Aurelia Ramirez walks by tents and debris along Folsom Street.

Overdose Deaths Swell Among SF’s Maya Residents, Highlighting Urgent Need for Culturally Competent Drug Health Services

Since the beginning of the COVID-19 pandemic, San Francisco’s Mayans have been dying of drug overdoses at elevated rates. More robust health services are needed, experts say, and providers should be culturally competent and able to communicate effectively with these residents, who may not be fluent in English or Spanish.

A man knocks on the door of a makeshift shelter covered in blue tarps.

Booted From the Army, He Spiraled. Now He Works to Solve the Veteran Homelessness Crisis.

Homeless veterans make up only a small fraction of America’s homeless population, and they have been a priority in efforts to house the homeless. Since 2019, Congress has committed billions of dollars in resources to end veteran homelessness, and the number of unhoused veterans, who make up 8% of the homeless nationwide, has been cut almost in half since then, though last year saw a 7.4% uptick in numbers.

But the proportion of homeless veterans living outdoors has increased. California, in particular, has more homeless veterans lingering on the street than any other state. More than 7,400 veterans live outside. Add in another 3,100 other veterans who live in shelters or temporary housing, and that’s 10,500, or almost one-third of all homeless veterans in the country.

A severe shortage of affordable housing and the tremendous cost of living in California are partly to blame. But it’s estimated that more than half of homeless veterans suffer from a mental illness, and 70% are affected by substance use disorder; often the two groups overlap. For those veterans, if outreach, supportive housing, and a veteran’s readiness for change don’t align, homelessness often remains the default.

Several people stand in front of an evergreen tree covered in small white lights. They are holding vertical white banners displaying lists of people's names in colorful letters. Other banners are spread on the ground in front of them. A woman with shoulder-length gray hair wearing a black coat addresses the crowd speaking into a microphone on a stand.

2023 Is San Francisco’s Deadliest Year on Record for Drug Overdoses

Last Thursday San Francisco’s chief medical examiner released the city’s updated overdose death count — 752 so far — making 2023 the worst year on record for drug-related fatalities. One-third of those people were listed as having no fixed address. Later that day, a crowd gathered at Civic Center Plaza to remember more than 420 who died in the city while experiencing homelessness this year.

Three people wearing vests and jackets with city logos speak with a man standing in the entrance of a tent covered with plastic tarps on a city sidewalk.

SF ‘Failing’ on Housing as Overdose Solution, Health Expert Says

Sarah Evans has spent decades advancing drug overdose prevention initiatives around the world. As a division director for Open Society Foundations — a grantmaking network founded and chaired by business magnate George Soros — Evans promotes one surefire way to help abate San Francisco’s homelessness and fatal overdose crisis: housing.

“The way that people get off the street is by getting into housing, where people can get support and stay there even while they are continuing to struggle with substance use disorders of all kinds and mental health issues,” said Evans, who leads the organization’s drug policy programs globally. “It literally is the only way.”

San Francisco isn’t doing enough to meet this housing need, according to health experts.

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.