Office of the City Administrator

City & County of San Francisco

Carmen Chu, City Administrator
London N. Breed, Mayor
David Serrano Sewell, Executive Director
Office of the Chief Medical Examiner

January 17, 2024

Subject: Report on 2023 Accidental Overdose Deaths

The enclosed report provides preliminary data of accidental overdose deaths in the City and County of San Francisco
from January 1, 2023, to December 31, 2023. During this period, the preliminary number of accidental overdose deaths
is 806. The preliminary number of accidental overdose deaths in December 2023 is 52.

The preliminary number of accidental overdose deaths involving Xylazine and Bromazolam from January 1, 2023 to
December 31, 2023 is 37 and 42, respectively.

The reports are published by the Office of the Chief Medical Examiner (OCME), Forensic Laboratory Division, to
comply with local and state reporting guidelines and further OCME’s mission to provide neutral data to inform
policymakers. Please note, these results are preliminary as of testing to January 8, 2024, and are subject to change as
the OCME finalizes the manner and cause of each death.

Pertinent for accurate use of these reports is understanding the source of the data and its subsequent summarization
process. Decedent demographic and case information were obtained from the OCME case management system.
Additionally, specific details from investigator narratives, forensic toxicology results, and where available,
preliminary autopsy findings, were utilized. Collected demographic information included race, gender, age, fixed
address status, fixed address location, and death location.

Due to their significance in accidental overdose deaths, the reported drugs for open cases were specific to fentanyl,
heroin, medicinal opioids, methamphetamine and cocaine. Their detection in blood was captured to best determine
relevance in each case. Medicinal opioid-positive cases required the presence of codeine, hydrocodone, oxycodone,
morphine, hydromorphone, oxymorphone, buprenorphine, tramadol, and/or methadone. Heroin-likely determination
was more closely evaluated, requiring the presence of specific heroin markers in blood or urine, expected morphine
to codeine ratios, and/or case details consistent with heroin use. Closed casework included any drug and alcohol-
involved accidental overdose where the death has been certified.

Sincerely,

Luke N. Rodda, Ph.D.

Chief Forensic Toxicologist and Director, Forensic Laboratory Division

cc: Office of the City Administrator

enclosures: Preliminary Accidental Drug Overdose Data Reports for January 2023 through December 2023

Accredited by the National Association of Medical Examiners | American Board of Forensic Toxicologists
Preliminary Accidental Drug Overdose Data Report for
January 2023 through December 2023
 OFFICE OF THE CHIEF MEDICAL EXAMINER CITY AND COUNTY OF SAN FRANCISCO

Preliminary Accidental Drug Overdose Data Report Gender Race Age

3
as of testing to January 8, 2024 136 53 38
98 3 22
111

JAN-DEC
250

311

2023
239 168

667 6 148
165
16.9% Female 5% Asian 0% <15 15-24 3%
82.8% Male 31% Black
0.4%
14% 25-34 35-44 21%
Non-Binary 18% Latinx 20% 45-54 55-64 30%
1% Native American 12% >=65 Unknown 0%
39% White
7% Other/Unknown

Fixed Address Fixed Address Location Death Location

4 62
117 150
226 235

171
105 164

99
576
31 90 158

71% Yes* 20% Tenderloin (94102) 19% Tenderloin (94102)

28% No 18% SOMA (94103) SOMA (94103)
11.17% Acc. Overdoses Open 20%
0% Unknown 16% Polk/Russian Hill (94109) 20% Polk/Russian Hill (94109)
88.83% Acc. Overdoses Closed *See Fixed Address Location 5% Inner Mission (94110) 12% Inner Mission (94110)
30% Others (SF Location) 29% Others
11% Others (non-SF Location)

900
Accidental Overdoses by Day of Death
800 806

700
653
600

500

400 407
370

300

200

100 61
40
0
1-Jan
1-Jan 1-Feb
31-Jan 1-Mar
2-Mar 1-Apr
2-Apr 1-May
2-May 1-Jun
1-Jun 1-Jul
1-Jul 1-Aug
31-Jul 1-Sep
31-Aug 1-Oct
30-Sep 1-Nov
30-Oct 1-Dec
29-Nov 29-Dec

Total Deaths Fentanyl Heroin Medicinal Opioids Methamphetamine Cocaine

"Acc. Overdoses Open" cases do not have a final cause and manner of death classification; "Acc. Overdoses Closed" cases have a final cause and manner of death classification.
“Fixed Address” denotes a verifiable address associated with the decedent, which may indicate their residence; it is not intended to verify a decedent's legal domicile, which is a broader legal
concept, pertaining to a person's permanent and primary residence for various legal matters.
"No Fixed Address" denotes a verifiable address associated with the decedent was unable to be determined (e.g., housing insecurity, multiple addresses in a short timeframe).
"Unknown Address" denotes the inability to identifty any reliable address associated with the decedent, or information source.
"Death Location" denotes the specific location to which the relevant agencies were called upon to locate the decedent.
For "Fixed Address Location" and "Death Location", the 4 most affected neighborhoods are represented, the "Others (non-SF)" category refers to all out county addresses, and the "Others (SF)"
category refers to all other zip codes within the City and County of San Francisco.
"Gender" refers to gender at time of death.
"Total Deaths" denotes Accidental Overdoses where one or more drugs contribute to the cause of death; however, every point for each drug series is inclusive, but not necessarily exclusive, of that
drug. "Total deaths" represents all accidental overdoses including ones for drugs not specified above.
PLEASE NOTE THIS DATA IS PRELIMINARY INFORMATION AND SUSCEPTIBLE TO CHANGE
 OFFICE OF THE CHIEF MEDICAL EXAMINER CITY AND COUNTY OF SAN FRANCISCO

Preliminary Accidental Drug Overdose Data Report Gender Race Age

1
as of testing to January 8, 2024 15 7 3 8 3
9

JANUARY 29
30

29
18

2023 18%
68

Female 4%
1

Asian
14

0% <15
17

15-24 4%
81% Male 36% Black 11% 25-34 35-44 21%
1% Non-Binary 17% Latinx 20% 45-54 55-64 35%
1% Native American 10% >=65 Unknown 0%
35% White
8% Other/Unknown

Fixed Address Fixed Address Location Death Location

3
17 14 14

28
21
12
9

9
67 7
13 21

80% Yes* 21% Tenderloin (94102) 17% Tenderloin (94102)

0.00% Acc. Overdoses Open 20% No 13% SOMA (94103) 14% SOMA (94103)
0% Unknown 10% Inner Mission (94110)
100.00% Acc. Overdoses Closed 11% Inner Mission (94110)
*See Fixed Address Location 19% Polk/Russian Hill (94109) 25% Polk/Russian Hill (94109)
31% Others (SF Location) 33% Others
4% Others (non-SF Location)

90
Accidental Overdoses by Day of Death
84
80

70

60 60

50

40 40
34
30

20

10
5
2
0
1-Jan 31-Jan

Total Deaths Fentanyl Heroin Medicinal Opioids Methamphetamine Cocaine

"Acc. Overdoses Open" cases do not have a final cause and manner of death classification; "Acc. Overdoses Closed" cases have a final cause and manner of death classification.
“Fixed Address” denotes a verifiable address associated with the decedent, which may indicate their residence; it is not intended to verify a decedent's legal domicile, which is a broader legal
concept, pertaining to a person's permanent and primary residence for various legal matters.
"No Fixed Address" denotes a verifiable address associated with the decedent was unable to be determined (e.g., housing insecurity, multiple addresses in a short timeframe).
"Unknown Address" denotes the inability to identifty any reliable address associated with the decedent, or information source.
"Death Location" denotes the specific location to which the relevant agencies were called upon to locate the decedent.
For "Fixed Address Location" and "Death Location", the 4 most affected neighborhoods are represented, the "Others (non-SF)" category refers to all out county addresses, and the "Others (SF)"
category refers to all other zip codes within the City and County of San Francisco.
"Gender" refers to gender at time of death.
"Total Deaths" denotes Accidental Overdoses where one or more drugs contribute to the cause of death; however, every point for each drug series is inclusive, but not necessarily exclusive, of that
drug. "Total deaths" represents all accidental overdoses including ones for drugs not specified above.
PLEASE NOTE THIS DATA IS PRELIMINARY INFORMATION AND SUSCEPTIBLE TO CHANGE
 OFFICE OF THE CHIEF MEDICAL EXAMINER CITY AND COUNTY OF SAN FRANCISCO

Preliminary Accidental Drug Overdose Data Report Gender Race Age

as of testing to January 8, 2024 6 3 1 2 11 5

FEBRUARY
18

21 21 15

2023 12%
46
Female 2%
1

Asian
8

0% <15
7
15-24 2%
88% Male 35% Black 10% 25-34 35-44 29%
0% Non-Binary 15% Latinx 13% 45-54 55-64 40%
2% Native American 4% >=65 Unknown 2%
40% White
6% Other/Unknown

Fixed Address Fixed Address Location Death Location

5 6 7

17 17

9
5
10

35
9
7 10
2

67% Yes* 17% Tenderloin (94102) 13% Tenderloin (94102)

0.00% Acc. Overdoses Open 33% No 14% SOMA (94103) 17% SOMA (94103)
0% Unknown 20% Polk/Russian Hill (94109)
100.00% Acc. Overdoses Closed 17% Polk/Russian Hill (94109)
*See Fixed Address Location 6% Haight-Ashbury (94117) 19% Inner Mission (94110)
29% Others (SF Location) 33% Others
14% Others (non-SF Location)

60
Accidental Overdoses by Day of Death

52
50

45

40

30 31

23
20

10

1 2
0
1-Feb 28-Feb

Total Deaths Fentanyl Heroin Medicinal Opioids Methamphetamine Cocaine

"Acc. Overdoses Open" cases do not have a final cause and manner of death classification; "Acc. Overdoses Closed" cases have a final cause and manner of death classification.
“Fixed Address” denotes a verifiable address associated with the decedent, which may indicate their residence; it is not intended to verify a decedent's legal domicile, which is a broader legal
concept, pertaining to a person's permanent and primary residence for various legal matters.
"No Fixed Address" denotes a verifiable address associated with the decedent was unable to be determined (e.g., housing insecurity, multiple addresses in a short timeframe).
"Unknown Address" denotes the inability to identifty any reliable address associated with the decedent, or information source.
"Death Location" denotes the specific location to which the relevant agencies were called upon to locate the decedent.
For "Fixed Address Location" and "Death Location", the 4 most affected neighborhoods are represented, the "Others (non-SF)" category refers to all out county addresses, and the "Others (SF)"
category refers to all other zip codes within the City and County of San Francisco.
"Gender" refers to gender at time of death.
"Total Deaths" denotes Accidental Overdoses where one or more drugs contribute to the cause of death; however, every point for each drug series is inclusive, but not necessarily exclusive, of that
drug. "Total deaths" represents all accidental overdoses including ones for drugs not specified above.
PLEASE NOTE THIS DATA IS PRELIMINARY INFORMATION AND SUSCEPTIBLE TO CHANGE
 OFFICE OF THE CHIEF MEDICAL EXAMINER CITY AND COUNTY OF SAN FRANCISCO

Preliminary Accidental Drug Overdose Data Report Gender Race Age

as of testing to January 8, 2024 14 6 4 7 2
9

MARCH 20
17

2023
26
18

54
12
15
21% Female 6% Asian 0% <15 15-24 3%
79% Male 29% Black 13% 25-34 35-44 26%
0% Non-Binary 18% Latinx 22% 45-54 55-64 25%
0% Native American 10% >=65 Unknown 0%
38% White
9% Other/Unknown

Fixed Address Fixed Address Location Death Location

8 13
20
23 15

10 13

45 7
5
4 3 15

66% Yes* 33% Tenderloin (94102) 29% Tenderloin (94102)

Acc. Overdoses Open 34% No 11% SOMA (94103) 10% SOMA (94103)
0.00%
0% Unknown 7% Polk/Russian Hill (94109)
100.00% Acc. Overdoses Closed 22% Polk/Russian Hill (94109)
*See Fixed Address Location 9% Bayview (94124) 19% Inner Mission (94110)
22% Others (SF Location) 19% Others
18% Others (non-SF Location)

80
Accidental Overdoses by Day of Death
70
68

60

50
48

40

32
30
27

20

10
5
2
0
1-Mar 31-Mar

Total Deaths Fentanyl Heroin Medicinal Opioids Methamphetamine Cocaine

"Acc. Overdoses Open" cases do not have a final cause and manner of death classification; "Acc. Overdoses Closed" cases have a final cause and manner of death classification.
“Fixed Address” denotes a verifiable address associated with the decedent, which may indicate their residence; it is not intended to verify a decedent's legal domicile, which is a broader legal
concept, pertaining to a person's permanent and primary residence for various legal matters.
"No Fixed Address" denotes a verifiable address associated with the decedent was unable to be determined (e.g., housing insecurity, multiple addresses in a short timeframe).
"Unknown Address" denotes the inability to identifty any reliable address associated with the decedent, or information source.
"Death Location" denotes the specific location to which the relevant agencies were called upon to locate the decedent.
For "Fixed Address Location" and "Death Location", the 4 most affected neighborhoods are represented, the "Others (non-SF)" category refers to all out county addresses, and the "Others (SF)"
category refers to all other zip codes within the City and County of San Francisco.
"Gender" refers to gender at time of death.
"Total Deaths" denotes Accidental Overdoses where one or more drugs contribute to the cause of death; however, every point for each drug series is inclusive, but not necessarily exclusive, of that
drug. "Total deaths" represents all accidental overdoses including ones for drugs not specified above.
PLEASE NOTE THIS DATA IS PRELIMINARY INFORMATION AND SUSCEPTIBLE TO CHANGE
 OFFICE OF THE CHIEF MEDICAL EXAMINER CITY AND COUNTY OF SAN FRANCISCO

Preliminary Accidental Drug Overdose Data Report Gender Race Age

as of testing to January 8, 2024 10 3 2
9 9

APRIL
16

17
19

2023
36
14
61
17
14% Female 3% Asian 0% <15 15-24 0%
86% Male 23% Black 13% 25-34 35-44 24%
0% Non-Binary 20% Latinx 24% 45-54 55-64 27%
0% Native American 13% >=65 Unknown 0%
51% White
4% Other/Unknown

Fixed Address Fixed Address Location Death Location

2
9 13
18
22
17

12
18

53 12
9 4 6

75% Yes* 17% Tenderloin (94102) 18% Tenderloin (94102)

0.00% Acc. Overdoses Open 25% No 23% SOMA (94103) 25% SOMA (94103)
0% Unknown 8% Potrero Hill (94107)
100.00% Acc. Overdoses Closed 8% Potrero Hill (94107)
*See Fixed Address Location 17% Polk/Russian Hill (94109) 17% Polk/Russian Hill (94109)
32% Others (SF Location) 31% Others
4% Others (non-SF Location)

80
Accidental Overdoses by Day of Death
70 71

60 59

50

40
33
33
30

20

10
6
4
0
1-Apr 30-Apr

Total Deaths Fentanyl Heroin Medicinal Opioids Methamphetamine Cocaine

"Acc. Overdoses Open" cases do not have a final cause and manner of death classification; "Acc. Overdoses Closed" cases have a final cause and manner of death classification.
“Fixed Address” denotes a verifiable address associated with the decedent, which may indicate their residence; it is not intended to verify a decedent's legal domicile, which is a broader legal
concept, pertaining to a person's permanent and primary residence for various legal matters.
"No Fixed Address" denotes a verifiable address associated with the decedent was unable to be determined (e.g., housing insecurity, multiple addresses in a short timeframe).
"Unknown Address" denotes the inability to identifty any reliable address associated with the decedent, or information source.
"Death Location" denotes the specific location to which the relevant agencies were called upon to locate the decedent.
For "Fixed Address Location" and "Death Location", the 4 most affected neighborhoods are represented, the "Others (non-SF)" category refers to all out county addresses, and the "Others (SF)"
category refers to all other zip codes within the City and County of San Francisco.
"Gender" refers to gender at time of death.
"Total Deaths" denotes Accidental Overdoses where one or more drugs contribute to the cause of death; however, every point for each drug series is inclusive, but not necessarily exclusive, of that
drug. "Total deaths" represents all accidental overdoses including ones for drugs not specified above.
PLEASE NOTE THIS DATA IS PRELIMINARY INFORMATION AND SUSCEPTIBLE TO CHANGE
 OFFICE OF THE CHIEF MEDICAL EXAMINER CITY AND COUNTY OF SAN FRANCISCO

Preliminary Accidental Drug Overdose Data Report Gender Race Age

as of testing to January 8, 2024 14 2
9
11
9

MAY
28
28
15

2023
20

59
15 18
19% Female 0% Asian 0% <15 15-24 1%
81% Male 38% Black 12% 25-34 35-44 21%
0% Non-Binary 21% Latinx 25% 45-54 55-64 27%
0% Native American 12% >=65 Unknown 1%
38% White
3% Other/Unknown

Fixed Address Fixed Address Location Death Location

1 5 8 9
19 21

14
13 21

53 14
10 3 8

73% Yes* 15% Tenderloin (94102) 12% Tenderloin (94102)

0.00% Acc. Overdoses Open 26% No 25% SOMA (94103) 29% SOMA (94103)
1% Unknown 6% Inner Mission (94110)
100.00% Acc. Overdoses Closed 11% Inner Mission (94110)
*See Fixed Address Location 19% Polk/Russian Hill (94109) 19% Polk/Russian Hill (94109)
26% Others (SF Location) 29% Others
9% Others (non-SF Location)

80
Accidental Overdoses by Day of Death
73
70

64
60

50

40
40
38

30

20

10
6
3
0
1-May 31-May

Total Deaths Fentanyl Heroin Medicinal Opioids Methamphetamine Cocaine

"Acc. Overdoses Open" cases do not have a final cause and manner of death classification; "Acc. Overdoses Closed" cases have a final cause and manner of death classification.
“Fixed Address” denotes a verifiable address associated with the decedent, which may indicate their residence; it is not intended to verify a decedent's legal domicile, which is a broader legal
concept, pertaining to a person's permanent and primary residence for various legal matters.
"No Fixed Address" denotes a verifiable address associated with the decedent was unable to be determined (e.g., housing insecurity, multiple addresses in a short timeframe).
"Unknown Address" denotes the inability to identifty any reliable address associated with the decedent, or information source.
"Death Location" denotes the specific location to which the relevant agencies were called upon to locate the decedent.
For "Fixed Address Location" and "Death Location", the 4 most affected neighborhoods are represented, the "Others (non-SF)" category refers to all out county addresses, and the "Others (SF)"
category refers to all other zip codes within the City and County of San Francisco.
"Gender" refers to gender at time of death.
"Total Deaths" denotes Accidental Overdoses where one or more drugs contribute to the cause of death; however, every point for each drug series is inclusive, but not necessarily exclusive, of that
drug. "Total deaths" represents all accidental overdoses including ones for drugs not specified above.
PLEASE NOTE THIS DATA IS PRELIMINARY INFORMATION AND SUSCEPTIBLE TO CHANGE
 OFFICE OF THE CHIEF MEDICAL EXAMINER CITY AND COUNTY OF SAN FRANCISCO

Preliminary Accidental Drug Overdose Data Report Gender Race Age

as of testing to January 8, 2024 8 7 3
10
4
4

JUNE 21
8

2023
18

20
11
49
8
14% Female 5% Asian 0% <15 15-24 7%
86% Male 37% Black 7% 25-34 35-44 14%
0% Non-Binary 14% Latinx 19% 45-54 55-64 35%
0% Native American 18% >=65 Unknown 0%
32% White
12% Other/Unknown

Fixed Address Fixed Address Location Death Location

5 5
9
17
4 19
7

14
8
40 9
13
4

70% Yes* 13% Tenderloin (94102) 16% Tenderloin (94102)

Acc. Overdoses Open 30% No 10% SOMA (94103) 12% SOMA (94103)
0.00%
0% Unknown 20% Polk/Russian Hill (94109)
100.00% Acc. Overdoses Closed 16% Polk/Russian Hill (94109)
*See Fixed Address Location 10% Ingleside-Excelsior (94112) 23% Inner Mission (94110)
35% Others (SF Location) 33% Others
13% Others (non-SF Location)

60
Accidental Overdoses by Day of Death
57

50
49

40

30
27

22
20

10

5
2
0
1-Jun 30-Jun

Total Deaths Fentanyl Heroin Medicinal Opioids Methamphetamine Cocaine

"Acc. Overdoses Open" cases do not have a final cause and manner of death classification; "Acc. Overdoses Closed" cases have a final cause and manner of death classification.
“Fixed Address” denotes a verifiable address associated with the decedent, which may indicate their residence; it is not intended to verify a decedent's legal domicile, which is a broader legal
concept, pertaining to a person's permanent and primary residence for various legal matters.
"No Fixed Address" denotes a verifiable address associated with the decedent was unable to be determined (e.g., housing insecurity, multiple addresses in a short timeframe).
"Unknown Address" denotes the inability to identifty any reliable address associated with the decedent, or information source.
"Death Location" denotes the specific location to which the relevant agencies were called upon to locate the decedent.
For "Fixed Address Location" and "Death Location", the 4 most affected neighborhoods are represented, the "Others (non-SF)" category refers to all out county addresses, and the "Others (SF)"
category refers to all other zip codes within the City and County of San Francisco.
"Gender" refers to gender at time of death.
"Total Deaths" denotes Accidental Overdoses where one or more drugs contribute to the cause of death; however, every point for each drug series is inclusive, but not necessarily exclusive, of that
drug. "Total deaths" represents all accidental overdoses including ones for drugs not specified above.
PLEASE NOTE THIS DATA IS PRELIMINARY INFORMATION AND SUSCEPTIBLE TO CHANGE
 OFFICE OF THE CHIEF MEDICAL EXAMINER CITY AND COUNTY OF SAN FRANCISCO

Preliminary Accidental Drug Overdose Data Report Gender Race Age

as of testing to January 8, 2024 13 7 7 5 11
11

JULY 27
24 26
18

2023 66

16% Female 9% Asian

14

0% <15
17
15-24 1%
84% Male 30% Black 14% 25-34 35-44 23%
0% Non-Binary 18% Latinx 22% 45-54 55-64 33%
0% Native American 6% >=65 Unknown 1%
34% White
9% Other/Unknown

Fixed Address Fixed Address Location Death Location

1
10 11 13
20
25

12 9 22
13
53

3 15
4

67% Yes* 21% Tenderloin (94102) 16% Tenderloin (94102)

0.00% Acc. Overdoses Open 32% No 25% SOMA (94103) 28% SOMA (94103)
1% Unknown 8% Polk/Russian Hill (94109)
100.00% Acc. Overdoses Closed 19% Polk/Russian Hill (94109)
*See Fixed Address Location 6% Bayview-Hunters Point (94124) 11% Inner Mission (94110)
23% Others (SF Location) 25% Others
19% Others (non-SF Location)

90
Accidental Overdoses by Day of Death
80 79

70 69

60

50 51

40

33
30

20

10
5
3
0
1-Jul 31-Jul

Total Deaths Fentanyl Heroin Medicinal Opioids Methamphetamine Cocaine

"Acc. Overdoses Open" cases do not have a final cause and manner of death classification; "Acc. Overdoses Closed" cases have a final cause and manner of death classification.
“Fixed Address” denotes a verifiable address associated with the decedent, which may indicate their residence; it is not intended to verify a decedent's legal domicile, which is a broader legal
concept, pertaining to a person's permanent and primary residence for various legal matters.
"No Fixed Address" denotes a verifiable address associated with the decedent was unable to be determined (e.g., housing insecurity, multiple addresses in a short timeframe).
"Unknown Address" denotes the inability to identifty any reliable address associated with the decedent, or information source.
"Death Location" denotes the specific location to which the relevant agencies were called upon to locate the decedent.
For "Fixed Address Location" and "Death Location", the 4 most affected neighborhoods are represented, the "Others (non-SF)" category refers to all out county addresses, and the "Others (SF)"
category refers to all other zip codes within the City and County of San Francisco.
"Gender" refers to gender at time of death.
"Total Deaths" denotes Accidental Overdoses where one or more drugs contribute to the cause of death; however, every point for each drug series is inclusive, but not necessarily exclusive, of that
drug. "Total deaths" represents all accidental overdoses including ones for drugs not specified above.
PLEASE NOTE THIS DATA IS PRELIMINARY INFORMATION AND SUSCEPTIBLE TO CHANGE
 OFFICE OF THE CHIEF MEDICAL EXAMINER CITY AND COUNTY OF SAN FRANCISCO

Preliminary Accidental Drug Overdose Data Report Gender Race Age

as of testing to January 8, 2024 12 5 5 7 5

AUGUST
14
24
25
33

2023
17

76 2 19
20
14% Female 6% Asian 0% <15 15-24 6%
86% Male 27% Black 16% 25-34 35-44 19%
0% Non-Binary 22% Latinx 23% 45-54 55-64 28%
2% Native American 8% >=65 Unknown 0%
38% White
6% Other/Unknown

Fixed Address Fixed Address Location Death Location

7
12 15
22
24

16

13 20
10

64 3
13 21

73% Yes* 19% Tenderloin (94102) 17% Tenderloin (94102)

27% No 20% SOMA (94103) SOMA (94103)
0.00% Acc. Overdoses Open 23%
0% Unknown 20% Polk/Russian Hill (94109) 24% Polk/Russian Hill (94109)
100.00% Acc. Overdoses Closed *See Fixed Address Location 5% Inner Mission (94110) 11% Inner Mission (94110)
25% Others (SF Location) 25% Others
11% Others (non-SF Location)

100
Accidental Overdoses by Day of Death
90
88

80

70 71

60

50
42
43
40

30

20

10 7
6
0
1-Aug 31-Aug

Total Deaths Fentanyl Heroin Medicinal Opioids Methamphetamine Cocaine

"Acc. Overdoses Open" cases do not have a final cause and manner of death classification; "Acc. Overdoses Closed" cases have a final cause and manner of death classification.
“Fixed Address” denotes a verifiable address associated with the decedent, which may indicate their residence; it is not intended to verify a decedent's legal domicile, which is a broader legal
concept, pertaining to a person's permanent and primary residence for various legal matters.
"No Fixed Address" denotes a verifiable address associated with the decedent was unable to be determined (e.g., housing insecurity, multiple addresses in a short timeframe).
"Unknown Address" denotes the inability to identifty any reliable address associated with the decedent, or information source.
"Death Location" denotes the specific location to which the relevant agencies were called upon to locate the decedent.
For "Fixed Address Location" and "Death Location", the 4 most affected neighborhoods are represented, the "Others (non-SF)" category refers to all out county addresses, and the "Others (SF)"
category refers to all other zip codes within the City and County of San Francisco.
"Gender" refers to gender at time of death.
"Total Deaths" denotes Accidental Overdoses where one or more drugs contribute to the cause of death; however, every point for each drug series is inclusive, but not necessarily exclusive, of that
drug. "Total deaths" represents all accidental overdoses including ones for drugs not specified above.
PLEASE NOTE THIS DATA IS PRELIMINARY INFORMATION AND SUSCEPTIBLE TO CHANGE
 OFFICE OF THE CHIEF MEDICAL EXAMINER CITY AND COUNTY OF SAN FRANCISCO

Preliminary Accidental Drug Overdose Data Report Gender Race Age

1
as of testing to January 8, 2024 9 5 4 3
13

SEPTEMBER
10

18
20

2023
9
15
49 2 10 9
15% Female 7% Asian 0% <15 15-24 5%
83% Male 31% Black 17% 25-34 35-44 25%
2% Non-Binary 17% Latinx 15% 45-54 55-64 15%
3% Native American 22% >=65 Unknown 0%
34% White
8% Other/Unknown

Fixed Address Fixed Address Location Death Location

2
11 13
16 16

13

8 14
43 3 10
4 8

73% Yes* 26% Tenderloin (94102) 22% Tenderloin (94102)

27% No 23% SOMA (94103) 24% SOMA (94103)
0.00% Acc. Overdoses Open 0% Unknown 9% Polk/Russian Hill (94109) 14% Polk/Russian Hill (94109)
100.00% Acc. Overdoses Closed *See Fixed Address Location 7% Ingelside-Excelsior (94112) 14% Inner Mission (94110)
30% Others (SF Location) 27% Others
5% Others (non-SF Location)

70
Accidental Overdoses by Day of Death

60 59

52
50

40

32
30 29

20

10

4
0
1-Sep 30-Sep

Total Deaths Fentanyl Heroin Medicinal Opioids Methamphetamine Cocaine

"Acc. Overdoses Open" cases do not have a final cause and manner of death classification; "Acc. Overdoses Closed" cases have a final cause and manner of death classification.
“Fixed Address” denotes a verifiable address associated with the decedent, which may indicate their residence; it is not intended to verify a decedent's legal domicile, which is a broader legal
concept, pertaining to a person's permanent and primary residence for various legal matters.
"No Fixed Address" denotes a verifiable address associated with the decedent was unable to be determined (e.g., housing insecurity, multiple addresses in a short timeframe).
"Unknown Address" denotes the inability to identifty any reliable address associated with the decedent, or information source.
"Death Location" denotes the specific location to which the relevant agencies were called upon to locate the decedent.
For "Fixed Address Location" and "Death Location", the 4 most affected neighborhoods are represented, the "Others (non-SF)" category refers to all out county addresses, and the "Others (SF)"
category refers to all other zip codes within the City and County of San Francisco.
"Gender" refers to gender at time of death.
"Total Deaths" denotes Accidental Overdoses where one or more drugs contribute to the cause of death; however, every point for each drug series is inclusive, but not necessarily exclusive, of that
drug. "Total deaths" represents all accidental overdoses including ones for drugs not specified above.
PLEASE NOTE THIS DATA IS PRELIMINARY INFORMATION AND SUSCEPTIBLE TO CHANGE
 OFFICE OF THE CHIEF MEDICAL EXAMINER CITY AND COUNTY OF SAN FRANCISCO

Preliminary Accidental Drug Overdose Data Report Gender Race Age

as of testing to January 8, 2024 12 4 2
10
1
10

OCTOBER
21

10
28

2023
21

54 11 14
18% Female 3% Asian 0% <15 15-24 2%
82% Male 32% Black 15% 25-34 35-44 15%
0% Non-Binary 17% Latinx 21% 45-54 55-64 32%
0% Native American 15% >=65 Unknown 0%
42% White
6% Other/Unknown

Fixed Address Fixed Address Location Death Location

2 7
13 18 19
20

6
44
2
9 14
5 9

67% Yes* 10% Tenderloin (94102) 29% Tenderloin (94102)

30% No 20% SOMA (94103) 21% SOMA (94103)
25.76% Acc. Overdoses Open 3% Unknown 11% Polk/Russian Hill (94109) 14% Polk/Russian Hill (94109)
74.24% Acc. Overdoses Closed *See Fixed Address Location 5% Bayview-Hunter's Point (94124) 9% Inner Mission (94110)
18% Others (SF Location) 27% Others
16% Others (non-SF Location)

70
Accidental Overdoses by Day of Death
66

60 60

50

40 40

30
27

20

10
5
3
0
1-Oct 31-Oct

Total Deaths Fentanyl Heroin Medicinal Opioids Methamphetamine Cocaine

"Acc. Overdoses Open" cases do not have a final cause and manner of death classification; "Acc. Overdoses Closed" cases have a final cause and manner of death classification.
“Fixed Address” denotes a verifiable address associated with the decedent, which may indicate their residence; it is not intended to verify a decedent's legal domicile, which is a broader legal
concept, pertaining to a person's permanent and primary residence for various legal matters.
"No Fixed Address" denotes a verifiable address associated with the decedent was unable to be determined (e.g., housing insecurity, multiple addresses in a short timeframe).
"Unknown Address" denotes the inability to identifty any reliable address associated with the decedent, or information source.
"Death Location" denotes the specific location to which the relevant agencies were called upon to locate the decedent.
For "Fixed Address Location" and "Death Location", the 4 most affected neighborhoods are represented, the "Others (non-SF)" category refers to all out county addresses, and the "Others (SF)"
category refers to all other zip codes within the City and County of San Francisco.
"Gender" refers to gender at time of death.
"Total Deaths" denotes Accidental Overdoses where one or more drugs contribute to the cause of death; however, every point for each drug series is inclusive, but not necessarily exclusive, of that
drug. "Total deaths" represents all accidental overdoses including ones for drugs not specified above.
PLEASE NOTE THIS DATA IS PRELIMINARY INFORMATION AND SUSCEPTIBLE TO CHANGE
 OFFICE OF THE CHIEF MEDICAL EXAMINER CITY AND COUNTY OF SAN FRANCISCO

Preliminary Accidental Drug Overdose Data Report Gender Race Age

as of testing to January 8, 2024 2 4
10
15 12

NOVEMBER
19 15

2023
10
17
42
17 8
26% Female 7% Asian 0% <15 15-24 0%
74% Male 26% Black 21% 25-34 35-44 18%
0% Non-Binary 30% Latinx 14% 45-54 55-64 30%
0% Native American 18% >=65 Unknown 0%
33% White
4% Other/Unknown

Fixed Address Fixed Address Location Death Location

5 7 10

18 19

4
9
12

39
7 6
13
4

68% Yes* 18% Tenderloin (94102) 18% Tenderloin (94102)

32% No 10% SOMA (94103) 16% SOMA (94103)
47.37% Acc. Overdoses Open 0% Unknown 18% Polk/Russian Hill (94109) 23% Polk/Russian Hill (94109)
52.63% Acc. Overdoses Closed *See Fixed Address Location 10% Ingelside-Excelsior (94112) 11% Inner Mission (94110)
31% Others (SF Location) 33% Others
13% Others (non-SF Location)

60
Accidental Overdoses by Day of Death
57

50

40
39

30
29
26

20

10
5
5
0
1-Nov 30-Nov

Total Deaths Fentanyl Heroin Medicinal Opioids Methamphetamine Cocaine

"Acc. Overdoses Open" cases do not have a final cause and manner of death classification; "Acc. Overdoses Closed" cases have a final cause and manner of death classification.
“Fixed Address” denotes a verifiable address associated with the decedent, which may indicate their residence; it is not intended to verify a decedent's legal domicile, which is a broader legal
concept, pertaining to a person's permanent and primary residence for various legal matters.
"No Fixed Address" denotes a verifiable address associated with the decedent was unable to be determined (e.g., housing insecurity, multiple addresses in a short timeframe).
"Unknown Address" denotes the inability to identifty any reliable address associated with the decedent, or information source.
"Death Location" denotes the specific location to which the relevant agencies were called upon to locate the decedent.
For "Fixed Address Location" and "Death Location", the 4 most affected neighborhoods are represented, the "Others (non-SF)" category refers to all out county addresses, and the "Others (SF)"
category refers to all other zip codes within the City and County of San Francisco.
"Gender" refers to gender at time of death.
"Total Deaths" denotes Accidental Overdoses where one or more drugs contribute to the cause of death; however, every point for each drug series is inclusive, but not necessarily exclusive, of that
drug. "Total deaths" represents all accidental overdoses including ones for drugs not specified above.
PLEASE NOTE THIS DATA IS PRELIMINARY INFORMATION AND SUSCEPTIBLE TO CHANGE
 OFFICE OF THE CHIEF MEDICAL EXAMINER CITY AND COUNTY OF SAN FRANCISCO

Preliminary Accidental Drug Overdose Data Report Gender Race Age

1
as of testing to January 8, 2024 8 2 3
8
1
9

DECEMBER
15

2023
26
15

43 6
12
15% Female 6% Asian 0% <15 15-24 2%
83% Male 29% Black 17% 25-34 35-44 13%
2% Non-Binary 12% Latinx 23% 45-54 55-64 29%
0% Native American 15% >=65 Unknown 0%
50% White
4% Other/Unknown

Fixed Address Fixed Address Location Death Location

3 6 8
12
18

13
8 11

3
40
3 7 12

77% Yes* 15% Tenderloin (94102) 15% Tenderloin (94102)

23% No 20% SOMA (94103) 21% SOMA (94103)
88.46% Acc. Overdoses Open 0% Unknown 18% Polk/Russian Hill (94109) 23% Polk/Russian Hill (94109)
11.54% Acc. Overdoses Closed *See Fixed Address Location 8% Ingelside-Excelsior (94112) 6% Inner Mission (94110)
33% Others (SF Location) 35% Others
8% Others (non-SF Location)

60
Accidental Overdoses by Day of Death

52
50

40
37

30

23 22
20

10 11

6
4
0
1-Dec 31-Dec

Total Deaths Fentanyl Heroin Medicinal Opioids Methamphetamine Cocaine

"Acc. Overdoses Open" cases do not have a final cause and manner of death classification; "Acc. Overdoses Closed" cases have a final cause and manner of death classification.
“Fixed Address” denotes a verifiable address associated with the decedent, which may indicate their residence; it is not intended to verify a decedent's legal domicile, which is a broader legal
concept, pertaining to a person's permanent and primary residence for various legal matters.
"No Fixed Address" denotes a verifiable address associated with the decedent was unable to be determined (e.g., housing insecurity, multiple addresses in a short timeframe).
"Unknown Address" denotes the inability to identifty any reliable address associated with the decedent, or information source.
"Death Location" denotes the specific location to which the relevant agencies were called upon to locate the decedent.
For "Fixed Address Location" and "Death Location", the 4 most affected neighborhoods are represented, the "Others (non-SF)" category refers to all out county addresses, and the "Others (SF)"
category refers to all other zip codes within the City and County of San Francisco.
"Gender" refers to gender at time of death.
"Total Deaths" denotes Accidental Overdoses where one or more drugs contribute to the cause of death; however, every point for each drug series is inclusive, but not necessarily exclusive, of that
drug. "Total deaths" represents all accidental overdoses including ones for drugs not specified above.
PLEASE NOTE THIS DATA IS PRELIMINARY INFORMATION AND SUSCEPTIBLE TO CHANGE