Mayor London N. Breed and the Department of Public Health (DPH) announced on Sept. 30 a new overdose prevention program for single room occupancy hotels (SROs), to be carried out by DPH in partnership with the Harm Reduction Coalition and the Department of Homelessness and Supportive Housing.
The innovative program is in response to the rising number of overdose deaths in San Francisco, approximately 30 percent of which occur at SROs.
After years of keeping overdose deaths relatively flat, even in the face of a rising number of overdoses, San Francisco is seeing an increase in overdose deaths. This is largely the result of the introduction of fentanyl into the drug supply, which is a very potent opioid that carries a high risk of death by overdose.
“We must do more to fight the serious danger that fentanyl presents to our community, and this new program will help us meet people where they are and provide SRO residents with the training and medication to prevent overdose deaths,” said Mayor Breed. “This effort builds on San Francisco’s long history of implementing innovative solutions, working with the community, and emphasizing harm reduction to save lives.”
The number of fentanyl overdose deaths in San Francisco has increased each year since 2014. There were 36 fentanyl overdose deaths in 2017, 89 deaths in 2018, and in the first quarter of 2019 there were 39 fentanyl overdose deaths. Fentanyl has driven an overall 17 percent increase in all drug overdose deaths in San Francisco from 222 in 2017 to 259 in 2018. For the first time, fentanyl has surpassed heroin and prescription opioids as the leading cause of opioid overdose death.
“We knew fentanyl was coming and have been monitoring it closely,” said Dr. Grant Colfax, Director of Health. “Now it’s here. We will continue to expand our aggressive work to prevent overdoses and increase access to treatment.”
The Health Department supports the Harm Reduction Coalition’s Drug Overdose Prevention (DOPE) Project, which provided over 15,000 doses of naloxone to thousands of people at risk of experiencing or witnessing an overdose in 2018 alone.
DOPE recorded 1,658 overdose reversals in that year and is on track to nearly double that number in 2019. The DOPE Project continues to expand operations, with new sites and mobile activities in San Francisco. In addition, DPH provides low barrier access to buprenorphine to treat opioid use disorder and reduce overdose risk. DPH expanded the Street Medicine team, which is comprised of nurses, doctors, and social workers.
The Street Medicine team conducts outreach to homeless and marginally housed residents and clinicians provide prescriptions for the opioid treatment medication buprenorphine directly to people on the streets suffering from opioid addiction.
The new program will expand overdose prevention efforts even further. Based on the successful Tenant Overdose Response Organizers (TORO) program from Vancouver, the SRO project will work closely with SRO operators and tenants to develop on-site overdose prevention programs.
The project also will support the installation of naloxone-rescue boxes throughout the buildings to improve access to this critical life-saving medication. The SRO program will begin later this year and is supported by the California Department of Public Health, the California Department of Health Care Services and the federal Substance Abuse and Mental Health Services Administration.
“By deliberately expanding overdose prevention efforts to SROs, the residents, many of whom are formerly homeless and have struggled with mental health and substance use issues, will be empowered to save lives and support their community,” said Dr. Phillip Coffin, Director of Substance Use Research for the Department of Public Health.
The Department of Public Health reported an increase in overdose deaths in August, and earlier this month issued a health alert to San Francisco health providers when additional fentanyl overdoses occurred. Three men with no known history of opioid use required critical hospital care in San Francisco following fentanyl overdose, in three separate incidents. Two died from the overdoses and one recovered.