Drug Deaths Rise Alongside “Harm Reduction”

Homeless addicts on the verge of death need an intervention, not enablement.

Homeless men use Narcan to reverse an overdose from fentanyl on Laskie Street, South of Market, San Francisco, May 2, 2022 (Credit: Michael Shellenberger)

by Beige Luciano-Adams

After San Francisco drug deaths rose in the first three months of 2023, the San Francisco Chronicle reported that a professor of family and community medicine at the University of California, San Francisco (UCSF), had “largely attributed the increase in deaths to the closure of the Tenderloin Center in December.”

The Tenderloin Center, also known as “the Linkage Center,” had included a “supervised consumption site” where people could inject or smoke fentanyl, meth, and other drugs under the supervision of city workers and contractors. Mayor London Breed closed the project in December after it operated for nearly all of 2022.

“We simply didn’t let the project last long enough to see the benefits,” said Dan Ciccarone of UCSF.

“Fatal overdoses in San Francisco killed dozens more people in the first three months of this year compared with the same period last year,” noted San Francisco Chronicle reporter Christian Leonard. “Two hundred people died from accidental drug overdoses from January through March… That reflects a nearly 41% increase from the 142 deaths reported for the first three months last year.”

But comparing drug deaths in the first quarter of 2022 to the first quarter of 2023 is misleading. If you compare drug deaths from the fourth quarter of 2022 to the first quarter of 2023, the increase is only 6%, from 188 deaths to 200.

And San Francisco’s drug deaths started declining in 2021 before it had a supervised drug consumption site. Total San Francisco drug deaths in 2020, 2021, and 2022 were 725, 640, and 647.

Fentanyl-only deaths

Reached by phone, UCSF’s Ciccarone denied that he had “largely attributed” the rise in deaths to the closure of the supervised drug consumption site at the Tenderloin Center.

“I told the Chronicle reporter it’s one of several factors,” Ciccarone told me. “It’s not a conclusive cause, purely a correlation. There are lots of other things going on. It doesn’t explain the rise in overdose deaths.”

Due in part to widespread backlogs, most city and county medical examiners haven’t yet released preliminary 2023 or even full 2022 data. But in cities and counties all across the West, including Vancouver, San Diego, Los Angeles, Denver, Kern County, Alameda, Maricopa, it appears that drug deaths — both overdoses and poisonings, mostly from fentanyl — are still rising, with San Francisco’s decline during 2021 and 2022 anomalous.

And in each of those places, city and county health officials have for years been distributing Narcan, which reverses opioid overdoses, and claiming that more widespread distribution of it will reverse the drug death crisis.

On the streets and in homeless encampments, Narcan is so common that a shout of “Narcan!” will bring several people running to revive a person who has smoked too much fentanyl.

Harm reduction advocates say they need more supervised drug sites and “safe supply.”

But British Columbia has 38 supervised drug consumption sites and a “safe supply” policy, which makes a “range of opioids and stimulants” available by prescription, and saw drug deaths rise from 994 in 2016 when it announced supervised drug sites to 2,272 in 2022.

Why is that? If homeless encampments have been flooded with Narcan and other harm reduction measures, why do drug deaths continue to skyrocket?

Why Narcan Can’t

A San Francisco homeless outreach worker with Urban Alchemy discovers a man with a broken hip in the middle of the street, surrounded by needles and feces. December 2021. The man was still on the street one week later. (Photo credit: Michael Shellenberger)