chief medical examiner 01_ocme..."total deaths" denotes accidental overdoses where one or more drugs...

London N. Breed, Mayor

1 Newhall Street • San Francisco, CA 94124 • Phone (415) 641-3600

ACCREDITED BY THE AMERICAN BOARD OF FORENSIC TOXICOLOGY

OFFICE OF THE

CHIEF MEDICAL EXAMINER

February 17, 2021

The Honorable London N. Breed, Mayor

City and County of San Francisco

The Honorable Shamann Walton, President

Board of Supervisors

Grant Colfax, M.D., Director

Department of Public Health

Subject: Report on Accidental Overdose Deaths

Dear Mayor Breed, President Walton, and Director Colfax:

The enclosed report provides preliminary data of accidental overdose deaths in the City and County of San Francisco

from the recent four months of October 1, 2020, to January 31, 2021. This report satisfies the ordinance’s reporting

criteria. For your reference, a supplementary extended January 1, 2020, to January 31, 2021 report is enclosed.

The reports are published by the Office of the Chief Medical Examiner (OCME), Forensic Laboratory Division, to

comply with local and state reporting guidelines and further OCME’s mission to provide neutral data to inform

policymakers. Please note, these results are preliminary as of testing to February 16, 2021, and are subject to change

as the OCME finalizes the manner and cause of each death. These reports are not intended to replace other death

statistics within the City that rely on finalized death certificates.

Pertinent for accurate use of these reports is understanding the source of the data and its subsequent summarization

process. Decedent demographic and case information were obtained from the OCME case management system.

Additionally, specific details from investigator narratives, forensic toxicology results, and where available,

preliminary autopsy findings, were utilized. Collected demographic information included race, gender, age, fixed

address status, and locations of residence and death.

Due to their significance in accidental overdose deaths, the reported drugs were specific to fentanyl, heroin, medicinal

opioids, methamphetamine and cocaine. Their detection in blood was captured to best determine relevance in each

case. Medicinal opioid-positive cases required the presence of codeine, hydrocodone, oxycodone, morphine,

hydromorphone, oxymorphone, buprenorphine, tramadol, and/or methadone. Heroin determination was more closely

evaluated, requiring the presence of specific heroin markers in blood or urine, expected morphine to codeine ratios,

and/or case details consistent with heroin use.

Sincerely,

Luke N. Rodda, Ph.D.

Chief Forensic Toxicologist and Director, Forensic Laboratory Division

cc: Office of the City Administrator

enclosures: Preliminary Accidental Drug Overdose Data Reports for October 2020 through January 2021 Preliminary Accidental Drug Overdose Data Reports for January 2020 through January 2021

Residence

Tenderloin (94102)SOMA (94103)Inner Mission (94110)Western Addition (94115)Others

Gender

FemaleMale

OFFICE OF THE CHIEF MEDICAL EXAMINER CITY AND COUNTY OF SAN FRANCISCO

Race

AsianBlackLatinxNative AmericanWhiteOther/Unknown

Fixed Address

Yes (see residence)NoUnknown

0

10

20

30

40

50

60

70

1-Oct 31-Oct

Accidental Overdoses by Day of Death

Total Deaths Fentanyl Heroin Medicinal Opioids Methamphetamine Cocaine

PLEASE NOTE THIS DATA IS PRELIMINARY INFORMATION AND SUSCEPTIBLE TO CHANGE

Age

=65

Location of Death

Tenderloin (94102)SOMA (94103)Nob Hill (94109)Inner Mission (94110)Others

"Acc. Overdoses Open" cases do not have a final cause and manner of death classification; "Acc. Overdoses Closed" cases have a final cause and manner of death classification."No fixed address" denotes community members who may be experiencing homelessness."Residence" denotes address where decedent lived; "Location of Death" denotes the location where death was declared. For "Residence" and "Location of Death", the 4 most affected neighborhoods are represented, the "Others" category refers to all other zip codes within the City and County of San Francisco and any of out county residences."Gender" refers to gender at time of death."Total Deaths" denotes Accidental Overdoses where one or more drugs contribute to the cause of death; however, every point for each drug series is inclusive, but not necessarily exclusive, of that drug. "Total deaths" represents all accidental overdoses including ones for drugs not specified above.

Other CausesAcc. Overdoses OpenAcc. Overdoses Closed

56.83%34.53%8.63%

73%

8%18%

23%77%

25%18%

7%7%

43%

25%18%10%15%32%

3%18%13%

60%5%

0%20%23%

5%

5%13%33%

0%

Preliminary Accidental Drug Overdose Data Report as of February 16, 2021

OCTOBER2020

Gender

FemaleMale


Race


Residence

Tenderloin (94102)SOMA (94103)Nob Hill (94109)North Beach (94133)Others

Fixed Address


0

10

20

30

40

50

60

70

1-Nov




Age

=65

Location of Death




52.85%45.53%1.63%

66%

0%34%

10%90%

32%11%11%

8%39%

21%16%19%12%33%

3%22%16%

50%9%

0%16%24%14%

0%19%28%

0%


NOVEMBER2020

30-Nov

Gender

FemaleMale


Race


Residence

Tenderloin (94102)SOMA (94103)Inner Mission (94110)Sunset (94122)Others

Fixed Address


0

10

20

30

40

50

60

70

1-Dec 31-Dec




Age

=65

Location of Death




60.14%38.51%1.35%

75%

2%24%

22%78%

20%11%

9%7%

52%

19%15%12%12%42%

7%31%12%

46%3%

0%20%24%8%

8%17%22%

2%

Preliminary Accidental Drug Overdose Data Reportas of February 16, 2021

DECEMBER2020

Gender

FemaleMale


Race


Residence

Tenderloin (94102)SOMA (94103)Inner Mission (94110)Castro/Noe Valley (94114)Others

Fixed Address


0

10

20

30

40

50

60

70

1-Jan 31-Jan




Age

=65

Location of Death




63.03%36.97%0.00%

70%

2%28%

15%85%

37%16%

5%5%

37%

21%20%13%10%36%

2%26%11%

57%2%

0%21%13%10%

3%20%33%

2%


JANUARY2021

Preliminary Accidental Drug Overdose Data Reports for

January 2020 through January 2021



JAN-DEC2020

Race


Residence


Fixed Address


0

100

200

300

400

500

600

700

800 Accidental Overdoses by Day of Death


1-Jan 1-Feb 1-Mar 1-Apr 1-May 1-Jun 1-Jul 1-Aug 1-Sep 1-Oct 1-Nov 1-Dec


Age

=65

Location of Death




57.16%14.32%28.52%

71%

2%27%

18%82%

25%15%

9%8%

43%

22%16%16%13%32%

4%25%16%

0%

5%

0%16%22%

9%

4%23%25%

Gender

FemaleMale

48%

Gender

FemaleMale



JANUARY2020

Race


Residence

Tenderloin (94102)SOMA (94103)Ingleside (94112)North Beach (94133)Others

Fixed Address


0

5

10

15

20

25

30

35

40

1-Jan 31-Jan




Age

=65

Location of Death

Tenderloin (94102)North Beach (94133)Nob Hill (94109)Inner Mission (94110)Others



69.84%0.00%

30.16%

79%

0%21%

24%76%

27%13%

7%7%

47%

26%8%8%

16%42%

3%26%11%

50%11%

0%21%21%16%

0%18%24%

0%

Gender

FemaleMale



FEBRUARY2020

Race


Residence

Tenderloin (94102)SOMA (94103)Inner Mission (94110)Bayview (94124)Others

Fixed Address


0

5

10

15

20

25

30

35

40

45

50

1-Feb 29-Feb




Age

=65

Location of Death




61.95%0.00%

38.05%

65%

0%35%

23%77%

32%14%11%11%32%

35%12%12%19%23%

5%28%

7%

58%2%

0%16%21%

9%

2%33%19%

0%

Gender

FemaleMale



MARCH2020

Race


Residence

Tenderloin (94102)SOMA (94103)Inner Mission (94110)Twin Peaks (94131)Others

Fixed Address


0

10

20

30

40

50

60

1-Mar 31-Mar




Age

=65

Location of Death




63.04%0.00%

36.96%

71%

2%27%

18%82%

17%28%

8%8%

39%

25%24%12%10%29%

2%25%18%

47%8%

0%31%16%

8%

2%16%27%

0%

Gender

FemaleMale



APRIL2020

Race


Residence

Tenderloin (94102)Nob Hill (94109)Haight-Ashbury (94117)Inner Mission (94110)Others

Fixed Address


0

10

20

30

40

50

60

1-Apr 30-Apr




Age

=65

Location of Death




60.16%0.00%

39.84%

55%

0%45%

18%82%

37%15%11%11%26%

31%14%24%14%16%

8%20%18%

53%0%

0%14%14%

4%

8%31%29%

0%

Gender

FemaleMale



MAY2020

Race


Residence

Tenderloin (94102)SOMA (94103)Inner Mission (94110)Lake Merced (94132)Others

Fixed Address


0

10

20

30

40

50

60

70

80

1-May 31-May




Age

=65

Location of Death




51.75%0.00%48.25%

61%

0%39%

12%88%

24%29%

5%7%

36%

19%25%16%16%25%

4%26%16%

52%1%

0%14%28%

7%

3%28%20%

0%

Gender

FemaleMale



JUNE2020

Race


Residence

Tenderloin (94102)SOMA (94103)Chinatown (94108)Nob Hill (94109)Others

Fixed Address


0

10

20

30

40

50

60

70

80

1-Jun




Age

=65

Location of Death




48.94%0.00%

51.06%

72%

1%26%

7%93%

29%12%

8%10%42%

24%18%18%10%31%

4%18%26%

46%6%

0%8%

26%10%

7%24%24%

0%

30-Jun

Gender

FemaleMale



JULY2020

Race


Residence

Tenderloin (94102)SOMA (94103)Inner Mission (94110)Nob Hill (94109)Others

Fixed Address


0

10

20

30

40

50

60

70

80

1-Jul 31-Jul




Age

=65

Location of Death




55.26%7.89%

36.84%

76%

0%24%

22%78%

19%15%10%13%42%

13%16%19%15%37%

1%32%13%

46%7%

0%4%

24%16%

1%25%28%

0%

Gender

FemaleMale



AUGUST2020

Race


Residence


Fixed Address


0

10

20

30

40

50

60

70

80

1-Aug 31-Aug




Age

=65

Location of Death




51.37%19.18%29.45%

76%

6%18%

30%70%

24%15%13%11%37%

18%13%21%17%31%

4%28%18%

41%8%

0%21%23%

8%

4%18%25%

0%

Gender

FemaleMale



SEPTEMBER2020

Race


Residence


Fixed Address


0

10

20

30

40

50

60

70

1-Sep




Age

=65

Location of Death




56.30%23.70%20.00%

83%

2%15%

14%86%

24%10%

8%14%43%

22%15%19%

7%37%

7%25%24%

39%5%

0%17%15%

8%

3%32%24%

0%

30-Sep

Residence

Tenderloin (94102)SOMA (94103)Inner Mission (94110)Western Addition (94115)Others

Gender

FemaleMale


Race


Fixed Address


0

10

20

30

40

50

60

70

1-Oct 31-Oct




Age

=65

Location of Death




56.83%34.53%8.63%

73%

8%18%

23%77%

25%18%

7%7%

43%

25%18%10%15%32%

3%18%13%

60%5%

0%20%23%

5%

5%13%33%

0%


OCTOBER2020

Gender

FemaleMale


Race


Residence

Tenderloin (94102)SOMA (94103)Nob Hill (94109)North Beach (94133)Others

Fixed Address


0

10

20

30

40

50

60

70

1-Nov




Age

=65

Location of Death




52.85%45.53%1.63%

66%

0%34%

10%90%

32%11%11%

8%39%

21%16%19%12%33%

3%22%16%

50%9%

0%16%24%14%

0%19%28%

0%


NOVEMBER2020

30-Nov

Gender

FemaleMale


Race


Residence

Tenderloin (94102)SOMA (94103)Inner Mission (94110)Sunset (94122)Others

Fixed Address


0

10

20

30

40

50

60

70

1-Dec 31-Dec




Age

=65

Location of Death




60.14%38.51%1.35%

75%

2%24%

22%78%

20%11%

9%7%

52%

19%15%12%12%42%

7%31%12%

46%3%

0%20%24%8%

8%17%22%

2%


DECEMBER2020

Gender

FemaleMale


Race


Residence

Tenderloin (94102)SOMA (94103)Inner Mission (94110)Castro/Noe Valley (94114)Others

Fixed Address


0

10

20

30

40

50

60

70

1-Jan 31-Jan




Age

=65

Location of Death




63.03%36.97%0.00%

70%

2%28%

15%85%

37%16%

5%5%

37%

21%20%13%10%36%

2%26%11%

57%2%

0%21%13%10%

3%20%33%

2%


JANUARY2021

2021 02_OCME Overdose Report Cover Letter_v2January20-January21 XLS Report Template (LNR edit)JAN-DEC'20JANFEBMARAPRMAYJUNJULAUGSEPOCTNOVDECJAN '21

chief medical examiner 01_ocme..."total deaths" denotes accidental overdoses where one or more drugs...

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