And, San Francisco has thrown money, resources, time and energy to --not so much solve the problem--but get a handle on the number of deaths caused by fentanyl.
San Francisco's health department, at times criticized for not doing enough to encourage people to go into drug treatment programs, is focusing on a different kind of recovery campaign.
On Wednesday, those who have been through treatment were featured on billboards to encourage others to seek help.
The campaign features nine people in recovery who have found success in treatment. The "Living Proof" campaign coincides with the expansion of the city's treatment-on-demand program.
Last May, we followed the Health Department's Night Navigation Team as they offered people on the street a consultation with an on-call doctor who could prescribe medication and offer treatment to try to get them off fentanyl and other opioids.
"In one month, we had over 200 prescriptions that we were able to prescribe and nine people to rehab," said Douglas Liu, a night navigator last May.
MORE: Bay Area researchers develop powerful fentanyl blocker 'Subetadex'
A month later, in June, the number of accidental overdoses dropped and continued to remain lower. So far this year, from January to September 2024, the number of deaths related to an accidental overdose was 504, whereas last year during the same period the number reached 631.
"We have also learned that people do want treatment and do want help, and what we have learned from our evening programs is that people are coming into care and stabilizing, said Dr. Hillary Kunins, the health department's Director of Behavioral Health Services and Mental Health SF.
But the reality is that there are often empty beds, meaning people aren't always showing up at detox or residential treatment programs. That shows taking that first step for treatment is difficult, ask anyone on the street.
We had a candid conversation with Abby Moe who told us she's glad that the price of fentanyl has gone up significantly in recent months. That way she's been able to cut back.
"I do like a five-dollar-a-habit-a-day. That's why I like it. It's easier on your body, because you doing have to do so much," Moe said.
MORE: DEA puts fentanyl into focus as data shows drug overdoses now #1 killer of Americans 18-45
At the moment she's not ready to seek treatment.
Lyanne Melendez: "How many more are in need of that? I mean, do you have a number of people who are addicted on our streets to Fentanyl?"
Kunins: "So, we don't have an exact number."
Melendez: "Ballpark."
Kunins: "We think there are probably several thousand."
MORE: SF Night Navigation Team reaches out to drug users in at-risk neighborhoods
Through billboards, the health department is now also counting on others who have been in the trenches to say that recovery is possible.
Shavonne Allen was once addicted to heroin and never had a mentor to help during her recovery.
She now wants to be that person.
"Anyone who is struggling with addiction, you tend to isolate, you have shame, and you don't really want to let people know what's going on. Eventually, you can't hide it any longer, " Allen said.
"It is a crisis that for those who have been working in this field as I have for more than 20 years, the scale and seriousness that fentanyl has brought to our city and the country really has challenged us to do more and to do better and rethink how we do things, and I think holding the hope and the possibility that this can be different and will be different is what keeps us going," said Kunins.