San Francisco, CA — Mayor London N. Breed, the San Francisco Department of Public Health (SFDPH), and the San Francisco Fire Department (SFFD) announced today an expansion of the Street Overdose Response Team (SORT) to include a follow-up team of health care specialists in substance use who can provide long-term, continual care for drug overdose survivors to support them on the path toward wellness.

Like many communities throughout the country, San Francisco has seen a rapid increase in drug overdoses in recent years due to the proliferation of the powerful, synthetic opioid fentanyl. As part of the City’s urgent response to the overdose crisis, SORT launched on August 2, 2021 with a medical clinician and community paramedic to immediately engage with people following an overdose. In its first six weeks, SORT responded to more than 300 calls, of which about half, or 153 people, were cases of overdoses. The team distributed harm reduction supplies like fentanyl test strips and naloxone (Narcan) to more than 115 people, and helped more than 20 people start the opioid treatment medication buprenorphine.

The newly expanded follow-up team, led by SFDPH’s Street Medicine program, will re-engage with those same individuals within 72-hours to provide medical care in the field, maintain a connection over the long-term and guide them to care, treatment, and other overdose prevention measures. This could include ongoing buprenorphine treatment, primary care, and connections to mental health services to reduce risk of future risk of overdose. This follow-up team anticipates building a case list of approximately 700 targeted individuals who will receive ongoing care beyond the 72-hour follow-up.

“The Street Overdose Response Team has started out strong, and it’s exciting to see the team take this next step in providing long-term follow-up care,” said Mayor Breed. “We know how important it is to keep engaging with people who are at risk, getting them the care they need, and showing them that there is a way out of their crisis.”

By bringing the “clinic” to the person, SORT builds on the City’s effective street team model of care to target people vulnerable to overdoses. SORT is designed to specifically support people experiencing homelessness, whose rate of overdose deaths has doubled in the past year and who account for at least one-quarter of all overdose deaths in the City.

“San Francisco is responding to the drug overdose crisis through expanding multiple effective programs and services, however, what sets SORT apart, is the targeted and focused intervention immediately after an overdose,” said Director of Health, Dr. Grant Colfax. “SORT provides us with a unique opportunity to reach our residents at the highest risk of drug overdose and connect them with life-saving treatment.”

San Francisco saw a steep increase in overdose deaths beginning in the second half of 2018, which continued through 2019. In 2020, San Francisco saw approximately 700 overdoses, more overdose deaths than ever before. Overdose deaths are still at record highs, although after seeing peaks in January and February of 2021, monthly totals have decreased by approximately 30 percent according to preliminary data from the Office of the Chief Medical Examiner (OCME).

SORT targets its efforts to reach those most impacted by the drug crisis and those who experience the most significant barriers to accessing City services. This includes our residents experiencing homeless who contend with instability that makes treatment challenging and members of the Black/African American community who face structural racism in their path to wellness. Initial data from SORT shows that the team is meeting those most in need—of the total people served thus far, a quarter identify as Black/African American and over half are unsheltered.

“The Firefighters, EMTs, and paramedics of the Fire Department respond to dozens of drug overdose emergencies every day,” said Fire Chief Jeanine Nicholson. “The Street Overdose Response Team is a pioneering effort to actively identify and engage overdose survivors in real time, begin meaningful treatment at the scene, and provide continued and coordinated care across City agencies.”

SORT and other new initiatives build on our existing programs and efforts to curb overdose deaths and provide low-barrier access to addiction treatment. San Francisco has taken major steps towards enhancing overdose prevention programs, including opening the SoMa RISE Center, a drug sobering center in the South of Market neighborhood, this winter. This center is a place where people can recover off the street from methamphetamine, opiate and other drug intoxication and be connected to care. 

More information about SORT can be found at: sf.gov/street-overdose-response-team

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