Reducing fatal and non-fatal overdoses in the Tenderloin

Data trends about San Francisco’s work to reduce overdoses in the Tenderloin

Lives are being saved everyday thanks to increased engagement and response by City staff and community providers offering outreach, overdose education, referrals to treatment, and naloxone on the streets of the neighborhood and at the Tenderloin Center.

The Tenderloin Center closed December 4, 2022.  The center, part of San Francisco’s Tenderloin Emergency Initiative, was planned as a temporary site to reduce overdose deaths and increase connections to services, as well as to collect data for future sites and services. SF Public Health is supporting people seeking and receiving services by facilitating their transition to trusted providers in the neighborhood, who offer similar services as the TLC.

Overdose reversals by Emergency Medical Services

The following dashboard shows the number of overdose reversals recorded by Emergency Medical Services (EMS) responders each week. Overdose reversals involve the administration of naloxone, a medication that can rapidly reverse an opioid overdose, and are performed by EMS or another responder prior to EMS arrival.

The chart compares the number of overdose reversals within the Tenderloin to the number of overdose reversals outside the Tenderloin. Combined, these two numbers represent all EMS overdose reversals citywide. Clicking on a column in the chart will filter the data for that week. Weeks are represented by an operational period (OP), which begins on Monday and ends the following Sunday.

Use the buttons at the top of the chart to toggle between viewing total overdose reversals and viewing overdose reversals within the Tenderloin by location type, such as on the street or in a private residence.

Data notes and sources

Data notes and sources

This data is provided by the Department of Emergency Management. Data is updated weekly with a lag of one week. Overdose reversals are performed by EMS or by another party prior to EMS arrival. Overdose reversals are presumed to have occurred in emergency medical calls that involved the administration of naloxone and did not result in death.

Overdoses reversed at the Tenderloin Center

Employees at the TLC are trained to intervene in drug overdoses. The Center is equipped with naloxone – a medication that can rapidly reverse an opioid overdose. Emergency medical responders are typically available nearby to provide additional support.

The following chart shows the cumulative and weekly number of reversed drug overdoses occurring at the TLC. The cumulative number is a complete count. When the weekly amount is less than five, the weekly count is reflected as “Less than 5” to protect guest privacy. Each week is represented by an operational period (OP), which begins on Monday and ends the following Sunday.

Operational periods with less than five reversed overdoses are obscured to protect patient privacy. These results appear as gray bars in the chart below.

We've changed the way the data is presented: Data collection and posting has been discontinued as of December 4, 2022.

Data notes and sources

Data notes and sources

This data is reported by staff at the TLC each week.

Naloxone distributed to community members

Naloxone is a medication that can rapidly reverse an opioid overdose. The Tenderloin Center and its Public Health Street Outreach team partners provide naloxone to people who use drugs and their peers to help prevent overdose deaths. These outreach teams include:

  • Street Crisis Response Team (SCRT)
  • Street Overdose Response Team (SORT)
  • Community Health Equity and Promotion (CHEP)
  • Felton Engagement Specialist Team (FEST) supported by the Felton Institute
  • Department of Public Health (DPH) Tenderloin Outreach Team

The dashboard below shows the number of doses of naloxone distributed by staff at the TLC and by Street Outreach teams. The card at the top shows the total doses distributed over time by both groups. The clustered bar chart shows the number of doses distributed by the TLC (in orange) and by Street Outreach teams (in blue) by week. Each week is represented by an Operational Period (OP), which begins on Monday and ends the following Sunday.  Hover your mouse over one of the bars to see the total number of doses distributed by both groups for each Operational Period.  The table shows the same information.

Teams began tracking distribution data at varying points during the initiative. This data does not represent all sources of naloxone distribution in the Tenderloin, as there are other providers and community groups that also distribute this medication. Additionally, a very small number of doses distributed are actually doses administered to individuals in the Tenderloin.

Data notes and sources

Data notes and sources

The number of naloxone doses distributed by the Tenderloin Center represent those given out to guests at the Tenderloin Center.  The number of naloxone doses distributed by San Francisco Public Health Street Outreach teams represent those given out to primarily residents living in the Tenderloin neighborhood. This count may include people who live in other neighborhoods, such as South of Market or Civic Center.

Before August 1, 2022 the number of doses distributed by Felton Engagement Specialist Team (FEST) used to include a very small number of doses administered.  The number of doses distributed by Street Crisis Response Team (SCRT) used to include and still does include a very small number of doses administered.  Doses distributed by Street Overdose Response Team (SORT), Community Health Equity and Promotion (CHEP), and Department of Public Health (DPH) Tenderloin Outreach teams have never included doses administered.  Together, the sum of these four groups represents the number of doses of naloxone distributed by San Francisco Public Health Street Outreach teams operating in the Tenderloin neighborhood.

This data does not include naloxone distributed by other San Francisco departments, private health providers, or community partners.

Overdoses reversed by peers in the community

The City and its community partners provide naloxone to people who use drugs and their peers to help prevent overdose deaths. When a client requests a refill of naloxone at the TLC, they can report how they used previous doses. This includes the number of overdoses they helped to reverse with naloxone.

The following chart shows the number of overdoses reversed by peers in the community.

This data is incomplete. Not all overdose reversals are reported, and the TLC is one of many programs distributing naloxone. Nonetheless, this data helps reveal the lives saved by community members with additional doses of naloxone made available by the TLC.

Data notes and sources

Data notes and sources

Overdose reversals are self-reported by clients refilling naloxone prescriptions at the TLC. Reports are not validated by staff. Multiple doses of naloxone may be used for one overdose event.

Each overdose reversal appears in the operational period (OP) in which it was reported to the TLC.

This data is reported by staff at the TLC each week.

Accidental overdose deaths

The following dashboard shows the number of accidental overdose deaths in the Tenderloin each month. San Francisco’s Office of the Chief Medical Examiner certifies the cause and manner of death. The chart presents accidental overdose deaths on a monthly basis.

Data notes and sources

Data notes and sources

This data is provided by the Office of the Chief Medical Examiner (OCME). This is preliminary data and may change subject to further forensic analyses by the OCME. The location of death is determined by the zip code for the Tenderloin neighborhood (94102) and may not align with the geographic boundaries used for other reports on this page.