San Francisco has embarked on a pioneering wastewater testing program to gain insights into the city’s illicit drug use, focusing on substances such as fentanyl, methamphetamine, and cocaine. This initiative is especially pertinent following a record number of overdose deaths in 2023.

Key Highlights:

  • New Data Insights: Jeffrey Hom, the director of population behavioral health at the San Francisco Department of Public Health, emphasized the uniqueness of this data, providing the city with unprecedented insights into drug consumption patterns.
  • Record Overdose Deaths: The city witnessed its worst year for overdose fatalities in 2023, with 806 accidental deaths recorded.
  • Testing Program Details:
    • Began in November 2023.
    • Samples collected bi-weekly from two city locations (east and west sides).
    • Analyzes for fentanyl, cocaine, methamphetamine, and their metabolites.
  • Early Findings:
    • Higher drug concentrations, notably of fentanyl, cocaine, and methamphetamine, were found on the city’s east side.
    • Stimulants showed significantly higher concentrations across the city, indicating widespread use.
  • Comparison Challenges: Hom highlighted the difficulty in comparing drug prevalence due to differences in how substances are metabolized by the body, focusing instead on monitoring supply and usage trends over time.
  • Public Health Application: The city aims to use this data to inform the public about overdose risks and drug supply trends.
  • Future Plans:
    • The program is part of a study funded by the National Institute on Drug Abuse, ending in August.
    • Officials hope to continue and expand the program post-study, including testing frequency and the range of drugs monitored.
  • Contextual Use of Wastewater Testing:
    • San Francisco utilized wastewater testing during the COVID-19 pandemic for virus tracking.
    • Marin County also adopted this approach in July 2023 to monitor fentanyl overdoses, highlighting its effectiveness in public health surveillance.

This initiative marks a significant step forward in understanding and responding to drug use and overdose risks in San Francisco, offering a model for other municipalities facing similar challenges.