There was an increase in drug overdose deaths in San Francisco during the COVID-19 pandemic, according to a research letter published online May 12 in JAMA Network Open.
Ayesha Appa, M.D., from the University of California in San Francisco, and colleagues used data from the Office of the Chief Medical Examiner to compare unintentional overdose deaths (involving fentanyl, heroin, medicinal opioids, methamphetamine, and cocaine) in San Francisco 8.5 calendar months before and after the initial COVID-19 shelter-in-place order in March 2020.
The researchers found that 365 and 537 people experienced fatal overdoses before and after the shelter-in-place order, respectively. The median number of weekly overdose deaths was 10 before the shelter-in-place order versus 15 after the order, representing a 50 percent increase. Decedent age and sex were similar between time periods. The death rate for Black decedents remained disproportionately high (272 per 100,000 Black residents versus 89 per 100,000 White residents). After the order, the proportion of decedents experiencing homelessness increased from 23 to 34 percent. The percentage of fentanyl-attributable deaths increased (from 62 to 72 percent).
“Our findings suggest that to complement a strong public health response to COVID-19, there must be more robust overdose prevention for people who use drugs, particularly for people experiencing homelessness, people who identify as Black, and people who use fentanyl and/or stimulants,” the authors write.