San Francisco recorded its smallest monthly number of drug-overdose deaths of 2025 in September — and the second-smallest number in any month since at least 2020 — according to a preliminary report published Tuesday by The City’s medical examiner.
The City’s 38 fatal overdoses last month were 10 fewer than in August, according to the Office of the Chief Medical Examiner. Since the office started publishing monthly reports in 2020 amid the ongoing opioid epidemic, the only month in which San Francisco had fewer total deaths was October 2024 (37).
“I am encouraged,” said Daniel Tsai, the director of the San Francisco Department of Public Health. “I know we’re making real progress, and I and others here are not yet satisfied about where we are and the work that we continue to have to do.”
Tsai has repeatedly said that any overdose death is one too many. Last year, The City recorded its smallest annual total of deaths (635) since 2020. Through September, San Francisco was on pace to record about 663 fatal overdoses, which would be the third-highest total since the Medical Examiner’s Office started releasing reports.
Tsai said his department has been focusing on its street teams, which were consolidated from nine to six earlier this year. The teams now all fall under the umbrella of the Department of Emergency Management after previously operating across multiple city departments, and they are taking a more neighborhood-based approach.
“I was talking to a nurse on my team the other day, who was mentioning prior to this new neighborhood street-team configuration, how difficult it was sometimes to get somebody into even a shelter,” he said.
The goal has been to engage with people on the street more and get them into some sort of stabilization within 24 to 48 hours of contact, he said. Streamlining the teams has made doing so easier, Tsai said.
“While there are growing pains for sure, that level of collaboration and focus is working,” he said.
In a statement that also pointed to a San Francisco Chronicle report that said The City is on track to hit a 70-year low in homicides, Mayor Daniel Lurie credited the street teams’ consolidation — part of his “Breaking the Cycle” plan — and legislation making it easier for the Mayor’s Office to sign leases for treatment facilities and contracts with providers as part of the fight against The City’s homelessness and fentanyl crises.