chief Medical Examiner’s Office works to fully confirm the causes.

August’s death toll is tied with January 2023 for the most fatal overdoses in a month, with 79% of the victims testing positive for fentanyl. 

Approximately 25% of the August deaths occurred in the Polk and Russian Hill neighborhoods. Another 23% of the deaths occurred in the South of Market neighborhood, and 18% took place in the Tenderloin. The data shows that 74% of the victims had a fixed residence in the city.

On the last day of August, many people held demonstrations, memorials and protests across the city in honor of Overdose Awareness Day. 

In the 24 hours prior to Overdose Awareness Day, the Chief Medical Examiner’s Office told The Standard it received 13 bodies to investigate. While it's unclear how many of those people died of overdoses, the death toll represented a spike, as the office investigated an average of 4.6 deaths per day last year. The office investigates any death that is designated as suspicious, not just overdoses.  

Residents and local leaders are divided on how to abate the crisis. Some are calling for overdose-prevention sites where people can use drugs under the supervision of people trained to reverse overdoses. Others are advocating for stricter enforcement of laws that prohibit public drug use. 

The city operated a "safe consumption" site for roughly 11 months last year, with staff reversing 333 overdoses while it was open. But city officials discontinued the site as concerns flared over its hefty price tag, its impact on the community and its failure to connect many clients to drug treatment programs. 

In late May, the city launched a pilot program tapping a portion of the police department to arrest people suspected of using drugs in public, taking those individuals to jail for roughly four hours. 

However, the program has thus far seen little success in connecting people to treatment. Just two people out of 476 arrested through early September entered a rehabilitation program, according to Police Chief Bill Scott.