What we know about substance use and overdose

• The City recognizes that even one overdose death is too many and remains committed to taking a public health approach to this crisis and saving lives.
• There are many paths to addiction and just as many paths to recovery.
• For those seeking treatment for opioid use disorder, the continuum is centered around treatment involving methadone and buprenorphine.
• These two FDA-approved medications have been shown to reduce mortality by up to 50%.
• People who use drugs experience profound stigma and face barriers to receiving services.
• Increasing community engagement and social support are essential to overcoming barriers, saving lives, reducing stigma, and improving outcomes for people who use drugs.
• Punitive policies have not been shown to be effective at reducing overdose deaths. Incarceration is known to significantly increase risk of dying of drug overdose.

Increase availability of substance use services

• Establish “Wellness Hubs” as a cornerstone of the City’s efforts, which will provide overdose prevention services and resources, services to improve health, and linkages to treatment.
• Expand access and remove barriers to treatment for opioid use disorder, including fentanyl addiction.
• Prevent overdoses from being fatal by supporting and broadening overdose prevention services (naloxone, fentanyl test strips, drug checking, and safe consumption).
• Improve post-overdose outcomes by enhancing targeted overdose response teams and connecting people to care.

Strengthen community engagement and social support

• Develop communication (including public messaging campaigns) to the public about drug use and the continuum of services available to people who use drugs
• Scale up public overdose response trainings and naloxone distribution using a citywide, data-driven approach
• Collaborate with community organizations and develop partnerships to support populations most affected by overdose. 

Implement a “whole city” approach to overdose prevention

• Train all DPH staff who regularly work with people who use drugs in overdose recognition and response. 
• Establish protocols for first responders to refer and rapidly connect people who use drugs to health resources, overdose prevention services, and drug treatment
• Make overdose prevention training and naloxone available in all city-run housing facilities
• Embed overdose prevention resources in a range of settings that meet the needs of people who use drugs, such as in social services, health care, higher education, entertainment venues, and hubs that co-locate services
• Promote low-barrier, street-based services and sufficient drop-in spaces throughout the city that are non-judgmental and welcoming to people who use drugs

Track overdose trends and related drug use metrics

• Work to measure the unmet need for treatment among people who use drugs.
• Centralize data collection on drug-related metrics, including fatal and non-fatal overdose. 
• Use data to improve programs (e.g.: community assessment with a focus on drug overdoses among Black/African American San Franciscans).
• Develop materials for communicating data, including a publicly available dashboard for tracking important citywide metrics.
• Meet regularly with community members and stakeholders to review data, discuss findings, and guide future planning.