We spoke with advocates and city leaders about the plan to tackle this crisis.
In 2025, San Francisco's fatal drug overdose numbers surpassed every other county in the country but one: Baltimore.
San Francisco Supervisor Matt Dorsey said he is not shocked.
"What we are seeing right now is other counties are improving faster than San Francisco is," he said.
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"What I'm hoping is that we have to do everything we can to turn off the magnet and stop being a destination city for drug related lawlessness," Dorsey said.
CDC data revealed that even though San Francisco has the second highest overdose rate for a big city, the total number of overdoses is going down with 2025 being the lowest number in the last five years.
"It's alarming. For years, we've been doing the wrong thing, and I feel like for the past year and a half we have pivoted and are headed into the right direction," Steve Adami said.
We met Steve Adami, executive director of a homeless initiative by the Salvation Army at the city's first abstinence-based shelter he believes places like this are making a difference.
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"The program is full we've had no overdose deaths, no overdoses, 80% success rate. I feel like we are opening the right types of programs that will help people overcome addiction, overcome homelessness and reclaim their lives," Adami said.
The current 58 people in the program must pass a breathalyzer test when they come in, get checked by security and have to follow a 9 p.m. curfew and have required meetings with onsite managers, creating a drug free environment.
"For years, we were very enabling. We were approaching the drug and homeless crisis as if it was only a housing crisis. We weren't really addressing why people were on the streets. That is what has changed now," Adami said.
San Francisco is facing a $643 million budget deficit that could grow to $1 billion over the next five years, something that could put financial pressure to services aimed at addressing this crisis.
"I'm advocating to Mayor Lurie and to my colleagues to make sure we do everything we can to avoid budget cuts for drug treatments and recovery services. I just think, given the drug crisis we are facing, anything that we can do to support and incentivize people to get sober to get into recovery and to save their lives is money we should be spending," Dorsey said.
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The city's Department of Public Health said the budget will prioritize the expansion of treatment and capacity.
"The RESET center, I think, it's potentially a game changer. I think this is something that is going to enable us to scale up arrests. Yes, it's only 24 beds, but it's also an enforcement zone in the south of market neighborhood," Matt Dorsey said.
The RESET center is part of the city's new approach where law enforcement will take people who are intoxicated or doing drugs on the streets into custody and take them to the center, where they will get help instead of jail time. The center is set open next month.
SFDPH Statement:
"SFDPH takes a multi-pronged approach to addressing overdoses in San Francisco that prioritizes moving people who use fentanyl and other opioids into treatment and on the path of sustained recovery and long-term stability. SFDPH leads this important work with the support of the Mayor's Office and our city and community partners, in alignment with goals of Mayor Lurie's Breaking the Cycle initiative and is seeing progress. Since the height of the crisis in 2023, fatal overdoses in 2025 were down by approximately 23%.
The SFDPH budget prioritizes high-impact interventions to continue this important work, including proactive outreach and engagement, effective treatment, and support systems to prevent people from falling out of care. Recognizing we need to more to prevent overdoses in the fentanyl era, SFDPH is rapidly expanding San Francisco's treatment and stabilization capacity to ensure are placed at the right level of clinical intensity and not stuck in emergency rooms, jails, or on the street. We are also expanding outreach and clinical care to those communities most impacted by overdoses, such as residents in permeant supportive housing and Black/African American communities, where overdose rates are highest. This is an ongoing system transformation to create a seamless pathway from engagement to recovery.
Every overdose death is tragedy that could have been prevented through clinical interventions and strong social support. Public Health is committed to saving lives from overdose with high-impact interventions and strategic, long-term improvements to our system of care.
To immediately access addiction treatment in San Francisco, call the Department of Public Health at 888-246-3333."