A gradual drop in drug deaths that had given public well being officers hope in preventing the overdose disaster now seems to be reversing course in components of the Bay Space.
In Santa Clara County, drug fatalities have begun to rise after falling to a four-year low final fall, in line with county coroner information. The pattern is mirrored in San Francisco, the one different place within the five-county area that publicly stories overdose deaths.
“We’re at this point of extreme uncertainty of what’s going to happen next,” stated Keith Humphreys, a behavioral science professor at Stanford College and professional on overdose traits.
In the course of the coronavirus pandemic, drug deaths exploded as fentanyl — a particularly highly effective artificial opioid — took maintain throughout the nation and public well being restrictions remoted folks of their properties, drove huge job losses and blocked entry to remedy.
However in the course of 2023, overdose deaths began a dramatic decline. The drop got here amid a federal push to disrupt the unlawful worldwide drug commerce and stress China to crack down on producers of the chemical substances wanted to synthesize fentanyl. Testing quickly revealed that fentanyl had change into much less potent, and researchers stated it grew to become tougher to seek out on the road.
In latest months, nevertheless, researchers, drug enforcement officers and remedy suppliers say extra harmful fentanyl and methamphetamines seem like flowing into the Bay Space — probably driving the rise in overdose deaths.
“Illicit markets that are disrupted often reorganize,” Humphreys stated.
In Santa Clara County, there have been a median of 29 drug fatalities a month between October 2024 and March 2025, up from a low of 25 month-to-month fatalities on common within the earlier six-month interval between Could 2024 and October 2024. On the peak of the overdose disaster in early 2023, the county averaged round 40 drug deaths a month.
Overdose dying investigations typically take months, and more moderen full information was not out there.
In San Francisco, the variety of drug fatalities rose to a median of 61 in Could, up from a median of 43 in November. Town averaged a document 73 deaths in summer season 2023.
Based on the newest information from the Facilities for Illness Management and Prevention, deadly overdoses in California and throughout the U.S. have continued to fall by means of February, although at a slower charge in latest months. The company had reported a spike in drug fatalities in January, however revised the figures this month after updating the way it fashions provisional overdose dying information.
In whole, the CDC reported greater than 78,300 folks died of overdoses within the U.S. through the 12-month interval ending in February. Greater than 9,700 of these deaths have been in California.
Kevin Casey, 36, who lives in a midway home close to downtown San Jose and describes himself as an occasional exhausting drug consumer, stated he’s seen extra folks overdosing recently. He’s sworn off fentanyl, he stated, as a result of it’s too dangerous.
“I did it twice, and I OD’d,” Casey stated whereas smoking an digital vape in St. James Park. “I like the pure heroin.”
Researchers say it’s nonetheless unclear how extra lethal medicine may very well be getting into the Bay Space. In response to efforts to chop off drug distribution channels, specialists say cartels might have established new smuggling routes or drug labs. Chinese language producers of fentanyl precursor chemical substances might have developed strategies to evade detection, or precursor vegetation in India might have boosted output to fill provide gaps.
“If you squeeze the balloon on one end, it sometimes pops out the other side in an unexpected way,” stated Dr. Daniel Ciccarone, a drug researcher on the College of California, San Francisco.
Bob Beris, particular agent accountable for the federal Drug Enforcement Administration’s San Francisco division, which covers Northern California, stated his workplace often exams fentanyl efficiency and was unsurprised that overdose deaths are trending up within the Bay Space.
“What we’re seeing is higher purity,” Beris stated, noting the opioid is usually blended into different medicine, together with black market capsules marketed as prescription painkillers.
He stated methamphetamine testing has proven that drug continues to be extraordinarily lethal nationwide.
“Fentanyl gets a lot of the headlines, but meth is still an issue, and purity levels of meth are really high,” Beris stated.
In Santa Clara County, meth has lengthy been a significant reason behind overdose deaths. From October 2024 by means of March 2025, the drug accounted for 47% of overdose deaths, up from 40% the yr prior, in line with county coroner information. Deaths attributable to a mix of meth and opioids made up 19% of fatalities, whereas opioids alone accounted for 11%.
“We know that meth has been around for a very long time, and it’s changing,” stated Sara Morales, a program director with South Bay remedy supplier Momentum for Well being. “Clients are experiencing more psychosis. Our clients are sicker in general when they come into treatment than they used to be.”
Dr. Cheryl Ho, behavioral well being medical director for Santa Clara County, stated many homeless folks use meth to remain alert on the road and thrust back violence or sexual assault. She stated the drug can also be a rising concern for the broader inhabitants.
“We are seeing it in all walks of life,” Ho stated.
To date this yr, the DEA stated it has already seized twice as a lot meth because it did in all of final yr nationally and pledged to additional its crackdown on unlawful drug markets. Even so, Humphreys, with Stanford, stated meth poses a selected problem because it’s cheaper and simpler to provide than fentanyl. And in contrast to fentanyl, meth has no life-saving overdose reversal treatment similar to Narcan.
Humphreys warned that Trump administration proposals to slash funding for remedy and public well being applications, in addition to not too long ago permitted cuts to Medicaid, might hamper the response to an inflow of meth or a possible surge in overdoses.
“When you take a trillion dollars out of Medicaid,” he said, “you are effectively kneecapping the addiction care system.”
