Susan Lefever, wearing a black jacket and crossbody purse, stands in front of the glass windows of a storefront. There are flyers posted on the glass behind her.

San Francisco’s Fatal Overdose Crisis Was Decades in the Making

As San Francisco continues to search for solutions, our team at “Civic” is exploring the origins of the city’s opioid overdose crisis, what has been done to help and what might be making things worse. After six months of research involving hundreds of studies, reports and archival news clippings, and three dozen interviews with people with lived experience and professional expertise in homelessness, addiction, medicine, criminal justice, housing, social work, street outreach, business, education, harm reduction, policymaking and advocacy, we’re launching the series, “San Francisco and the Overdose Crisis.”

Over six episodes, the series will explore what influenced rampant opioid addiction and its connection to homelessness, the 150-year history of policing and prosecuting drugs in San Francisco, the long battle to open a safe consumption site in the city, and grassroots efforts to stem the tide of drug-related fatalities. 

People stand and sit under and around a white shade structure. There is a table stacked with pizza boxes and other snacks, with three large bundles of bottled water underneath.

Berkeley Says It Was Aggressive in Homeless Encampment Sweeps, Promises Reforms

Berkeley is accelerating plans to more humanely deal with homelessness in the wake of a San Francisco Public Press report on a chaotic encampment raid in October, and city staffers say they will start collaborating with unhoused people and homeless advocates when planning to clean or clear large encampments.

Several city departments are changing procedures in response to complaints from those living in encampments and their advocates, and from residential and commercial neighbors.

A fence enclosing the Tenderloin Linkage Center at United Nations Plaza in San Francisco is covered in black tarp and signs promoting the center and its services. Pedestrians walk along a red brick-paved sidewalk outside of the enclosed area.

With Overdose Deaths Surging, Critics Chide City, State for Curbing Safe Consumption Centers

San Francisco’s chief medical examiner delivered grim statistics last week about a recent increase in deaths related to drug use. In the first three months of the year, 200 people died of accidental overdose. That’s up significantly from the first quarter last year, with 142 deaths.

These tragedies were disproportionately suffered by marginalized groups. The biggest increase in deaths occurred among those who lacked housing. People listed as having “no fixed address” accounted for 61 overdose deaths in the first quarter, up from 26 during the same period in 2022. Black residents accounted for 33% of fatal overdoses in the first quarter this year, despite representing only 5% of the city’s population.

Addiction experts say the recent increase in overdose deaths could be linked to the closure of the Tenderloin Linkage Center, a temporary facility that operated in United Nations Plaza from January to December 2022 to help drug users and people without housing access supportive services.

Public Records Referenced in Oct. 4 Berkeley Encampment Sweep Article

1-Redacted_Incident-Report-22-46598Download

2-RE_-Campers-parked-for-weeks-across-the-streetDownload

3-Memorandum-to-City-Manager-on-Harrison-Corridor-9.26.22Download

4-RE_-Eighth-Street-Campers-UpdateDownload

5-RE_-Camelia-Street-encampmentDownload

6-Follow-up-Report-on-Harrison-Encampments-29Download

To initiate a massive encampment sweep at Eight and Harrison streets, Berkeley police and city staff began rousting people living in tents and vehicles shortly after 6 a.m. on Oct. 4.

‘Everything Is Gone, and You Become More Lost’: 12 Hours of Chaos as Berkeley Clears Encampment

In early October, Berkeley police and city officials roused 53 unhoused residents — claiming they were harboring rodents — and seized and destroyed 29 tents and three self-made structures. People begged to retrieve personal items and work tools before the property was tossed into a phalanx of garbage trucks. Four vehicles in which people had been living were towed to impound lots. They would be crushed 15 days later, per the city’s request. 

While some operable cars and RVs were allowed to remain in the neighborhood, and people without vehicles who chose to stay were offered two-person tents, the overall effect of the sweep was that dozens of unhoused people had their belongings taken and their daily existence turned upside down.

A man holds a clipboard while standing next to a woman, below a design featuring a clipboard with lines leading to items like an image of tents, an image of handcuffs, a syringe, a questionnaire.

San Francisco Rations Housing by Scoring Homeless People’s Trauma. By Design, Most Fail to Qualify.

Co-published with ProPublica.

Tabitha Davis had just lost twins in childbirth and was facing homelessness. The 23-year-old had slept on friends’ floors for the first seven months of her pregnancy, before being accepted to a temporary housing program for pregnant women. But with the loss of the twins, the housing program she’d applied to live in after giving birth — intended for families — was no longer an option.

A few weeks later, Davis was informed that the score she’d been given based on her answers to San Francisco’s “coordinated entry” questionnaire wasn’t high enough to qualify for permanent supportive housing. It was a devastating blow after an already traumatizing few months.

A tent stands to the left of a pile of charred debris under the charred bottom of an overpass.

What Reporters Learned Mapping Encampment Fires

Fires in encampments, tents and other makeshift shelters occurred more frequently in recent years, reporting from the San Francisco Public Press and Mission Local shows. But incident counts alone do not offer a clear explanation of what is happening on the street.