San Francisco (SF) has been devastated over the past four years by a shocking and unprecedented rise in overdose and opioid-involved overdose fatality rates, fueled by the introduction of fentanyl into our region. While fentanyl-related deaths made up just 8% of opioid-related deaths in 2015, that percentage had jumped to 79% by 2020. Data for 2020 indicated that SF had rocketed past traditionally hard-hit jurisdictions such as Philadelphia, St. Louis, Baltimore, and Seattle to have the second highest known accidental overdose rate of any county in the US, at 81.4 deaths per 100,000. Preliminary data suggests that this year may produce the highest number of overdose deaths yet, with more than 200 people having already died of a drug overdose during the first 3 months of 2023, as compared to 142 overdose deaths during the first 3 months of 2022. Black/African American and homeless populations are the most disproportionately affected groups in SF, with Black/African Americans experiencing overdose mortality at rates 5 times greater than the county as a whole. The SF Public Health Department proposes to implement a multi-faceted, partnership-based initiative entitled Strengthening San Francisco Overdose Prevention Collaborations (SSOPC), the goal of which is to use and apply data to reduce overdose-related opioid and stimulant-related morbidity and mortality through expanded cooperation and partnerships involving the public health and behavioral health sectors, local health systems, community-based organizations, and public safety entities. Among other 5-year outcomes, the project will seek achieve a reduction of at least 30% in both fatal and non-fatal drug overdose in SF while achieving at least a 50% reduction in overdose-related racial disparities. Key short-term activities of the program include: a) enhancing countywide substance use and overdose prevention navigation coordination while convening an innovative navigator community of practice i
nvolving at least 40 overdose and non-overdose-specific navigators; b) appointing an overarching County Overdose Navigator to provide centralized client linkage to and retention in care and treatment across both County and community-based agencies and programs that serves at least 240 clients each year; c) expanding and strengthening the SF Overdose Prevention Collaborative, supporting overdose navigators in 7 SF hospital emergency departments who conduct one-on-one visits with at least 3,500 non-fatal ED overdose patients each year; d) purchasing two Fourier Transform Infrared (FTIR) Spectroscopy Devices to provide site-based and mobile drug checking to test for the presence of fentanyl and other substances in at least 15,000 illicit drugs samples per year; e) expanding naloxone distribution and training to reach at least 10,000 people who use drugs in SF each year while distributing at least 26,000 doses of Narcan / naloxone; f) overseeing a naloxone distribution and peer-based overdose prevention education program for residents of permanent supportive housing facilities that reaches a minimum of 1,500 residents per year; g) implementing a stigma reduction campaign that supports peer overdose prevention champions in at least 4 Black/African American organizations with the goal of expanding naloxone distribution and overdose prevention education in Black communities while reducing stigma regarding substance use disorder treatment; h) supporting a high-quality academic detailing program that provides at least 360 academic detailing visits with clinical providers each year; i) expanding the County’s overdose prevention and surveillance dashboard while disseminating overdose prevention data, approaches, and best practices throughout the city; and j) developing a new Overdose Fatality Review program in SF, with the goal of fully launching the program late in program year 2 or early in program year 3.