San Francisco Drug Overdose Deaths Spiked to Record High In 2023

Gavin Newsom [L], a homeless person [R] (Justin Sullivan/Getty Images)
January 17, 2024

More than 800 people died of accidental drug overdoses in San Francisco in 2023, making last year the deadliest on record, according to a Wednesday report from the city’s medical examiner.

Fentanyl accounted for most of the 806 deaths, followed by meth and cocaine. Thirty-seven people died from Xylazine, an adulterant known as "tranq" that Chinese suppliers sell cheaply by the kilogram in powdered form, and which is commonly mixed with fentanyl, cocaine, and heroin. Its side effects include rotting flesh that could require limb amputations. Forty-two people overdosed on Bromazolam, another increasingly common street drug that causes dizziness, drowsiness and amnesia.

These numbers shatter San Francisco’s previous record of 726 deaths in 2020, when the city was shuttered under some of the nation’s strictest COVID-19 lockdowns. The spike comes after Gov. Gavin Newsom (D.) and Mayor London Breed (D.) made the city’s drug crisis a political priority, with Newsom sending in the state’s national guard and highway patrol to try to stymie fentanyl trafficking. In October, he announced an anti-opioid task force for San Francisco.

The city's medical examiner noted that these numbers are only preliminary, which means they could change after further investigation.

Last year showed a striking increase from 2022 and 2021, which clocked 649 and 642 accidental overdoses, respectively.

Meanwhile, progressive activists are pressuring city leaders—including Breed, who is vying for reelection this year—to skirt state laws and open "safe" drug injection sites. The city already passes out drug paraphernalia including hypodermic needles and syringes, and tin foil and cans that are commonly used for cooking drugs, ABC News has reported.