San Francisco health officials reassess strategies as overdose deaths increase
A preliminary count revealed that 61 people died last month from accidental drug overdose, nearly the same amount as February 2024 when 63 people died from overdose. February's preliminary number of overdose deaths is slightly higher than January 2025, when 57 people died.
San Francisco Department of Public Health director Daniel Tsai made the announcement during a press conference on Tuesday, just three weeks into his new position after being appointed by Mayor Daniel Lurie.
"What this really underscores is how urgent and important this work is that we have at the department," Tsai said. "Every one of those 61 deaths is unacceptable. It's preventable, and we as a department are going to be doing everything possible to tackling this epidemic."
Tsai is attempting to navigate the city's response to preventing overdose deaths through reassessing strategies already in place, including aspects of harm reduction.
"When I'm in discussions with our providers, clinicians, and others, people affirm the work happening with many of our providers and partners across the city," Tsai said. "But almost everyone agrees that something has to change."
While he did not specify details of an exact plan, the department intends to alter its policy of handing out supplies like foil and straws in public areas used for smoking substances such as fentanyl. Fentanyl, a highly potent synthetic opioid, has contributed to the majority of overdose deaths in recent years.
"The policy that we will pivot on is distributing smoking supplies like foil, pipes, straws, particularly in public spaces," Tsai said.
Researchers at University of California, San Francisco have found that smoking fentanyl increases the risk of fatal overdose due to the resin that accumulates in smoking paraphernalia.
Sharing smoking devices that contain fentanyl residue could be just as if not more deadly than sharing needles, according to the 2024 paper authored by researchers at UCSF.
Tsai made it clear that the department will continue its practice of supplying clean syringes used for injecting drugs in order to help reduce the spread of illnesses like hepatitis C and HIV.
"San Francisco is not backing away in any way, shape or form from the tested, proven public health intervention of sterile syringe access, full stop," Tsai reaffirmed.
Tsai's announcement comes
one day after Lurie signed "Breaking the Cycle,"
a comprehensive strategy aimed at combating the overlapping issues of homelessness and drug addiction.
The executive directive calls for more coordinated services, better measurement of outcomes, and accountability for government. The idea is to get more people off the street and connected to services, keep public spaces clean and safe, and better manage taxpayer resources.
One aspect of the directive includes immediately modifying the city's policy of distributing clean smoking supplies, which garnered support from several supervisors.
"Mayor Lurie's directive is taking aim at some sacred cows here -- from harm reduction to homelessness spending -- that quite frankly deserve scrutiny for why they've failed to achieve better outcomes," Supervisor Matt Dorsey said in a statement.
"Reassessing fentanyl supply policies is a necessary step to prioritize treatment and recovery," said Supervisor Stephen Sherrill in the directive's press release.
Tsai said that the department will release more details on its changes to supplying equipment used for smoking drugs in the near future.
"My team will be meeting rapidly with a range of folks in the community over the coming week or week and a half before we roll out a more concrete policy pivot," Tsai said.
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